Primary biliary cirrhosis: an infectious disease caused by Chlamydia pneumoniae?
OBJECTIVE
The etiology and pathogenesis of primary biliary cirrhosis (PBC) remain elusive. Both an infectious etiology and molecular mimicry have been implicated. The aim is to study the prevalence of Chlamydial antigens and RNA in the liver tissue of patients with PBC.


METHODS
We compared the prevalence of Chlamydial antigen and RNA in 25 explants with PBC who underwent orthotopic liver transplantation with 105 explanted livers from other chronic liver disease. We also studied 14 liver biopsies from patients with early stages of PBC. Donor livers were also studied.


RESULTS
In all 39 patients with PBC, Chlamydia pneumoniae antigens were present but not Chlamydia trachomatis, and only 9/105 (8.5%) of patients in the other categories were positive (P<0.01) for C. pneumoniae. Eight explanted PBC livers were tested for C. pneumoniae 16S RNA by in situ hybridization and were positive.


CONCLUSIONS
The presence of C. pneumoniae antigen and RNA in liver tissue of patients with PBC suggests that C. pneumoniae antigen may trigger an immune response based on molecular mimicry.
Abdulkarim
Ahmad S
AS
Division of Gastroenterology and Hepatology, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
Petrovic
Lydia M
LM
Kim
Woong R
WR
Angulo
Paul
P
Lloyd
Ricardo V
RV
Lindor
Keith D
KD
D000328:Adult; D000368:Aged; D000942:Antigens, Bacterial / Q000032:analysis; D016022:Case-Control Studies; D023521:Chlamydophila Infections / Q000150:complications*; D016993:Chlamydophila pneumoniae / Q000235:genetics / Q000276:immunology; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D008099:Liver / Q000382:microbiology; D008105:Liver Cirrhosis, Biliary / Q000382:microbiology* / Q000601:surgery; D008107:Liver Diseases / Q000382:microbiology; D016031:Liver Transplantation; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D012329:RNA, Bacterial / Q000032:analysis; D012336:RNA, Ribosomal, 16S / Q000032:analysis; D014019:Tissue Donors
D000942:Antigens, Bacterial; D012329:RNA, Bacterial; D012336:RNA, Ribosomal, 16S