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Issue title: Transient Environmental Agents Involved in the Cause of Primary Biliary Cirrhosis
Article type: Research Article
Authors: Ortega-Hernandez, Oscar-Danilo | Levin, Nancy-Agmon; | Altman, Arie; | Shoenfeld, Yehuda;
Affiliations: The Zabludowicz Center for Autoimmune Diseases and Department of Medicine B, Sheba Medical Center, Tel-Aviv, Israel | Tel-Aviv University, Tel-Aviv, Israel
Note: [] Corresponding author: Prof. Yehuda Shoenfeld, Head, Department of Medicine B, Chaim Sheba Medical Center. Tel Hashomer 52621, Israel. Tel.: +972 3 530 2652; Fax: +972 3 535 2855; E-mail: [email protected]
Abstract: Primary biliary cirrhosis (PBC) is a chronic progressive cholestatic liver disease which is characterized by the breakdown of self-tolerance to the highly conserved pyruvate dehydrogenase complex, specially the pyruvate dehydrogenase E2 complex (PDC-E2). The breakdown of the tolerance to such antigens leads to an autoimmune process characterized by portal inflammation and immune-mediated destruction of the intrahepatic bile ducts. Epidemiological studies have suggested that infections agents can trigger or even exacerbate the disease. Among other gram negative bacteria, Escherichia Coli, and Nosphingobium aromaticivorans are the most associated agents reported hitherto. Epidemiological and molecular evidence points towards molecular mimicry between some components of these microorganisms and specific amino-acid sequences that are present in proteins on normal cells of the biliary tract. In this review, we revisit all reports suggesting that infectious agents might be associated with the autoimmune pathogenesis of PBC. We also retrieve the immune molecular mimicry mechanisms that are likely involved with the autoimmune process in PBC.
Keywords: Primary biliary cirrhosis, infectious agents, molecular mimicry, tolerance, autoimmunity
DOI: 10.3233/DMA-2010-0771
Journal: Disease Markers, vol. 29, no. 6, pp. 277-286, 2010
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