Fischler Björn, Woxenius Susanne, Nemeth Antal, Papadogiannakis Nikos
Department of Pediatrics, Huddinge University Hospital, Karolinska Institutet, SE-141 86 Stockholm, Sweden.
J Pediatr Surg. 2005 Mar;40(3):541-6. doi: 10.1016/j.jpedsurg.2004.11.035.
The aim of this report was to study the amount and distribution of immunoglobulin deposits in liver biopsies from infants with biliary atresia (BA) and correlate the results to the cytomegalovirus (CMV) infection status.
Stored liver biopsies from 18 patients with BA and from 6 control patients without liver disease were immunohistochemically stained to detect IgG and IgM deposits. The intensity of the immunoglobulin staining was evaluated by a semiquantitative scoring scale. Ongoing CMV infection was defined as the detection of CMV-IgM in serum and/or the isolation of CMV in the urine and was noted in 9 of the patients with BA.
When analyzing the immunoglobulin deposits on the hepatocellular canalicular membrane the intensity score for IgM deposits was significantly higher in biopsies from patients with BA infected with CMV than in those without. No canalicular staining was detected in control biopsies.
The results support the possibility that immunologic mechanisms are of importance in the pathogenesis of BA and that a CMV infection may trigger such mechanisms.
本报告旨在研究胆道闭锁(BA)婴儿肝脏活检中免疫球蛋白沉积的数量和分布,并将结果与巨细胞病毒(CMV)感染状态相关联。
对18例BA患者和6例无肝脏疾病的对照患者的储存肝脏活检组织进行免疫组织化学染色,以检测IgG和IgM沉积。通过半定量评分量表评估免疫球蛋白染色的强度。持续性CMV感染定义为血清中检测到CMV-IgM和/或尿液中分离出CMV,18例BA患者中有9例被检测出。
分析肝细胞膜小管上的免疫球蛋白沉积时,感染CMV的BA患者活检组织中IgM沉积的强度评分显著高于未感染CMV的患者。对照活检组织未检测到小管染色。
结果支持免疫机制在BA发病机制中起重要作用以及CMV感染可能触发这种机制的可能性。