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Editor,—Haydon and Neuberger (OpenUrlCrossRefPubMedWeb of Science) elegantly summarised the possibility that specific bacterial and viral pathogens may trigger early bile duct damage in the pathogenesis of primary biliary cirrhosis (PBC). It was concluded that a chronic infection, probably of viral origin, was driving an immune response with antimitochondrial and other autoantibodies enhancing the tissue damage in later stages of PBC. Besides detection of antibodies specific for mycobacterial antigens, such as the 55 kDa and 65–75 kDa antigens of M gordonae, in PBC the authors emphasised, based on studies by Mason and colleagues1 and others, that immune responses detected by immunoblotting to retroviral proteins with homology to HIV p24 and other retroviral antigens, such as HIAP, are common in PBC, in primary sclerosing cholangitis (PSC), and in Sjögren's disease.
Recent studies propose a possible role forHelicobacter pylori in Sjögren's disease.2 ,3 Contradictory data have appeared more recently based on a possible high relevance of anti-Helicobacter antibodies in saliva and sera of these patients.4 Most recently, Foxet al found that patients …