¹Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria, Australia

Correspondence: Dr IR Mackay, Department of Biochemistry and Molecular Biology, Monash University, Clayton, Vic. 3800, Australia. Email: ian.mackay@med.monash.edu.au

Received 26 October 2001; Accepted 26 October 2001.

Abstract

Premises for the subspecialty of hepatoimmunology include the recognition that the liver is a lymphoid organ with unique immunological properties. These properties ensure efficient innate defence against intestinal microbes and toxins, confer a particular capacity for induction of tolerance, and provide for apoptotic disposal of redundant lymphocytes. Pathological responses within the liver are elicited when: (i) hepatotropic viruses (hepatitis virus B and C) escape immune elimination and reside in hepatocytes; (ii) the liver becomes the site of autoimmune responses directed against either hepatocytes (autoimmune hepatitis) or biliary ductules (primary biliary cirrhosis); or (iii) the liver in the course of disposal of drugs generates neoantigens that provoke adverse allergic responses. Recent advances in the understanding of the immunopathogenesis of these entities are reviewed.