Table 4.
Evidence for the influence of immune mechanisms on the aetiology of PSC
Humoral immunity | Increased circulating immune complexes |
Elevated immunoglobulin levels (IgG and IgM) | |
Low titres of non-organ specific autoantibodies (ANA and SMA) | |
High titres of antineutrophil antibodies | |
Autoantibodies to BEC surface antigens | |
Cell mediated immunity | Decreased levels of circulating peripheral CD8+ve Tcells |
Portal T cell and NK cell infiltrate | |
Increased activated and memory T cells | |
Restricted T cell receptor repertoire (Vβ3) | |
Aberrant expression of HLA-DR on BEC | |
Coexpression of costimulatory molecules and HLA-DR on BECs | |
Increased circulating and tissue bound adhesion molecules | |
Immune effector mechanisms | Enhanced cytokine expression in the liver |
Immunogenetic mechanisms | HLA associations |