The chemical pathway to primary biliary cirrhosis

Carlo Selmi, Claudio A. Cocchi, Massimo Zuin, M. Eric Gershwin

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)23-29
Number of pages7
JournalClinical Reviews in Allergy and Immunology
Issue number1
Publication statusPublished - Feb 2009


  • Autoimmune cholangitis
  • Geoepidemiology
  • Molecular mimicry
  • Xenobiotics

ASJC Scopus subject areas

  • Immunology and Allergy


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