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• W2079683456 abstract "See “α-enolase autoantibodies cross-reactive to viral proteins in a mouse model of biliary atresia,” by Lu BR, Brindley SM, Tucker RM, et al, on page 1753. See “α-enolase autoantibodies cross-reactive to viral proteins in a mouse model of biliary atresia,” by Lu BR, Brindley SM, Tucker RM, et al, on page 1753. Biliary atresia (BA), a condition unique to infancy, is the end result of a destructive, idiopathic, inflammatory process affecting both intra- and extrahepatic bile ducts, leading to fibrosis and obliteration of the biliary tract and ultimately to biliary cirrhosis. It is the most serious and most frequent surgically correctable liver disorder in infancy, as well as the most prevalent indication for liver transplantation in children.1Mieli-Vergani G. Vergani D. Biliary atresia.Semin Immunopathol. 2009; 31: 371-381Crossref PubMed Scopus (61) Google Scholar Indeed, approximately 50% and 80% of patients with BA undergo transplantation by age 2 and 20, respectively.2Shneider B.L. Brown M.B. Haber B. et al.A multicenter study of the outcome of biliary atresia in the United States, 1997 to 2000.J Pediatr. 2006; 148: 467-474Abstract Full Text Full Text PDF PubMed Scopus (295) Google Scholar Studies of bile duct remnants removed at surgery and from serial sectioning and reconstruction of surgical and post mortem liver specimens suggest that BA in most cases arises from a sclerosing inflammatory process affecting previously formed bile ducts.3Gautier M. Eliot N. Extrahepatic biliary atresia Morphological study of 98 biliary remnants.Arch Pathol Lab Med. 1981; 105: 397-402PubMed Google Scholar The cause of such inflammatory process remains largely unknown. It is conceivable that BA represents a common final phenotypic pathway of neonatal liver injury owing to diverse causes, including developmental, vascular, or infectious factors, that may act antenatally or within the first 3 months of life, in a genetically predisposed individual,4Sokol R.J. Mack C. Etiopathogenesis of biliary atresia.Semin Liver Dis. 2001; 21: 517-524Crossref PubMed Scopus (133) Google Scholar as supported by familial occurrence.5Smith B.M. Laberge J.M. Schreiber R. et al.Familial biliary atresia in three siblings including twins.J Pediatr Surg. 1991; 26: 1331-1333Abstract Full Text PDF PubMed Scopus (56) Google Scholar Whatever the initiating event, as bile flow increases perinatally, bile leakage from the abnormal ducts is likely to trigger an intense inflammatory reaction, with consequent obliteration of the biliary tree. Bile extravasated into periductal tissues would lead to protracted inflammation and fibrosis, causing secondary obliteration and obstruction of the more distal bile ducts. The detergent effect of the extravasated bile, however, cannot be the only explanation for liver damage, because the disease can progress also when the Kasai portoenterostomy achieves adequate bile flow. Proposed etiologies in BA include defective morphogenesis secondary to genetic factors, vascular abnormalities, exposure to toxins, viral infection, and immune-mediated mechanisms. Viral infection and immune mechanisms are the fascinating themes on which the literature has focused in more recent years. The presence of a portal tract mononuclear cell infiltrate at liver histology suggested a primary inflammatory process leading to bile duct obstruction. Early studies reported the presence of lymphocytes in the connective tissue of the porta hepatis in children with BA6Gosseye S. Otte J.B. De Meyer R. et al.A histological study of extrahepatic biliary atresia.Acta Paediatr Belg. 1977; 30: 85-90PubMed Google Scholar and a relationship between intramural mononuclear inflammatory cells and epithelial cell necrosis in bile duct remnants.7Bill A.H. Haas J.E. Foster G.L. Biliary atresia: histopathologic observations and reflections upon its natural history.J Pediatr Surg. 1977; 12: 977-982Abstract Full Text PDF PubMed Scopus (47) Google Scholar The seasonal clustering of human BA cases and experimental evidence of virus induced BA have suggested a link between this disorder and exposure to viral agents,8Yoon P.W. Bresee J.S. Olney R.S. et al.Epidemiology of biliary atresia: A population-based study.Pediatrics. 1997; 99: 376-382Crossref PubMed Scopus (195) Google Scholar similar to other complex diseases.9Kivity S. Agmon-Levin N. Blank M. et al.Infections and autoimmunity—friends or foes?.Trends Immunol. 2009; 30: 409-414Abstract Full Text Full Text PDF PubMed Scopus (310) Google Scholar An initial bile duct epithelial injury caused by viral infection would lead to a progressive, immune-mediated sclerosing process resulting in damage and eventually obstruction of the bile ducts.10Mack C.L. Tucker R.M. Sokol R.J. et al.Biliary atresia is associated with CD4(+) Th1 cell-mediated portal tract inflammation.Pediatric Research. 2004; 56: 79-87Crossref PubMed Scopus (167) Google Scholar, 11Minnick K.E. Kreisberg R. Dillon P.W. Soluble ICAM-1 (sICAM-1) in biliary atresia and its relationship to disease activity.J Surg Res. 1998; 76: 53-56Abstract Full Text PDF PubMed Scopus (29) Google Scholar, 12Leifeld L. Ramakers J. Schneiders A.M. et al.Intrahepatic MxA expression is correlated with interferon-alpha expression in chronic and fulminant hepatitis.J Pathol. 2001; 194: 478-483Crossref PubMed Scopus (17) Google Scholar Several viruses have in turn been suggested in the pathogenesis of human BA, including hepatitis B virus,13Landing B.H. Considerations of the pathogenesis of neonatal hepatitis, biliary atresia and choledochal cyst—the concept of infantile obstructive cholangiopathy.Prog Pediatr Surg. 1974; 6: 113-139PubMed Google Scholar cytomegalovirus,14Domiati-Saad R. Dawson D.B. Margraf L.R. et al.Cytomegalovirus and human herpesvirus 6, but not human papillomavirus, are present in neonatal giant cell hepatitis and extrahepatic biliary atresia.Pediatr Dev Pathol. 2000; 3: 367-373Crossref PubMed Scopus (88) Google Scholar, 15Fischler B. Ehrnst A. Forsgren M. et al.The viral association of neonatal cholestasis in Sweden: a possible link between cytomegalovirus infection and extrahepatic biliary atresia.J Pediatr Gastroenterol Nutr. 1998; 27: 57-64Crossref PubMed Scopus (149) Google Scholar human herpes viruses,16Drut R. Drut R.M. Gomez M.A. et al.Presence of human papillomavirus in extrahepatic biliary atresia.J Pediatr Gastroenterol Nutr. 1998; 27: 530-535Crossref PubMed Scopus (51) Google Scholar group C rotavirus,17Riepenhoff Talty M. Gouvea V. Evans M.J. et al.Detection of group C rotavirus in infants with extrahepatic biliary atresia.J Infect Dis. 1996; 174: 8-15Crossref PubMed Scopus (212) Google Scholar and reovirus.18Tyler K.L. Sokol R.J. Oberhaus S.M. et al.Detection of reovirus RNA in hepatobiliary tissues from patients with extrahepatic biliary atresia and choledochal cysts.Hepatology. 1998; 27: 1475-1482Crossref PubMed Scopus (197) Google Scholar Studies suggesting a viral involvement in the pathogenesis of BA in humans, however, have been largely anecdotal or provided controversial results.19Brown W.R. Sokol R.J. Levin M.J. et al.Lack of correlation between infection with reovirus 3 and extrahepatic biliary atresia or neonatal hepatitis.J Pediatr. 1988; 113: 670-676Abstract Full Text PDF PubMed Scopus (89) Google Scholar, 20Bobo L. Ojeh C. Chiu D. et al.Lack of evidence for rotavirus by polymerase chain reaction/enzyme immunoassay of hepatobiliary samples from children with biliary atresia.Pediatr Res. 1997; 41: 229-234Crossref PubMed Scopus (82) Google Scholar, 21Steele M.I. Marshall C.M. Lloyd R.E. et al.Reovirus 3 not detected by reverse transcriptase-mediated polymerase chain reaction analysis of preserved tissue from infants with cholestatic liver disease.Hepatology. 1995; 21: 697-702PubMed Google Scholar No solid link between BA and infection with common hepatoptropic viruses, namely, hepatitis A, B, and C, exists in the literature and the proposed associations with cytomegalovirus, human papilloma virus, and human herpes viruses are also unconvincing.14Domiati-Saad R. Dawson D.B. Margraf L.R. et al.Cytomegalovirus and human herpesvirus 6, but not human papillomavirus, are present in neonatal giant cell hepatitis and extrahepatic biliary atresia.Pediatr Dev Pathol. 2000; 3: 367-373Crossref PubMed Scopus (88) Google Scholar, 15Fischler B. Ehrnst A. Forsgren M. et al.The viral association of neonatal cholestasis in Sweden: a possible link between cytomegalovirus infection and extrahepatic biliary atresia.J Pediatr Gastroenterol Nutr. 1998; 27: 57-64Crossref PubMed Scopus (149) Google Scholar, 22Tarr P.I. Haas J.E. Christie D.L. Biliary atresia, cytomegalovirus, and age at referral.Pediatrics. 1996; 97: 828-831PubMed Google Scholar, 23Jevon G.P. Dimmick J.E. Biliary atresia and cytomegalovirus infection: a DNA study.Pediatr Dev Pathol. 1999; 2: 11-14Crossref PubMed Scopus (69) Google Scholar, 24Drut R. Drut R.M. Gomez M.A. et al.Presence of human papillomavirus in extrahepatic biliary atresia.J Pediatr Gastroenterol Nutr. 1998; 27: 530-535Crossref PubMed Scopus (83) Google Scholar Epidemiologic studies on reovirus and rotavirus, currently believed to be the most likely infectious agents involved in the pathogenesis of BA25Kahn E. Biliary atresia revisited.Pediatr Dev Pathol. 2004; 7: 109-124Crossref PubMed Scopus (59) Google Scholar on the basis of experimental models, are also conflicting. Interest in reovirus stems from the observation that infection in weanling mice causes bile duct and liver damage similar to that observed in BA,26Bangaru B. Morecki R. Glaser J.H. et al.Comparative studies of biliary atresia in the human newborn and reovirus-induced cholangitis in weanling mice.Lab Invest. 1980; 43: 456-462PubMed Google Scholar the lesions persisting after the viral antigens are no longer detected. Nevertheless, serum anti-reovirus antibodies were not consistently detected in infants with BA,19Brown W.R. Sokol R.J. Levin M.J. et al.Lack of correlation between infection with reovirus 3 and extrahepatic biliary atresia or neonatal hepatitis.J Pediatr. 1988; 113: 670-676Abstract Full Text PDF PubMed Scopus (89) Google Scholar, 27Morecki R. Glaser J.H. Cho S. et al.Biliary atresia and reovirus type 3 infection.N Engl J Med. 1982; 307: 481-484Crossref PubMed Scopus (199) Google Scholar, 28Dussaix E. Hadchouel M. Tardieu M. et al.Biliary atresia and reovirus type 3 infection.N Engl J Med. 1984; 310: 658PubMed Google Scholar, 29Glaser J.H. Balistreri W.F. Morecki R. Role of reovirus type 3 in persistent infantile cholestasis.J Pediatr. 1984; 105: 912-915Abstract Full Text PDF PubMed Scopus (85) Google Scholar possibly because of a high incidence of passively transferred maternal anti-reovirus immunoglobulin G antibodies. Studies in the liver tissue have also given discrepant results. Although reovirus antigens are found in the bile duct remnants of infants with BA27Morecki R. Glaser J.H. Cho S. et al.Biliary atresia and reovirus type 3 infection.N Engl J Med. 1982; 307: 481-484Crossref PubMed Scopus (199) Google Scholar, 30Morecki R. Glaser J.H. Johnson A.B. et al.Detection of reovirus type 3 in the porta hepatis of an infant with extrahepatic biliary atresia: ultrastructural and immunocytochemical study.Hepatology. 1984; 4: 1137-1142Crossref PubMed Scopus (72) Google Scholar and evidence of reovirus infection by nested reverse transcriptase polymerase chain reaction in snap frozen BA liver was reported,18Tyler K.L. Sokol R.J. Oberhaus S.M. et al.Detection of reovirus RNA in hepatobiliary tissues from patients with extrahepatic biliary atresia and choledochal cysts.Hepatology. 1998; 27: 1475-1482Crossref PubMed Scopus (197) Google Scholar these findings could not be independently reproduced.19Brown W.R. Sokol R.J. Levin M.J. et al.Lack of correlation between infection with reovirus 3 and extrahepatic biliary atresia or neonatal hepatitis.J Pediatr. 1988; 113: 670-676Abstract Full Text PDF PubMed Scopus (89) Google Scholar, 21Steele M.I. Marshall C.M. Lloyd R.E. et al.Reovirus 3 not detected by reverse transcriptase-mediated polymerase chain reaction analysis of preserved tissue from infants with cholestatic liver disease.Hepatology. 1995; 21: 697-702PubMed Google Scholar The demonstration that murine BA can be induced by a rotavirus has elicited a strong interest in the possible role of this pathogen in the causation of the human disease. Rotavirus infection of newborn mice in the first 24 hours of life leads to jaundice, acholic stools, and hyperbilirubinemia by the end of the first week of life. Progressive inflammation and obstruction of the extrahepatic bile duct is observed by 2 weeks, mimicking human BA.31Riepenhofftalty M. Schaekel K. Clark H.F. et al.Group-A rotaviruses produce extrahepatic biliary obstruction in orally inoculated newborn mice.Pediatr Res. 1993; 33: 394-399PubMed Google Scholar, 32Petersen C. Biermanns D. Kuske M. et al.New aspects in a murine model for extrahepatic biliary atresia.J Pediatr Surg. 1997; 32: 1190-1195Abstract Full Text PDF PubMed Scopus (125) Google Scholar, 33Petersen C. Grasshoff S. Luciano L. Diverse morphology of biliary atresia in an animal model.J Hepatol. 1998; 28: 603-607Abstract Full Text PDF PubMed Scopus (58) Google Scholar, 34Czech-Schmidt G. Verhagen W. Szavay P. et al.Immunological gap in the infectious animal model for biliary atresia.J Surg Res. 2001; 101: 62-67Abstract Full Text PDF PubMed Scopus (83) Google Scholar In this animal model, which has been replicated in various laboratories, bile duct injury is associated with an initial CD4 T-helper 1 (Th1) immune response that through the release of interferon-γ induces macrophages to produce tumor necrosis factor-α and nitric oxide,35Mack C.L. Tucker R.M. Sokol R.J. et al.Armed CD4(+) Th1 effector cells and activated macrophages participate in bile duct injury in murine biliary atresia.Clin Immunol. 2005; 115: 200-209Crossref PubMed Scopus (89) Google Scholar immune activation that persists after viral clearance, somehow similar to what was demonstrated in a sequential study in infants with BA.36Narayanaswamy B. Gonde C. Tredger J.M. et al.Serial circulating markers of inflammation in biliary atresia: evolution of the post-operative inflammatory process.Hepatology. 2007; 46: 180-187Crossref PubMed Scopus (92) Google Scholar Mack et al37Mack C.L. Tucker R.M. Lu B.R. et al.Cellular and humoral autoimmunity directed at bile duct epithelia in murine biliary atresia.Hepatology. 2006; 44: 1231-1239Crossref PubMed Scopus (109) Google Scholar induced bile duct–specific inflammatory changes into naïve syngeneic immunodeficient mice by adoptively transferring T cells obtained from mice in which rotavirus had induced BA. The appearance of bile duct lesions in the absence of virus in the recipients suggests that biliary epithelial cell specific autoreactive T cells are generated in the course of rotavirus infection and cause biliary damage. In keeping with a T helper orchestrated immune process, an abundance of CD4 T lymphocytes has been described in the liver and extrahepatic bile ducts of BA patients,38Davenport M. Gonde C. Redkar R. et al.Immunohistochemistry of the liver and biliary tree in extrahepatic biliary atresia.J Pediatr Surg. 2001; 36: 1017-1025Abstract Full Text Full Text PDF PubMed Scopus (165) Google Scholar possibly via the enhanced expression of adhesion molecules.38Davenport M. Gonde C. Redkar R. et al.Immunohistochemistry of the liver and biliary tree in extrahepatic biliary atresia.J Pediatr Surg. 2001; 36: 1017-1025Abstract Full Text Full Text PDF PubMed Scopus (165) Google Scholar An oligoclonal expansion of CD4+ and CD8+ T cells has also been observed in the livers of infants with BA, suggesting an antigen-driven cellular immune response.39Mack C.L. Falta M.T. Sullivan A.K. et al.Oligoclonal expansions of CD4(+) and CD8(+) T-cells in the target organ of patients with biliary atresia.Gastroenterology. 2007; 133: 278-287Abstract Full Text Full Text PDF PubMed Scopus (84) Google Scholar Using DNA microarray techniques, Bezerra et al40Bezerra J.A. Tiao G. Ryckman F.C. et al.Genetic induction of proinflammatory immunity in children with biliary atresia.Lancet. 2002; 360: 1653-1659Abstract Full Text Full Text PDF PubMed Scopus (176) Google Scholar reported the up-regulation of Th1 cytokine encoding genes, such as IFN-γ, and down-regulation of genes encoding Th2 cytokines. A possible Th2 involvement in the pathogenesis of BA, however, is suggested by the finding in affected children of circulating autoantibodies, including antineutrophil cytoplasmic antibodies41Sokol R.J. Mack C. Narkewicz M.R. et al.Pathogenesis and outcome of biliary atresia: current concepts.J Pediatr Gastroenterol Nutr. 2003; 37: 4-21Crossref PubMed Scopus (248) Google Scholar and antibodies directed to α-enolase and vimentin.42Lu B.R. Mack C.L. Inflammation and biliary tract injury.Curr Opin Gastroenterol. 2009; 25: 260-264Crossref PubMed Scopus (17) Google Scholar In the current issue of Gastroenterology, Lu et al43Lu B.R. Brindley S.M. Tucker R.M. et al.α-enolase autoantibodies cross-reactive to viral proteins in a mouse model of biliary atresia.Gastroenterology. 2010; 139: 1753-1761Abstract Full Text Full Text PDF PubMed Scopus (68) Google Scholar aimed to establish the potential role of humoral autoimmunity in BA. The authors search for biliary autoantigens possible targets of humoral immune responses in a rotavirus induced BA animal model and then investigate whether these autoantibodies are present in affected infants. In the animal model part of the study, antibodies to a protein of biliary origin are detected in mice that develop bile duct obstruction after infection with rotavirus at birth. A target of the humoral autoimmune reaction is identified as α-enolase, a 48-kD glycolytic enzyme expressed in most tissues, that shares amino acid sequence similarities with rotavirus-encoded proteins, suggesting a role for molecular mimicry in the generation of the autoantibody. To support this notion, inhibition experiments in which antiviral reactivity is absorbed by incubation of the sera with α-enolase and, conversely, anti-enolase reactivity is absorbed by the use of viral sequences, should be a priority for future studies. Further, cross-reactivity experiments should be applied also to the cellular immune reaction, because the same group demonstrated a pathogenic role for T cells in adoptive transfer experiments. Such work will help in clarifying the relative roles of cellular and humoral autoimmunity in the pathogenesis of BA in the experimental animal model. The authors identify reactivity to α-enolase also in an high proportion of infants with BA and in a smaller proportion of controls, suggesting a role for the autoantibody as a disease biomarker. It should be noted, however, that reactivity to α-enolase is present in autoimmune liver disease,44Terrier B. Degand N. Guilpain P. et al.Alpha-enolase: a target of antibodies in infectious and autoimmune diseases.Autoimmun Rev. 2007; 6: 176-182Crossref PubMed Scopus (132) Google Scholar, 45Bogdanos D.P. Gilbert D. Bianchi I. et al.Antibodies to soluble liver antigen and alpha-enolase in patients with autoimmune hepatitis.J Autoimmune Dis. 2004; 1: 4Crossref PubMed Scopus (20) Google Scholar, 46Akisawa N. Maeda T. Iwasaki S. et al.Identification of an autoantibody against alpha-enolase in primary biliary cirrhosis.J Hepatol. 1997; 26: 845-851Abstract Full Text PDF PubMed Scopus (38) Google Scholar, 47Fukuda Y. Miyazawa Y. Imoto M. et al.In situ distribution of enolase isozymes in chronic liver disease.Am J Gastroenterol. 1989; 84: 601-605PubMed Google Scholar, 48Moodie F.D. Leaker B. Cambridge G. et al.Alpha-enolase: a novel cytosolic autoantigen in ANCA positive vasculitis.Kidney Int. 1993; 43: 675-681Crossref PubMed Scopus (86) Google Scholar, 49Orth T. Kellner R. Diekmann O. Identification and characterization of autoantibodies against catalase and alpha-enolase in patients with primary sclerosing cholangitis.Clin Exp Immunol. 1998; 112: 507-515Crossref PubMed Scopus (75) Google Scholar as suggested by the authors, but also in a wide variety of other disorders, including rheumatoid arthritis,50Goeb V. Thomas-L'Otellier M. Daveau R. et al.Candidate autoantigens identified by mass spectrometry in early rheumatoid arthritis are chaperones and citrullinated glycolytic enzymes.Arthritis Res Ther. 2009; 11: R38Crossref PubMed Scopus (92) Google Scholar, 51Saulot V. Vittecoq O. Charlionet R. et al.Presence of autoantibodies to the glycolytic enzyme alpha-enolase in sera from patients with early rheumatoid arthritis.Arthritis Rheum. 2002; 46: 1196-1201Crossref PubMed Scopus (132) Google Scholar inflammatory bowel disease,52Vermeulen N. Vermeire S. Arijs I. et al.Seroreactivity against glycolytic enzymes in inflammatory bowel disease.Inflamm Bowel Dis. 2010 Jul 13; ([Epub ahead of print])Google Scholar Behçet disease,53Lee K.H. Chung H.S. Kim H.S. et al.Human alpha-enolase from endothelial cells as a target antigen of anti-endothelial cell antibody in Behçet's disease.Arthritis Rheum. 2003; 48: 2025-2035Crossref PubMed Scopus (172) Google Scholar systemic sclerosis,54Terrier B. Tamby M.C. Camoin L. et al.Antifibroblast antibodies from systemic sclerosis patients bind to {alpha}-enolase and are associated with interstitial lung disease.Ann Rheum Dis. 2010; 69: 428-433Crossref PubMed Scopus (46) Google Scholar severe asthma,55Nahm D.H. Lee K.H. Shin J.Y. et al.Identification of alpha-enolase as an autoantigen associated with severe asthma.J Allergy Clin Immunol. 2006; 118: 376-381Abstract Full Text Full Text PDF PubMed Scopus (49) Google Scholar multiple sclerosis,56Forooghian F. Cheung R.K. Smith W.C. et al.Enolase and arrestin are novel nonmyelin autoantigens in multiple sclerosis.J Clin Immunol. 2007; 27: 388-396Crossref PubMed Scopus (42) Google Scholar Hashimoto encephalopathy,57Fujii A. Yoneda M. Ito T. et al.Autoantibodies against the amino terminal of alpha-enolase are a useful diagnostic marker of Hashimoto's encephalopathy.J Neuroimmunol. 2005; 162: 130-136Abstract Full Text Full Text PDF PubMed Scopus (137) Google Scholar melanoma,58Suzuki A. Iizuka A. Komiyama M. et al.Identification of melanoma antigens using a Serological Proteome Approach (SERPA).Cancer Genomics Proteomics. 2010; 7: 17-23PubMed Google Scholar lung cancer,59He P. Naka T. Serada S. et al.Proteomics-based identification of alpha-enolase as a tumor antigen in non-small lung cancer.Cancer Sci. 2007; 98: 1234-1240Crossref PubMed Scopus (103) Google Scholar and premature ovarian failure.60Edassery S.L. Shatavi S.V. Kunkel J.P. et al.Autoantigens in ovarian autoimmunity associated with unexplained infertility and premature ovarian failure.Fertil Steril. 2010 May 25; ([Epub ahead of print])PubMed Google Scholar This extensive reactivity is likely to reflect the ubiquitous distribution of this glycolytic enzyme but for α-enolase to be used as a BA biomarker, the study of a large number of children with idiopathic neonatal cholestasis should be undertaken. It would also be relevant to study the antibody changes over time in relation to different clinical outcomes of BA and to establish whether infants without anti–α-enolase reactivity belong to a different clinical phenotype. Ideally, future work on human BA should be performed using a recombinant form of human α-enolase expressed in eukaryotic systems to better reflect the in vivo events and should be extended to the investigation of specific cellular immunity. The story of complex diseases is paved with a large number of infectious etiological candidates that fell short of being proven as etiological factors, as well represented by primary biliary cirrhosis.61Selmi C. Ross S.R. Ansari A.A. et al.Lack of immunological or molecular evidence for a role of mouse mammary tumor retrovirus in primary biliary cirrhosis.Gastroenterology. 2004; 127: 493-501Abstract Full Text Full Text PDF PubMed Scopus (106) Google Scholar For this reason we encourage independent confirmation of the data presented in this issue of Gastroenterology.43Lu B.R. Brindley S.M. Tucker R.M. et al.α-enolase autoantibodies cross-reactive to viral proteins in a mouse model of biliary atresia.Gastroenterology. 2010; 139: 1753-1761Abstract Full Text Full Text PDF PubMed Scopus (68) Google Scholar α-Enolase Autoantibodies Cross-Reactive to Viral Proteins in a Mouse Model of Biliary AtresiaGastroenterologyVol. 139Issue 5PreviewBiliary atresia (BA) is a neonatal cholangiopathy of unknown etiology. The bile duct injury that occurs in patients with BA might result from a hepatobiliary viral infection followed by an autoimmune response against the bile duct epithelia. We aimed to identify autoantigens recognized by serum antibodies in the Rhesus rotavirus (RRV)-induced mouse model of BA; findings were correlated with BA in humans. Full-Text PDF" @default.
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