Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
Curr Opin Gastroenterol. 2012 Jan;28(1):10-7. doi: 10.1097/MOG.0b013e32834c7ae4.
New knowledge on rotavirus infection in children and well established mouse models has renewed interest in whether rotavirus could cause biliary atresia, an idiopathic, obliterative infantile disease of bile ducts that is the primary indication for liver transplant in children.
Studies in the rotavirus mouse model of biliary atresia indicate that infection of biliary epithelium is an inaugural event leading to biliary inflammation and obstruction, which is preceded by systemic spread of rotavirus, which also occurs during human rotavirus enteric infections. Viral factors, including rotavirus gene 4, are important for biliary infection and biliary atresia in mice. Specific host factors related to inflammatory processes (natural killer and T cells, interferon) are also critical, and a paucity of regulatory T cells in neonates may play a key role in pathogenesis in experimental biliary atresia. Rotavirus vaccination has substantially decreased rotavirus diarrheal disease worldwide and might enable demonstration of a cause-effect relationship between rotavirus infection and biliary atresia in humans.
Rotavirus can be detected in the serum of mice and children and causes biliary atresia in neonatal mice. Approaches to re-examine whether rotavirus causes biliary atresia in children are discussed based on concepts from the mouse model of biliary atresia and rotavirus vaccination programs.
儿童轮状病毒感染的新知识和成熟的小鼠模型，使人们重新关注轮状病毒是否会导致胆道闭锁，这是一种特发性、婴儿期闭塞性胆管疾病，是儿童肝移植的主要指征。
在胆道闭锁的轮状病毒小鼠模型研究中，感染胆管上皮是导致胆道炎症和阻塞的初始事件，这之前是轮状病毒的全身扩散，而这种情况也发生在人类轮状病毒肠道感染期间。病毒因素，包括轮状病毒基因 4，对小鼠的胆道感染和胆道闭锁很重要。与炎症过程相关的特定宿主因素（自然杀伤细胞和 T 细胞、干扰素）也很关键，新生儿调节性 T 细胞缺乏可能在实验性胆道闭锁的发病机制中起关键作用。轮状病毒疫苗接种已大大降低了全球轮状病毒腹泻病的发病率，这可能使我们能够证明人类轮状病毒感染与胆道闭锁之间存在因果关系。
可以在小鼠和儿童的血清中检测到轮状病毒，并导致新生小鼠发生胆道闭锁。根据胆道闭锁的小鼠模型和轮状病毒疫苗接种计划的概念，我们讨论了重新检查轮状病毒是否会导致儿童胆道闭锁的方法。
