Clinical Reviews in Allergy & Immunology

, Volume 42, Issue 2, pp 199–212 | Cite as

Autoimmunity and Environment: Am I at risk?

  • Daniel Smyk
  • Eirini I. Rigopoulou
  • Harold Baum
  • Andrew K. Burroughs
  • Diego Vergani
  • Dimitrios P. Bogdanos


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.


AMA Genetics Estrogen PBC Risk factors Urinary tract infections Xenobiotics 



Anti-mitochondrial antibodies


Anti-nuclear antibodies

E. coli

Escherichia coli


First-degree relatives


Hormone replacement therapy


Estrogen receptor


Primary biliary cirrhosis


Pyruvate dehydrogenase complex


Rheumatoid arthritis


Systemic lupus erythematosus


Ulcerative colitis


Uropathogenic E. coli


Urinary tract infection


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Daniel Smyk
    • 1
  • Eirini I. Rigopoulou
    • 2
  • Harold Baum
    • 1
  • Andrew K. Burroughs
    • 3
  • Diego Vergani
    • 1
  • Dimitrios P. Bogdanos
    • 1
    • 4
  1. 1.Institute of Liver StudiesKing’s College London School of Medicine at King’s College HospitalLondonUK
  2. 2.Department of Medicine and Research Laboratory of Internal Medicine, University Hospital of LarissaUniversity of Thessaly Medical SchoolThessalyGreece
  3. 3.The Sheila Sherlock Liver Centre, and University Department of SurgeryRoyal Free HospitalLondonUK
  4. 4.Liver Immunopathology and Liver Immunodiagnostics, Institute of Liver Studies and Liver UnitKing’s College London School of Medicine at King’s College HospitalLondonUK

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