Tuberculosis is not a risk factor for primary biliary cirrhosis: a review of the literature

Daniel S Smyk1, Dimitrios P Bogdanos, Albert Pares

  • 1Institute of Liver Studies, King's College Hospital and Division of Transplantation Immunology and Mucosal Biology, School of Medicine, King's College London, London SE5 9RS, UK.

Insights

Primary biliary cirrhosis (PBC), a progressive liver disease, is often associated with granulomas. While Mycobacterium tuberculosis can cause granulomas, research suggests it is unlikely to be an infectious trigger for PBC.

Area of Science:

  • Hepatology
  • Immunology
  • Infectious Diseases

Background:

  • Primary biliary cirrhosis (PBC) is a progressive cholestatic liver disease characterized by cholestasis, antimitochondrial antibodies (AMA), chronic nonsuppurative cholangitis, and granulomata.
  • The presence of granulomata in PBC and Mycobacterium tuberculosis being a common cause of granulomas has led to hypotheses of a causal link between tuberculosis and PBC.

Purpose of the Study:

  • To comprehensively review and discuss evidence supporting or refuting an association between Mycobacterium tuberculosis infection and PBC.
  • To explore immunological, microbiological, and epidemiological data regarding the potential link between tuberculosis exposure and PBC induction.

Main Methods:

  • Review of serological and histological evidence connecting PBC and Mycobacterium tuberculosis.
  • Analysis of immunological and microbiological findings related to PBC and tuberculosis exposure.
  • Evaluation of large-scale epidemiological studies on PBC comorbidities and tuberculosis.
  • Examination of genome-wide association studies in both tuberculosis and PBC patients.

Main Results:

  • Investigated serological markers (e.g., AMA) and molecular evidence of Mycobacterium tuberculosis in PBC patients.
  • Discussed immunological and microbiological data exploring the association of PBC with Mycobacterium tuberculosis exposure.
  • Analyzed epidemiological data and genome-wide association studies concerning PBC and tuberculosis.
  • Genome-wide association studies provide hints regarding the assumed association between Mycobacterium tuberculosis exposure and PBC induction.

Conclusions:

  • Despite the granulomatous nature of PBC and Mycobacterium tuberculosis being a frequent cause of granulomas, current evidence suggests Mycobacterium tuberculosis is an unlikely infectious trigger for primary biliary cirrhosis.

Related Concept Videos

Pulmonary Tuberculosis I01:29

Pulmonary Tuberculosis I

Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Pulmonary Tuberculosis III01:31

Pulmonary Tuberculosis III

Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:
Pulmonary Tuberculosis II01:28

Pulmonary Tuberculosis II

Tuberculosis, or TB, is a bacterial infectious disease caused by Mycobacterium tuberculosis. While its primary impact is on the lungs, leading to pulmonary tuberculosis, it can also affect various other organs, a condition referred to as extrapulmonary tuberculosis.
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
Pulmonary Tuberculosis IV01:26

Pulmonary Tuberculosis IV

Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
Pulmonary Tuberculosis V01:28

Pulmonary Tuberculosis V

Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the progression...
Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...