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Cell-mediated Immune Response in Primary Biliary Cirrhosis to a Protein Fraction from Human Bile

Br Med J 1973; 4 doi: (Published 03 November 1973) Cite this as: Br Med J 1973;4:274
  1. A. L. W. F. Eddleston,
  2. I. G. McFarlane,
  3. C. G. Mitchell,
  4. W. D. Reed,
  5. Roger Williams


    Cell-mediated immune responses to a protein fraction of human bile have been demonstrated, using the leucocyte migration test, in eight out of 10 patients with primary biliary cirrhosis but in only three out of nine with active chronic hepatitis. In the latter condition sensitization to a liver-specific hepatocellular antigen was found more frequently (five out of nine patients) than in primary biliary cirrhosis (two out of 10). These results, as well as the granuloma formation observed histologically, suggest that the initial bile duct lesion in primary biliary cirrhosis may be associated with a cell-mediated response to antigens—perhaps derived from bile duct epithelial cells—which may be normal constituents of hepatic bile.