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Background: Autotaxin (ATX) or ecto-nucleotide pyrophosphatase/phosphodiesterase-2 is a secreted lysophospholipase D that hydrolyzes extracellular lysophospholipids into the lipid mediator lysophosphatidic acid, a ligand for specific G protein-coupled receptors. Lysophosphatidic acid stimulates the proliferation and contractility of hepatic stellate cells, a key player in liver fibrogenesis, and inhibits their apoptosis. Objective: To determine serum ATX levels in pediatric and adolescent patients with chronic liver diseases of different etiologies and to compare it with the control group and to correlate between serum ATX level and disease severity, stage of fibrosis in liver biopsy in patients with chronic liver disease. Patients and Methods: This was a cross sectional-case controlled study carried out in Ain Shams University pediatric Hospital, in the period between January 2023 and December 2023. To all patients and controls, serum sample was withdrawn to assess autotaxin level. For patients with chronic liver disease data was collected from hepatology clinic files including laboratory investigations and liver biopsy done within 1 year, to assess the degree of liver fibrosis and activity. Results: Regarding serum autotaxin level, it was significantly higher in patients with chronic liver disease(868.8ng/dl) compared to control(30ng/dl, p = 0.000). Serum autotaxin level was higher in females (median 2582.5 ng/dl) than males (median 586) (p = 0.038). The study showed significant correlation in serum autotaxin level and etiology of chronic liver disease (p = 0.008). Also, there was a positive correlation with MELD score(r = 0.563) (p = 0.045), PELD score(r = 0.503) (p = 0.007) and severity of Child Pugh score (p = 0.000). Regarding Ishak fibrosis score there was a significant correlation with serum autotaxin level (r = 0.734) (p = 0.000), METAVIR fibrosis score (0.717) (p = 0.000). Roc analysis curve shows high sensitivity 100% and specificity of 100% of autotaxin to predict fibrosis in patients with chronic liver disease, the cut off value is 97.4ng/ml. Conclusion: Developments of serum biomarkers have focused on the diagnosis of cirrhosis and the assessment of advanced fibrosis. Serum autotaxin as a biomarker for fibrosis in patients with chronic liver disease. Serum autotaxin level has shown a direct association with stage of fibrosis in patients with chronic liver disease. Also, serum autotaxin can be used to determine the severity of liver fibrosis and to evaluate the prognosis of liver cirrhosis. [ABSTRACT FROM AUTHOR]

Background: Celiac disease (CD) is an immune-mediated intolerance to gluten .CD has been recognized as a multisystem disorder which may affect other extra intestinal organs, such as the skin, thyroid, heart, nervous system, pancreas and liver. Individuals with CD are at increased risk of liver disease namely cryptogenic liver disorder and autoimmune liver disorder. However, until now, it remains unknown whether these two forms of liver disease are really different entities or only different severities of the same disorder. Objective: To evaluate the association of CD with autoimmune hepatitis in pediatrics. Subjects and Methods: This was a cross-sectional study that was conducted at the Pediatric Hepatology Clinic and Pediatric Gastroenterology Clinic, Children's Hospital, Ain Shams University. The study included 2 groups of patients each comprised 20 children and adolescents as follow: Group I: Patients with established diagnosis of autoimmune hepatitis (AIH). All patients were receiving corticosteroids and azathioprine Group II: Patients with established diagnosis of CD. In group I patients with AIH, CD was screened for using anti-tissue transglutaminase (tTG) IgA in addition to measuring serum IgA to determine the need to measure anti-tTG IgG. Immunological markers (ANA, anti-smooth muscle antibody (ASMA) and liver and kidney microsomal (LKM) antibodies in addition to protein electrophoresis were done for group II patients with CD to screen for AIH. Results: All patients in group I with AIH had normal serum IgA levels and were found negative for anti-tTG IgA. Also, group II patients with CD were negative for ANA, ASMA and LKM antibodies with normal protein electrophoresis. Conclusion: The current study showed that CD does not seem to have significant association with AIH, however, the small sample size is a study limitation. Further wider scale studies are needed to evaluate the risk of AIH in CD. [ABSTRACT FROM AUTHOR]