Serum level of interleukin-13 receptor alpha 2 in infants with biliary atresia - is it of value?

Aim of the study: We aimed to assess the utility of serum level IL-13Rα2 receptors as a non-invasive marker for early diagnosis of biliary atresia (BA) and selection of BA patients indicated for Kasai portoenterostomy.

Material and methods: The study included 60 infants with neonatal cholestasis in three groups; early BA group ( n = 20), delayed BA group ( n = 20) and non-BA cholestasis group ( n = 20). A fourth group of 20 healthy neonates ( n = 20) served as controls. IL-13Rα2 was measured by enzyme-linked immunosorbent assay in all patients and controls.

Results: The mean value of IL-13Rα2 was significantly higher in delayed BA group (11.05 ± 10.9 ng/ml) compared to early BA (0.34 ± 0.37 ng/ml), non-BA (0.54 ± 0.85 ng/ml) and control (0.24-0.2 ng/ml) groups. The levels of serum IL-13Rα2 increase with the severity of the degree of fibrosis. IL-13Rα2 at a cutoff level > 0.782 ng/ml could predict late fibrosis with accuracy of 77.55% ( p < 0.0001). IL-13Rα2 could differentiate between preserved and disturbed liver architecture at a cut off value of more than 0.42 ng/ml with an accuracy of 81.6%.

Conclusions: Serum IL-13Rα2 not a diagnostic marker for BA however it could be used as a noninvasive marker for detection of advanced liver fibrosis and presence of disturbed liver architecture that helps in patient selection for undergoing Kasai operation. Serum IL-13Rα2 could be a future therapeutic target for management of BA patients and any fibrotic liver disease.