Are Dysregulated Inflammatory Responses to Commensal Bacteria Involved in the Pathogenesis of Hepatobiliary-Pancreatic Autoimmune Disease? An Analysis Using Mice Models of Primary Biliary Cirrhosis and Autoimmune Pancreatitis

Figure 1

Hypothetical pathogenesis of PBC and AIP. During the initiation phase, weak but silently infiltrating PAMPs and/or antigen(s), such as avirulent bacteria, trigger and upregulate the innate immune system. Second, the progressive phase features the persistence of this PAMP attack or stimulation by molecular mimicry and/or exposure or stimulation from commensal flora possessing the same antigenic epitope that the initial pathogen and/or PAMP possessed, thereby upregulating the host immune response to the target antigen. These slowly progressive steps eventually lead to the development of autoimmune diseases. Modified from previous papers [25, 61].