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Journal of Pediatric Gastroenterology & Nutrition:
doi: 10.1097/MPG.0b013e3182153900
Original Articles: Hepatology and Nutrition

Urotensin II Levels Are an Important Marker for the Severity of Portal Hypertension in Children

Pawar, Reshma*; Kemp, William; Roberts, Stuart; Krum, Henry; Yandle, Tim§; Hardikar, Winita*

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Background and Aim: Urotensin II (U-II), a somatostatin-like cyclic peptide, was recently identified as the most potent human vasoconstrictor peptide; however, the contribution of U-II–mediated alterations in peripheral vascular tone in disease states such as chronic liver disease and portal hypertension is poorly characterised. There are no data examining U-II in chronic liver disease in children. In this study, we aimed to determine whether U-II levels in healthy children are ontogenically regulated and we explored the effect of chronic liver disease on peripheral circulating U-II levels.

Materials and Methods: U-II levels from healthy controls (n = 129) were compared with a healthy adult population (n = 80) in addition to a well-characterised cohort of children with chronic liver disease (n = 20). U-II was measured by radioimmunoassay.

Results: There was no correlation between U-II and age in healthy children (r2 = 0, P = 0.8). U-II levels were similar between the paediatric and the adult control populations (1.35 ± 0.96 vs 1.25 ± 0.78, P = 0.8). U-II was significantly elevated in children with liver disease compared with controls (1.35 ± 0.96 pmol/L vs 3.56 ± 2.21 pmol/L; P < 0.001). In addition, U-II levels positively correlated with severity of liver disease as determined by Child-Pugh score (P < 0.05) and paediatric end-stage liver disease score (P < 0.001). Levels of U-II also correlated with long-term clinical outcome.

Conclusions: These data suggest that U-II is an important marker of severity of portal hypertension in children. It is independent of age and may be a potential therapeutic target in the chronic liver disease population.

Copyright 2011 by ESPGHAN and NASPGHAN


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