Article

Clinical Reviews in Allergy & Immunology

, Volume 42, Issue 2, pp 199-212

First online:

Autoimmunity and Environment: Am I at risk?

  • Daniel SmykAffiliated withInstitute of Liver Studies, King’s College London School of Medicine at King’s College Hospital
  • , Eirini I. RigopoulouAffiliated withDepartment of Medicine and Research Laboratory of Internal Medicine, University Hospital of Larissa, University of Thessaly Medical School
  • , Harold BaumAffiliated withInstitute of Liver Studies, King’s College London School of Medicine at King’s College Hospital
  • , Andrew K. BurroughsAffiliated withThe Sheila Sherlock Liver Centre, and University Department of Surgery, Royal Free Hospital
  • , Diego VerganiAffiliated withInstitute of Liver Studies, King’s College London School of Medicine at King’s College Hospital
  • , Dimitrios P. BogdanosAffiliated withInstitute of Liver Studies, King’s College London School of Medicine at King’s College HospitalLiver Immunopathology and Liver Immunodiagnostics, Institute of Liver Studies and Liver Unit, King’s College London School of Medicine at King’s College Hospital Email author 

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Abstract

The complex interplay between environmental factors and genetic susceptibility plays an essential role in disease pathogenesis. This is especially true for autoimmunity, where clinical reports, genomic and epidemiological studies, as well as animal models have identified several environmental and genetic risk factors associated with autoimmune disease. The complexity of this relationship is demonstrated by the vast array of environmental factors that have now been implicated in the induction, and possibly the maintenance of autoimmune disease. The multitude of environmental factors implicated includes both infectious and non-infectious agents. Here, we review one specific autoimmune disease, primary biliary cirrhosis (PBC), as a model for environmental risk factors acting in concert with genetic susceptibility in the disease pathogenesis. PBC is an ideal model, as both infectious and non-infectious environmental agents have been identified as risk factors, and their study provides clues for unravelling the pathogenesis of the disease.

Keywords

AMA Genetics Estrogen PBC Risk factors Urinary tract infections Xenobiotics