The 2-oxo-acid dehydrogenase complexes and, in particular, the E2 component of the pyruvate dehydrogenase complex (PDC) are the target of antimitochondrial antibodies (AMA). More than 95% of primary biliary cirrhosis (PBC) patients have detectable levels of autoantibodies to PDC-E2 and in general these react with a region of the molecule that contains the prosthetic group lipoic acid (LA). LA is vital to the function of the enzyme, although there is conflicting evidence as to whether its presence is required for PDC-E2 recognition by AMA. Some, but not all, monoclonal antibodies (mAbs) to PDC-E2 produce an intense staining pattern at the apical surface of bile duct epithelial cells (BEC) in patients with PBC, and it has been argued that the molecule at the apical surface of PBC bile duct cells is a modified form of PDC-E2 or a cross-reactive molecule, acting as a molecular mimic. Herein, we characterize the epitopes recognized by 4 anti-PDC-E2 mAbs that give apical staining patterns (3 mouse and 1 human). In particular, by using a combination of recombinant antigens, competitive inhibition assays, and a unique peptide-on-bead assay, we determined that these apically staining mAbs recognize 3 or 4 distinct epitopes on PDC-E2. More importantly, this suggests that a portion spanning the entire inner lipoyl domain of PDC-E2 can be found at the BEC apical surface. In addition, competition assays with patient sera and a PDC-E2-specific mAb showed significant epitope overlap with only 1 of the 3 mouse mAbs and showed a differential response to the peptide bound to Primary biliary cirrhosis (PBC) is a destructive autoimmune disease of intrahepatic bile ducts characterized by inflammation of the portal triads, fibrosis, and the presence of antimitochondrial antibodies (AMA). 1,2 The major autoantigens recognized by AMA are related members of the 2-oxoacid dehydrogenase complexes including the pyruvate dehydrogenase complex (PDC-E2), the branched chain ketoacid dehydrogenase complex-E2, and the 2-oxo-glutarate dehydrogenase complex-E2. It has been hypothesized that a molecular mimic of the PDC-E2 molecule is expressed at high levels in the apical region of biliary epithelial cells (BEC) in PBC. [3][4][5] We have previously described a series of 8 monoclonal antibodies (mAbs) against the mitochondrial antigens of PBC that produce this disease-specific staining pattern. 6,7 Essentially, when probed with these disease-specific mAbs, small bile ducts in tissue from patients with PBC, but not controls, show intense staining at the apical surface of the cells lining the lumen. This pattern is in addition to the normal cytoplasmic pattern seen with mAbs against mitochondrial proteins. The fact that such apical staining is seen only with these select mAbs but not all mAbs that react with PDC-E2 has led to the hypothesis that a molecule(s) cross-reactive with PDC-E2 is located at the apical surface of PBC BEC. 3,4 Extensive efforts have been made to elucidate the AMA epitopes and link them to pathology. The consensus is that altho...