Liver Immunopathology, Institute of Liver Studies and Liver Unit, King's College London School of Medicine at King's College Hospital, Denmark Hill Campus, London SE5 9RS, UK.
Clin Res Hepatol Gastroenterol. 2012 Apr;36(2):110-21. doi: 10.1016/j.clinre.2011.07.013. Epub 2011 Sep 8.
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.
自身免疫性肝病包括自身免疫性肝炎（AIH）、原发性胆汁性肝硬化（PBC）和原发性硬化性胆管炎。多种环境和遗传危险因素与这些疾病有关。复发性尿路感染（rUTI）与 PBC 强烈相关，与 AIH 则较少相关。这些观察结果最初是基于对 PBC 女性患者中明显菌尿的观察。更大规模的流行病学研究表明，复发性尿路感染与 PBC 之间确实存在很强的相关性。在流行病学研究中，AIH 与复发性尿路感染没有联系；然而，用呋喃妥因治疗尿路感染会诱发 AIH。由于大肠埃希菌是女性尿路感染中最常见的分离菌，因此有人认为微生物和人类 PDC-E2（PBC 的主要自身抗原靶标）表位之间的分子模拟可能解释了尿路感染和 PBC 之间的联系。多项研究已经证明了涉及微生物和自身抗原模拟物的分子模拟和免疫交叉反应。这篇综述将探讨尿路感染和自身免疫性肝病相关的文献。这将包括病例报告和流行病学研究，以及实验数据。
