title: Primary biliary cirrhosis: an infectious disease caused by Chlamydia pneumoniae?
abstract: 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.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
authors.forename: Ahmad S
authors.initials: AS
authors.lastname: Abdulkarim
authors.forename: Lydia M
authors.initials: LM
authors.lastname: Petrovic
authors.forename: Woong R
authors.initials: WR
authors.lastname: Kim
authors.forename: Paul
authors.initials: P
authors.lastname: Angulo
authors.forename: Ricardo V
authors.initials: RV
authors.lastname: Lloyd
authors.forename: Keith D
authors.initials: KD
authors.lastname: Lindor
mesh_terms: 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
chemical_list: D000942:Antigens, Bacterial; D012329:RNA, Bacterial; D012336:RNA, Ribosomal, 16S