Cause Of Biliary Atresia Research Articles

BILIARY ATRESIA AND REOVIRUS TYPE-3 INFECTION

In a recent American study it was found that 17 of 25 patients with extrahepatic biliary atresia had IgG antibodies to reovirus type-3 as compared with only 3 of 37 age matched controls. However, an European group found antibodies to reovirus type-3 in only 13 of 28 patients and in 15 of 30 controls. So it was concluded that reovirus is not an important cause of biliary atresia in Europe. We have performed an identical study using a similar serologic method. IgG antibodies to reovirus type-3 were detected in 16 of 23 neonates with extrahepatic biliary atresia (70%), while only 14 of 35 age-matched controls were positive (40%) (p < 0.05). We also tested maternal blood of 16 children with biliary atresia. Fourteen mothers had IgG antibodies against reovirus (88%), while 5 of 7 controls (70%) were positive. To investigate the occurrence of a recent infection in the mothers, we tested these maternal sera for IgM antibodies. Three out of sixteen mothers of infants with biliary atresia had high titres of IgM antibodies to reovirus. None of seven controls was positive. These results suggest a major role for reovirus type-3 infection in the causation of extrahepatic biliary atresia. In addition, infection of the mother could be important in the pathogenesis of biliary atresia in their children.

Biliary atresia and reovirus type 3 infection.

NEONATAL biliary atresia was originally thought to be a developmental malformation. However, microscopical examination of bile ducts resected during portoenterostomy has revealed inflammatory lesions suggesting an ongoing postnatal process such as infection.1 , 2 Viral isolation and serologic studies have usually been negative except for an occasional case associated with cytomegalovirus or congenital rubella infection.3 4 5 6 Our interest in reovirus type 3 (reo-3) as a potential cause of biliary atresia was stimulated by the observations of Stanley et al.7 They described chronic obstructive jaundice in mice, associated with choledochal obliteration that followed intraperitoneal injection of reo-3 into weanling animals.8 Although hepatic injury is . . .