Albeit each is relatively rare, congenital cholestatic liver diseases collectively impact pediatric health significantly. Amongst them, biliary atresia (BA) is the most common cause of pediatric end-stage liver disease and the leading indication for pediatric liver transplantation. The Childhood Liver Disease Research Network (ChiLDReN) was established in 2009 to expand the scope of the Biliary Atresia Research Consortium to study numerous rare congenital cholestatic liver diseases including Alagille syndrome, Progressive Familial Intrahepatic Cholestasis, a1- Antitrypsin Deficiency, Mitochodrial Hepatopathies, and Bile Salt Synthesis Defects. Since then, numerous high impact observations have been reported by the NIDDK-funded consortium. Primary Sclerosing Cholangitis is currently being added as a disease of focus by the network. The Children?s Hospital Los Angeles (CHLA) clinical research center has been very active in all aspects of the network?s efforts. In this application, we restate our commitment to improve the clinical outcomes of patients with congenital liver diseases. The overall objectives of this application are to impact survival of children with rare liver diseases via (1) the enrollment of subjects into the various clinical studies and trials within the ChiLDREN consortium and (2) a translational ancillary study focused on CoQ10, as a biomarker of liver fibrosis. The central hypothesis of objective #2 is that serum levels of CoQ10 correlate with extent of liver fibrosis. This project is innovative because (1) CHLA has the only Principal Investigator who is a pediatric surgeon, thus providing surgical insight and perspective for a Steering Committee otherwise comprised of pediatric hepatologists and (2) CoQ10 is a novel potential biomarker for liver fibrosis.

Public Health Relevance

Infant and pediatric cholestatic liver diseases are rare and individual hospitals cannot accumulate sufficient experience to make meaningful scientific contributions which are the basis for the management algorithms of these diseases. ChiLDReN will continue to facilitate the accrual of larger cohorts of patients with these rare diseases. This research proposal details our continued commitment to the enrollment of subjects into the various ChiLDReN studies and a project focused on a new and potentially novel marker of liver fibrosis.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project--Cooperative Agreements (U01)
Project #
5U01DK084538-12
Application #
10019514
Study Section
Special Emphasis Panel (ZDK1)
Program Officer
Doo, Edward
Project Start
2009-09-10
Project End
2024-05-31
Budget Start
2020-06-01
Budget End
2021-05-31
Support Year
12
Fiscal Year
2020
Total Cost
Indirect Cost
Name
Children's Hospital of Los Angeles
Department
Type
DUNS #
052277936
City
Los Angeles
State
CA
Country
United States
Zip Code
90027
Ng, Vicky L; Sorensen, Lisa G; Alonso, Estella M et al. (2018) Neurodevelopmental Outcome of Young Children with Biliary Atresia and Native Liver: Results from the ChiLDReN Study. J Pediatr 196:139-147.e3
Alonso, Estella M; Ye, Wen; Hawthorne, Kieran et al. (2018) Impact of Steroid Therapy on Early Growth in Infants with Biliary Atresia: The Multicenter Steroids in Biliary Atresia Randomized Trial. J Pediatr 202:179-185.e4
Wang, Kasper S; Tiao, Greg; Bass, Lee M et al. (2017) Analysis of surgical interruption of the enterohepatic circulation as a treatment for pediatric cholestasis. Hepatology 65:1645-1654
Nguyen, Marie V; Zagory, Jessica A; Dietz, William H et al. (2017) Hepatic Prominin-1 expression is associated with biliary fibrosis. Surgery 161:1266-1272
Shneider, Benjamin L; Magee, John C; Karpen, Saul J et al. (2016) Total Serum Bilirubin within 3 Months of Hepatoportoenterostomy Predicts Short-Term Outcomes in Biliary Atresia. J Pediatr 170:211-7.e1-2
Russo, Pierre; Magee, John C; Anders, Robert A et al. (2016) Key Histopathologic Features of Liver Biopsies That Distinguish Biliary Atresia From Other Causes of Infantile Cholestasis and Their Correlation With Outcome: A Multicenter Study. Am J Surg Pathol 40:1601-1615
Lua, Ingrid; Li, Yuchang; Zagory, Jessica A et al. (2016) Characterization of hepatic stellate cells, portal fibroblasts, and mesothelial cells in normal and fibrotic livers. J Hepatol 64:1137-1146
Ye, Wen; Rosenthal, Philip; Magee, John C et al. (2015) Factors Determining ?-Bilirubin Levels in Infants With Biliary Atresia. J Pediatr Gastroenterol Nutr 60:659-63
Wang, Kasper S; Section on Surgery; Committee on Fetus and Newborn et al. (2015) Newborn Screening for Biliary Atresia. Pediatrics 136:e1663-9
Zagory, Jessica A; Nguyen, Marie V; Wang, Kasper S (2015) Recent advances in the pathogenesis and management of biliary atresia. Curr Opin Pediatr 27:389-94

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