Xu Yi, Yu Jiakang, Zhang Ruizhong, Yin Yingxian, Ye Jiawei, Tan Limei, Xia Huimin
Guangzhou Women and Children's Medical Centre, Guangzhou, China.
Clin Pediatr (Phila). 2012 Feb;51(2):109-13. doi: 10.1177/0009922811406264. Epub 2011 Dec 5.
The aims of this study were to detect the infection rates of DNA viruses in liver tissue of biliary atresia and to investigate the effect of perinatal infection of cytomegalovirus in biliary atresia.
A total of 85 liver biopsies (taken during Kasai portoenterostomy) were tested by fluorescence quantitative polymerase chain reaction for DNA viruses (herpes simplex virus [HSV], Epstein-Barr virus [EBV], varicella zoster virus [VZV], cytomegalovirus [HCMV], and adenovirus). Immunocytochemical detection of CMV-pp65 antigenemia assay was used to detect the presence of viral protein in liver samples. Human intrahepatic biliary epithelial cells was infected by the laboratory strain AD169 of HCMV in vitro.
Virus DNA was found in the biopsies (51/85 HCMV, 5/85 ADV, 3/85 EBV). The biopsies of 2 patients were tested positive for 2 viruses simultaneously. They include one case of HCMV in combination with ADV and one case of ASV in combination with EBV. CMV-pp65 antigenemia were distributed in hepatocyte, vascular endothelial cell, and biliary duct endothelial cell. The cytopathic effect and apoptosis were observed after HCMVAD169 infected human intrahepatic biliary epithelial cells at 6 days.
Human intrahepatic biliary epithelial cell is the target cell of HCMV. The etiology of biliary atresia is probably multifactorial. The perinatal infection of HCMV is one of the important etiologies for biliary atresia in China.
本研究旨在检测胆道闭锁患儿肝组织中DNA病毒的感染率,并探讨围生期巨细胞病毒感染在胆道闭锁发病中的作用。
选取85例在Kasai肝门空肠吻合术中获取的肝组织活检标本,采用荧光定量聚合酶链反应检测DNA病毒(单纯疱疹病毒[HSV]、EB病毒[EBV]、水痘带状疱疹病毒[VZV]、巨细胞病毒[HCMV]和腺病毒)。采用免疫细胞化学检测CMV-pp65抗原血症试验检测肝组织样本中病毒蛋白的存在。体外用人巨细胞病毒实验室毒株AD169感染人肝内胆管上皮细胞。
活检标本中发现病毒DNA(51/85为HCMV,5/85为ADV,3/85为EBV)。2例患者的活检标本同时检测出2种病毒阳性。其中1例为HCMV合并ADV,1例为ASV合并EBV。CMV-pp65抗原血症分布于肝细胞、血管内皮细胞和胆管内皮细胞。HCMV AD169感染人肝内胆管上皮细胞6天后观察到细胞病变效应和凋亡。
人肝内胆管上皮细胞是HCMV的靶细胞。胆道闭锁的病因可能是多因素的。围生期HCMV感染是中国胆道闭锁的重要病因之一。