Serum matrix metalloproteinase 7 (MMP-7) and liver function in biliary atresia

Biliary atresia is one of the main factors leading to the need for liver transplantation in children. Currently, there is no non-invasive approach to diagnosing biliary atresia and differentiating it from other causes of cholestasis. This study aimed to evaluate matrix metalloproteinase 7 (MMP-7) levels as a diagnostic biliary atresia biomarker and its correlation with laboratory parameters. This cross-sectional study included infants with biliary atresia admitted to Dr. Soetomo General Academic Hospital, Surabaya. Blood samples, as well as baseline clinical and demographic data, were collected when admitted. MMP-7 levels were evaluated by enzyme-linked immunosorbent assay. There were 85 infants with biliary atresia, mean age 11 (7-35) weeks, 46 (54.1%) boys, with the onset of jaundice at 2 (1-20) weeks. The MMP-7 levels were 1.91 (0.39 - 9.95) ng/ml, Albumin 4.06 (1.41 - 4.79) g/dl,  Aspartate aminotransferase (AST) 235.37 ± 130.48 U/L, , Alanine aminotransferase (ALT) 143.2 (30 - 641) U/L,  Gamma-glutamyl transpeptidase (GGT) 361 (23.9-3746) U/L, direct bilirubin 8.75 ± 4.28 mg/dl, and total bilirubin 12.34 ± 6.36 mg/dl. MMP-7 showed a positive correlation with albumin levels (r=0.232; p=0.033), but correlated negatively with AST (r=-0.252; p=0.020) and ALT (r=-0.275; p=0.011) levels. Direct or total bilirubin, hemoglobin, leukocyte, platelet, and coagulation function levels were not associated with MMP-7 (p 0.05). There is a positive correlation between MMP-7 and albumin, but the relationship between MMP-7 and serum transaminases is reversed. MMP-7 may be used as a non-invasive diagnostic marker for biliary atresia.