Biliary atresia causes: Difference between revisions
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{{Biliary atresia}} | {{Biliary atresia}} | ||
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== Overview == | |||
==Overview== | |||
There have been many theories about etiopathogenesis such as Reovirus 3 infection, congenital malformation, congenital CMV infection, autoimmune theory. This means that the etiology and pathogenesis of biliary atresia are largely unknown. | There have been many theories about etiopathogenesis such as Reovirus 3 infection, congenital malformation, congenital CMV infection, autoimmune theory. This means that the etiology and pathogenesis of biliary atresia are largely unknown. | ||
== Causes == | ==Causes== | ||
Biliary atresia does not have a clear identified cause. It was previously thought to be idiopathic, a destructive inflammatory process leaving fibrotic remnants at the porta hepatis. It is now thought it may be secondary to viral infections or an autoimmune-induced injury in some cases. | Biliary atresia does not have a clear identified cause. It was previously thought to be idiopathic, a destructive inflammatory process leaving fibrotic remnants at the porta hepatis. It is now thought it may be secondary to viral infections or an autoimmune-induced injury in some cases. | ||
* Reovirus, | *Reovirus, | ||
* rotavirus, | *rotavirus, | ||
* cytomegalovirus (CMV)<ref name="pmid22105891">{{cite journal| author=Brindley SM, Lanham AM, Karrer FM, Tucker RM, Fontenot AP, Mack CL| title=Cytomegalovirus-specific T-cell reactivity in biliary atresia at the time of diagnosis is associated with deficits in regulatory T cells. | journal=Hepatology | year= 2012 | volume= 55 | issue= 4 | pages= 1130-8 | pmid=22105891 | doi=10.1002/hep.24807 | pmc=3319336 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22105891 }} </ref><ref name="pmid22144720">{{cite journal| author=Xu Y, Yu J, Zhang R, Yin Y, Ye J, Tan L | display-authors=etal| title=The perinatal infection of cytomegalovirus is an important etiology for biliary atresia in China. | journal=Clin Pediatr (Phila) | year= 2012 | volume= 51 | issue= 2 | pages= 109-13 | pmid=22144720 | doi=10.1177/0009922811406264 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22144720 }} </ref> | *cytomegalovirus (CMV)<ref name="pmid22105891">{{cite journal| author=Brindley SM, Lanham AM, Karrer FM, Tucker RM, Fontenot AP, Mack CL| title=Cytomegalovirus-specific T-cell reactivity in biliary atresia at the time of diagnosis is associated with deficits in regulatory T cells. | journal=Hepatology | year= 2012 | volume= 55 | issue= 4 | pages= 1130-8 | pmid=22105891 | doi=10.1002/hep.24807 | pmc=3319336 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22105891 }} </ref><ref name="pmid22144720">{{cite journal| author=Xu Y, Yu J, Zhang R, Yin Y, Ye J, Tan L | display-authors=etal| title=The perinatal infection of cytomegalovirus is an important etiology for biliary atresia in China. | journal=Clin Pediatr (Phila) | year= 2012 | volume= 51 | issue= 2 | pages= 109-13 | pmid=22144720 | doi=10.1177/0009922811406264 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22144720 }} </ref> | ||
** The highest association of a viral infection with biliary atresia is with CMV. There may be an inability to identify the virus because of a short timeframe to detect it, which leads to uncertainty in association. The viral infection of cholangiocytes may predispose to an aberrant autoimmune response, cascading to progressive biliary injury and cirrhosis. | **The highest association of a viral infection with biliary atresia is with CMV. There may be an inability to identify the virus because of a short timeframe to detect it, which leads to uncertainty in association. The viral infection of cholangiocytes may predispose to an aberrant autoimmune response, cascading to progressive biliary injury and cirrhosis. | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
There have been many theories about etiopathogenesis such as Reovirus 3 infection, congenital malformation, congenital CMV infection, autoimmune theory. This means that the etiology and pathogenesis of biliary atresia are largely unknown.
Causes
Biliary atresia does not have a clear identified cause. It was previously thought to be idiopathic, a destructive inflammatory process leaving fibrotic remnants at the porta hepatis. It is now thought it may be secondary to viral infections or an autoimmune-induced injury in some cases.
- Reovirus,
- rotavirus,
- cytomegalovirus (CMV)[1][2]
- The highest association of a viral infection with biliary atresia is with CMV. There may be an inability to identify the virus because of a short timeframe to detect it, which leads to uncertainty in association. The viral infection of cholangiocytes may predispose to an aberrant autoimmune response, cascading to progressive biliary injury and cirrhosis.
Environmental causes
References
- ↑ Brindley SM, Lanham AM, Karrer FM, Tucker RM, Fontenot AP, Mack CL (2012). "Cytomegalovirus-specific T-cell reactivity in biliary atresia at the time of diagnosis is associated with deficits in regulatory T cells". Hepatology. 55 (4): 1130–8. doi:10.1002/hep.24807. PMC 3319336. PMID 22105891.
- ↑ Xu Y, Yu J, Zhang R, Yin Y, Ye J, Tan L; et al. (2012). "The perinatal infection of cytomegalovirus is an important etiology for biliary atresia in China". Clin Pediatr (Phila). 51 (2): 109–13. doi:10.1177/0009922811406264. PMID 22144720.