# Colorado Center of Childhood Liver Disease Research Network

> **NIH NIH U01** · UNIVERSITY OF COLORADO DENVER · 2020 · $381,388

## Abstract

Project Summary
This Translational Science Acceleration Supplement application is being submitted to greatly accelerate
our discovery of mechanisms underlying biliary atresia (BA) pathogenesis and biomarker discovery for
mitochondrial hepatopathies (MH), by using translational approaches and biospecimens already obtained in
ChiLDReN studies. In the IVIG clinical trial (PRIME) in BA in ChiLDReN, it was discovered that plasma IL-8 (a
neutrophil chemokine) and neutrophil extracellular trap (NET) formation correlated with rising serum bilirubin at
90 days post-Kasai, and that increasing levels of IL-8 in the first 60 days post-Kasai was associated with
significantly increased risk of liver transplant/ death at 1 year. This led to our hypothesis that the
immunopathogenesis of BA involves HMGB1-induced neutrophil activation, resulting in NET formation and
NET-associated stellate cell activation. This will be tested by the following aims using ChiLDReN plasma, fixed
liver tissue and peripheral blood neutrophils from PROBE BA patients and controls: (1) establish the
mechanism of NETosis in BA: and (2) determine if NET-induced hepatic stellate cell activation occurs in BA.
We anticipate finding that NETosis will be increased in BA, will be NOX2 dependent, and will promote hepatic
stellate cell activation, which will establish a role for neutrophils in BA progression. In a second project, we will
investigate potential metabolomic and proteomic biomarkers for MH. MH may present as acute liver failure,
chronic liver disease, fatty liver disease, cholestasis or cirrhosis and may be difficult to distinguish from other
etiologies. There are no simple tests to detect the presence of a MH in an individual patient, nor are there
predictive or surrogate biomarkers for these disorders. The main objective of this proposal is to evaluate
plasma/serum samples from MITOHEP study participants and disease controls (from PROBE, BASIC and
LOGIC), for metabolomic (candidate and discovery) and protein (candidate) signatures that would be specific
and sensitive for MH. This study will be a collaboration between investigators at University of Colorado Denver
and Massachusetts General Hospital in Boston. Aims of this study are: (1) determine if a recently identified
plasma metabolomic biomarker panel present in adults with the mitochondrial disease MELAS would
distinguish MITOHEP participants from alpha-1 antitrypsin deficiency; (2) perform discovery metabolomics to
identify novel metabolite signatures for MH; and (3) determine the clinical utility of the candidate protein
mitochondrial biomarkers, fibroblast growth factor 21 (FGF-21) and growth differentiation factor 15 (GDF15), in
MITOHEP participants, liver disease controls and healthy pediatric controls. We anticipate that the metabolite
panel and protein biomarkers will distinguish MITOHEP patients from the disease control groups as well as
normal controls, and that we may discover new metabolite biomarkers for the diseases...

## Key facts

- **NIH application ID:** 10217635
- **Project number:** 3U01DK062453-19S1
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** RONALD J. SOKOL
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $381,388
- **Award type:** 3
- **Project period:** 2002-09-15 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10217635

## Citation

> US National Institutes of Health, RePORTER application 10217635, Colorado Center of Childhood Liver Disease Research Network (3U01DK062453-19S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10217635. Licensed CC0.

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