News.hust.edu.cn (Correspondent: Nie Wenwen) on August 28, the latest research result of professor Shaotao Tang 's team of pediatric surgery department of the Union Hospital was officially published in Hepatology, while being mainly launched in the column of "Rapid Communication".

According to the deputy editor of Hepatology, "Rapid Communication is a challenge for reviewers and editors, and only a few highly selected studies are eligible for inclusion. Due to the energy and attention involved, this column is used cautiously and only for breakthrough and influential research results".

It is reported that neonatal jaundice is very common in clinical practice, but it is difficult to distinguish due to a kind of disease (biliary atresia). To distinguish biliary atresia from neonatal jaundice, a series of complex examinations are needed. Various diagnostic methods have different accuracy rates, sometimes contradictory and the cost is high, which make patients suffer a lot, take a long time and delay their illness. The most important factor influencing the curative effect of biliary atresia (hepatojejunostomy) is the early operation age, and the best effect is within 60 days. How to make early, accurate, rapid and non-invasive diagnosis so as to identify this disease from neonatal jaundice as soon as possible has been a hot topic of the research field.

Professor Tang Shaotao's team has been working in the field of biliary atresia for 15 years, and has been supported by five National Natural Science Foundations and four Provincial Science Funds. For the first time, he established the threshold standard for the molecular diagnosis of serum matrix metalloproteinase-7 (MMP-7) for biliary atresia, which was jointly initiated by Wuhan Children's Hospital and Hubei Maternal and Child Health Hospital. The non-invasive detection of MMP-7 protein in vitro with one drop of blood can increase the sensitivity of diagnosis of biliary atresia to 98.67%, specificity to 95%. The whole detection time only needs 4 hours, and the cost is reduced to about 1000 yuan. The minimum age of definite diagnosis is advanced to 3 weeks or even earlier. This result is expected to revolutionize the clinical diagnosis of biliary atresia, which can be comparable to AFP (alpha fetoprotein) revolutionizing the diagnosis of liver cancer.

China has a large population base, and the number of cases of biliary atresia is far more than that of other countries. Due to the late diagnosis, the best operation time is easy to miss (hepatojejunostomy), and most of the children need liver transplantation. Tang Shaotao has been engaged in pediatric surgery for nearly 30 years. He is the director of pediatric surgery department of Union Hospital. He led the team to perform several hundred biliary atresia surgeries (hepatojejunostomy), with the longest survival of liver-preserving for 25 years (the patient was 48 days old then, thanks to early diagnosis). With the new diagnostic method of MMP-7 for biliary atresia, more children will be diagnosed at an early stage, and the proportion of children with biliary atresia that can have long-term survival of liver-preserving is expected to increase in the future.

The co-expert is professor Jorge Bezerra from Cincinnati Children's Hospital in the United States, who is an international authority in the field of pediatric liver disease and has long been engaged in basic and clinical research on cholestasis. Through high-throughput protein screening of 243 samples from the North American children's liver disease research alliance, 76 kinds of candidate protein of diagnostic value were found from 1,129 kinds of protein, and one of them, MMP-7, was verified in animal experiments. The result was published in Science Translational Medicine in 2017. Subsequently, the famous magazine Nature Review Gastroenterology and Hepatology wrote a special article, and made comments and predictions on the clinical value of MMP-7.

The co-author of the research, Dr. Li Yang, was an eight-year student at the Union Hospital. She graduated from the first clinical school of Huazhong University of Science and Technology in 2013, and went to Cincinnati Children's Hospital as a visiting scholar in 2015. Since 2016, she has been working as a full-time scientist in gastrointestinal hepatobiliary department of Cincinnati Children's Hospital, focusing on the research and clinical transformation of biliary atresia.