Association of stool microbial profile with short-term outcome in infants with biliary atresia after Kasai Portoenterostomy.
Joint CLDF and BSPGHAN Project Grant
Dr Vandana Jain of King’s College London shared updates on her research project with CLDF and what it means for the future of treating biliary atresia.
Biliary Atresia is a liver disease that presents in babies, involving the blockage of bile ducts, associated with life-long complications. A surgical procedure, called the Kasai, is needed to try and unblock these ducts. However, a large proportion of patients still have complications and require a liver transplant. Despite plenty of ongoing research into this condition, no treatment/medication has managed to reduce the rate of complications or the number of liver transplants.
Over the last few decades research has shown that the bacteria in the gut can affect your health and has been associated with childhood diseases such as inflammatory bowel disease and asthma. Importantly, the bacteria in the gut have been shown to affect certain adult liver diseases, which show similarities to biliary atresia.
Encouraging results regarding gut-bacteria related treatments in adult liver disease have been demonstrated.
In view of these findings, this study aims to explore the gut bacteria in biliary atresia, with the intention to find gut bacteria-related treatments, which could improve the outlook for these patients.
Our initial results have shown that there is a difference in the overall composition of the gut bacteria in babies with biliary atresia compared to healthy babies. One bacteria called ‘bifidobacterium’ is much lower in those with biliary atresia.
This difference is seen before the Kasai operation, but also at several timepoints after the operation.
This questions whether we could investigate ways to change the gut bacteria in biliary atresia babies so that it matches that of healthy babies. For example, by increasing the ‘bifidobacterium’ content and see what effect this has on disease.
Potential next steps
Potential next steps could include a trial involving Bifidobacterium supplementation after the Kasai operation to see if this improves the outlook for these children by potentially reducing complications such as portal hypertension and cirrhosis (scarring) and with it time to transplant.
This area of research is still in the early stages but we hope to hear more about the link between Bifidobacterium and biliary atresia and the impact this may have on future treatments.