Immunopathogenesis of cholestatic autoimmune liver diseases


Preclinical safety department, Novartis Pharma AG, Basel, Switzerland (J. Medina); Department of Gastrointestinal and Liver Diseases, Academic Medical Center, Amsterdam, The Netherlands (E. A. Jones); Liver Unit, Hospital de la Princesa, Universidad Autónoma de Madrid, Spain (C. García-Monzón, R. Moreno-Otero).Correspondence to: Ricardo Moreno-Otero, Liver Unit, Hospital de la Princesa, Diego de León 62, 28006-Madrid, Spain. Tel./fax: + 34 91 3093911; e-mail:


Primary biliary cirrhosis and primary sclerosing cholangitis are well recognized chronic cholestatic liver diseases that are considered to have an autoimmune basis. Recent progress in the study of autoimmune liver diseases has improved the recognition and characterization of these conditions. An important component of this progress has been the identification of liver disease-associated autoantibodies and their respective target antigens, and the development of specific assays for these autoantibodies. In addition, some nonhumoral immunological findings imply an involvement of specific immunopathogenic mechanisms in the development of these conditions. Furthermore, immunogenetic factors associated with increased susceptibility to some of these diseases have been identified. This article reviews the most relevant information relating to the postulated autoimmune pathogenesis of these diseases, with special emphasis on their associated humoral and cellular immunological abnormalities and immunopathogenetic factors. Some of the remaining important unresolved issues relating to the pathogenesis of these diseases, that need to be addressed in further research, are highlighted.