The chemical pathway to primary biliary cirrhosis.
Primary biliary cirrhosis (PBC) is a female predominant chronic disease of autoimmune pathogenesis and unknown etiology, although data suggest that genetic predisposition and environmental factors concur to its onset. Among nongenetic factors, several lines of evidence spanning from geoepidemiology to experimental findings support the role of xenobiotics, i.e., chemicals that are capable to induce molecular mimicry through cross reactivity. Indeed, specific xenobiotics are hypothesized to substitute lipoic acid residues on PBC-specific autoepitopes thus triggering autoimmunity. This is supported by data obtained with patient sera reactivities as well as animal models. The scenario is further complicated by the possibility that xenobiotic-metabolizing bacteria might also play a role. We will review the available evidence in this intriguing and rapidly growing field of research and critically discuss its potential implications.
Division of Internal Medicine and Liver Unit, San Paolo Hospital School of Medicine, University of Milan, Milan, Italy.
Carlo
C
Selmi
Claudio A
CA
Cocchi
Massimo
M
Zuin
M Eric
ME
Gershwin
D000818:Animals; D001323:Autoantibodies / Q000276:immunology / Q000378:metabolism; D001327:Autoimmune Diseases / Q000139:chemically induced* / Q000453:epidemiology / Q000276:immunology*; D001419:Bacteria / Q000276:immunology / Q000378:metabolism; D005260:Female; D006801:Humans; D007113:Immunity, Innate; D008105:Liver Cirrhosis, Biliary / Q000139:chemically induced* / Q000453:epidemiology / Q000276:immunology*; D015262:Xenobiotics / Q000378:metabolism / Q000633:toxicity
D001323:Autoantibodies; D015262:Xenobiotics