Detection of Group C Rotavirus in Infants with Extrahepatic Biliary Atresia

Abstract

The purpose of this retrospective study was to examine liver tissue from patients with cholestatic disease for the presence of group C rotavirus RNA. The reverse transcriptase-polymerase chain reaction (PCR) for genes 5 and 6 was used, and the PCR products were subjected to liquid hybridization with a 32P-labeled probe. A second amplification with nested primers was also used. Samples from 32 subjects (20 with biliary atresia or choledochal cyst and 12 controls) were tested. Ten of 20 biliary atresia patients were positive for group C rotavirus RNA; no controls were positive (P < .003). Three of the positive patients were positive for both genes 5 and 6. Six of the 10 had > 1 sample that was positive. These data suggest a possible relationship between group C rotavirus and extrahepatic biliary atresia in the 10 patients in whom virus RNA was detected.

Effect of Rotavirus Strain on the Murine Model of Biliary Atresia

“…Because rotavirus has been found in the blood of infected infants, it is possible that a perinatal rotavirus inoculation could result in biliary epithelial injury in a young infant. Detection of rotavirus within the livers of children affected with biliary atresia has been reported but not in a consistent fashion (4,27). Further study will be necessary to determine whether rotavirus has a causal effect in the disease process that occurs in humans.…”

“…Two types of evidence support a viral role in the pathogenesis of biliary atresia. The first type is patient-based studies in which viruses, including reovirus (11,19,20), cytomegalovirus (7,9), human papillomavirus (8), Epstein-Barr virus (10), and rotavirus (27), were found in the livers of infants with biliary atresia. The second type of evidence is the murine model of inflammatory cholangiopathy in which newborn mice injected with rhesus rotavirus (RRV) develop extrahepatic biliary obstruction and death (28).…”

Th-17 cells infiltrate the liver in human biliary atresia and are related to surgical outcome

“…A wide range of enteric viruses has been implicated including REOvirus and cytomegalovirus (CMV) but clinical evidence of exposure and its relevance is conflicting whether derived from serological studies (7,8,9) or more directly from PCR studies on liver biopsies to detect viral nucleic acids (10).…”

Armed CD4+ Th1 effector cells and activated macrophages participate in bile duct injury in murine biliary atresia

“…Two viruses which have been studied in humans as potential causes of duct damage are reovirus and rotavirus. Tyler et al [7] reported finding nested RT-PCR evidence of reovirus in infants with BA and Riepenhoff-Talty et al [8] found RT-PCR evidence of group C rotavirus (Reovirdae family) in BA hepatobiliary tissue. However, other investigators failed to find presence of these viruses in BA patients [9,10].…”