Detection of Reovirus Type 3 in the Porta Hepatis of an Infant with Extrahepatic Biliary Atresia: Ultrastructural and Immunocytochemical Study

Abstract

This report describes immunocytochemical and ultrastructural methods which led to the identification of Reovirus type 3 (Reo-3) in the porta hepatis of a patient with extrahepatic biliary atresia. The study indicates that Reo-3 antigenic sites are demonstrable by the avidin-biotinylated complex peroxidase method following formalin fixation and paraffin embedding, but are destroyed by freezing and thawing prior to fixation. Deparaffinization of the block and subsequent rembedding in epon-araldite did not alter immunoperoxidase staining. This procedure offered the advantage of higher light microscopic resolution of semithin (1 micron) sections and assisted in the selection of specific areas for ultrastructural studies. Localization of Reo-3 in extrahepatic biliary atresia was confined to a biliary remnant in which there were acutely inflammed, partially necrotic microscopic ducts. Electron microscopic examination of the immunoreactive sites revealed virus-like particles similar in appearance to Reo-3 particles in infected tissue culture cells. The observations presented here support previously reported serologic data which have shown an association between Reo-3 infection and extrahepatic biliary atresia.

Utilization of sialic acid as a coreceptor is required for reovirus-induced biliary disease

“…Some studies have demonstrated a correlation between the presence of anti-reovirus antibodies and biliary atresia, while others have not (16)(17)(18)(19)(20)(21)(22)(23). Our findings may explain the discordance between anti-reovirus seropositivity and biliary atresia.…”

Effect of Rotavirus Strain on the Murine Model of Biliary Atresia

“…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).…”

Detection and Identification of Mammalian Reoviruses in Surface Water by Combined Cell Culture and Reverse Transcription-PCR

“…However, research suggests that reoviruses may be associated with potentially more severe illnesses. Reoviruses have been linked to neonatal hepatitis, extrahepatic biliary atresia, meningitis, and myocarditis (9,16,25,28,29). Also, immunocompromised, young, and elderly individuals may become susceptible to severe bacterial respiratory disease due to an initial reovirus infection (5).…”