¹Division of Rheumatology, Allergy and Clinical Immunology University of California at Davis, Davis, California; Division of Internal Medicine Department of Medicine, Surgery and Dentistry San Paolo School of Medicine University of Milan, Milan, Italy

Correspondence: M Eric Gershwin, MD, Division of Rheumatology and Clinical Immunology, University of California at Davis TB 192, Davis, California, 95616. E-mail: megershwin@ucdavis.edu

Abstract

The etiology of primary biliary cirrhosis (PBC), much like that of other autoimmune diseases, remains enigmatic. In the case of PBC, several candidates have been proposed, including bacteria, chemicals, and retroviruses. The support for a retroviral etiology has led to a pilot therapeutical interventional program. However, there is limited objective data which can be used to support such a thesis. Until reproducible and mechanistically sound data can be offered, we suggest that pharmaceutical trials are unrealistic and should be discouraged.