Assistant Professor
Division of Neonatology

Project title: A Predictive Model for Pediatric Parenteral Nutrition Associated Cholestasis Using Novel Biomarkers:  Plasma Phytosterols, Cytokines, and Bile Acids and Erythrocyte Omega-6:Omega-3 Ratios

Sherin Devaskar, MD – UCLA
David Elashoff, PhD – UCLA

Multidisciplinary Expertise:  
Pediatrics, hepatology, nutrition and metabolism, biomarker discovery, biomathematics

Project Description:
Parenteral nutrition (or intravenous nutrition) is associated with a potentially lethal liver disease—parenteral nutrition associated cholestasis (PNAC).  Neonates are highly susceptible to PNAC. Liver biopsies and serum direct bilirubin are standard tests for PNAC diagnosis, but they have limitations.  There is a need to develop leading biomarkers as diagnostic tools that reflect early liver injury.  I have supporting evidence that high concentrations of phytosterols, omega-6:omega-3 fatty acid ratios, and cytokines impede biliary flow, resulting in an increase in bile acids. In a cohort of infants at high risk for PNAC, I will: 1.) assess changes in these biomarkers over time, and 2.) determine if a profile of biomarkers in combination with clinical risk factors can predict PNAC.  Should my hypothesis be correct, a biomarker profile could be used pro-actively to sub-select patients at high risk for PNAC so that therapeutic modalities could begin in a timely manner.