Abstract

Biliary atresia (BA) is a neonatal disease that results in obliteration of the biliary tree. The murine model of BA, which mirrors the human disease, is based upon infection of newborn mice with rhesus rotavirus (RRV), leading to an obstructive cholangiopathy. The purpose of this study was to characterize the temporal relationship between viral infection and the induction of this model. BALB/c mice were infected with RRV on day of life (DOL) 0, 3, 5, and 7. Groups were characterized as early-infection (infection by DOL 3) or late-infection (infection after DOL 5). Early RRV infection induced symptoms in 95% of pups with a mortality rate of 80%. In contrast, late infection caused symptoms in only 50% of mice, and 100% of pups survived. The clinical findings correlated with histological analysis of extrahepatic biliary trees, cytokine expression, and viral titers. Primary murine cholangiocytes isolated, cultured, and infected with RRV yielded higher titers of infectious virus in those harvested from DOL 2 versus DOL 9 mice. Less interferon alpha and beta was produced in DOL 2 versus DOL 9 RRV infected primary cholangiocytes. Injection of BALB/c interferon alpha/beta receptor knockout (IFN-αβR−/−) pups at DOL 7 showed increased symptoms (79%) and mortality (46%) when compared to late infected wild type mice. In conclusion, the degree of injury sustained by relatively immature cholangiocytes due to more robust RRV replication correlated with more severe clinical manifestations of cholangiopathy and higher mortality. Interferon alpha production by cholangiocytes appears to play a regulatory role. These findings confirm a temporal dependence of RRV infection in murine BA and begin to define a pathophysiologic role of the maturing cholangiocyte.

Highlights

  • Biliary atresia (BA) is a devastating inflammatory cholangiopathy, leading to obstruction of the biliary tree and, without treatment, death within two years of birth

  • 100% of BALB/c pups challenged with rhesus rotavirus (RRV) on day of life (DOL) 0 developed symptoms, and only 20% of mice were alive at 21 days of age

  • Harvested from DOL 2 mice replicate RRV to a higher titer than primary cholangiocytes harvested from DOL 9 mice, we examined the expression of interferon alpha/beta (IFN-α/ β), which plays a key role in the host defense against invading virus

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Summary

Introduction

Biliary atresia (BA) is a devastating inflammatory cholangiopathy, leading to obstruction of the biliary tree and, without treatment, death within two years of birth. It is the most common etiology of obstructive neonatal cholestasis and remains the number one indication for pediatric liver transplantation in the United States. The incidence of BA is estimated at 1 in 8,000-15,000 live births [1] and is a disease unique to infancy. Afflicted children manifest symptoms of biliary obstruction including jaundice, acholic stool, and failure to thrive in the first few weeks of life. Initial therapy includes surgical bypass; most patients require liver transplantation due to end-stage disease.

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