Table 1.

Evidence suggesting a role of xenobiotics in the development of primary biliary cirrhosis (PBC)

Evidence	Reference
Hair dyes, nail polish, and smoking are known risk factors	[31–34]
Clusters of PBC near areas of toxic waste	[81]
Induction of AMA in an animal model immunized with 6-bromohexanoate	[86]
Reactivity between several xenobiotics and PBC sera	[88]
AMA-positive PBC sera reacted against 6,8-bis(acetylthio)octanoic acid	[89]
AMA positivity in patients with excessive acetaminophen intake; Immunoreactivity between acetaminophen metabolites and AMA	[90]

Epidemiological studies have indicated that several chemical compounds are risk factors for the development of PBC. Molecular studies have provided evidence to suggest that peptide modification, and mimicry between compounds and AMA, may underlay the loss to tolerance to mitochondrial antigens