Table 2 Classic characteristics of autoimmune disease aetiology and the extent to which primary biliary cirrhosis demonstrates those characteristics
CharacteristicCharacteristic seen in PBC?Comment
Autoreactive immune responses to defined autoantigensYesPDC association is among the strongest seen in any autoimmune disease
Female predispositionYes10 : 1 Female to male ratio although classical disease occurs in men ruling out an obligate female association
HLA associationYesSignificant associations but with atypical alleles and weaker than in other autoimmune diseases
Induction of disease by sensitisation with autoantigenPossiblyObservation awaits replication
Response to immunosuppressive therapyPossiblyComprehensive trials equivocal. Probably effective in selected individuals with significant inflammatory component
Production of disease by adoptive transfer of autoreactive cells and/or antibodyPossiblyPreliminary data suggestive. As yet unconfirmed
Spontaneous animal model with identical antigen specificityNoNo confirmed spontaneous model
Both children and adults affectedNoDisease in children is anecdotal
Autoantigen distribution matches disease distributionNoPDC is universal but disease is highly restricted in its distribution
  • HLA, human leukocyte antigen; PBC, primary biliary cirrhosis; PDC, pyruvate dehydrogenase complex.