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Urinary tract infection as a risk factor for autoimmune liver disease: From bench to bedside

Smyk, DS; Bogdanos, DP; Kriese, S; Billinis, C; Burroughs, AK; Rigopoulou, EI; (2012) Urinary tract infection as a risk factor for autoimmune liver disease: From bench to bedside. Clinics and Research in Hepatology and Gastroenterology , 36 (2) 110 - 121. 10.1016/j.clinre.2011.07.013.

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Abstract

Autoimmune liver diseases include autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), and primary sclerosing cholangitis. A variety of environmental and genetic risk factors have been associated with these conditions. Recurrent urinary tract infections (rUTI) have been strongly associated with PBC, and to a lesser extent with AIH. These observations were initially based on the observation of significant bacteriuria in female patients with PBC. Larger epidemiological studies demonstrated that there was indeed a strong correlation between recurrent UTI and PBC. AIH has not been linked to recurrent UTI in epidemiological studies; however treatment of UTI with nitrofurantoin can induce AIH. As . Escherichia coli is the most prevalent organism isolated in women with UTI, it has been suggested that molecular mimicry between microbial and human PDC-E2 (the main autoantigenic target in PBC) epitopes may explain the link between UTI and PBC. Multiple studies have demonstrated molecular mimicry and immunological cross-reactivity involving microbial and self-antigen mimics. This review will examine the literature surrounding UTI and autoimmune liver disease. This will include case reports and epidemiological studies, as well as experimental data. © 2011 Elsevier Masson SAS.

Type:Article
Title:Urinary tract infection as a risk factor for autoimmune liver disease: From bench to bedside
DOI:10.1016/j.clinre.2011.07.013

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