Increased prevalence of primary biliary cirrhosis near superfund toxic waste sites

Ala, Aftab; Stanca, Carmen; Bu-Ghanim, Moueen; Ahmado, Imad; Branch, Andrea D.; Schiano, Thomas D.; Odin, Joseph A.; Bach, Nancy

doi:10.1002/hep.21076

Cited by 215 publications

(140 citation statements)

References 40 publications

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“…Again, an increased prevalence of PBC patients was identified in clusters around SFS. Furthermore, the clusters of PBC in our cohort (MSSM PBC database) correlated with the OPTN data [11]. The major contaminants in these superfund sites were halogenated aromatic hydrocarbons including polychlorethylene and benzene.…”

Section: Epidemiologymentioning

confidence: 63%

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Primary Biliary Cirrhosis: Environmental Risk Factors

2010

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Abstract. Primary biliary cirrhosis (PBC) is an autoimmune disease of unclear etiology. It is a chronic, progressive condition that causes intrahepatic ductal destruction ultimately leading to symptoms of cholestasis, cirrhosis and liver failure. The disease predominantly affects middle aged Caucasian women. It has a predilection to certain regions and is found in higher incidences in North America and Northern Europe. It also has a genetic predisposition with a concordance rate of 60% among monozygotic twins. Combinations of genetic and environmental factors are proposed in the pathogenesis of this disease with a compelling body of evidence that suggests a role for both these factors. This review will elucidate data on the proposed environmental agents involved the disease's pathogenesis including xenobiotic and microbial exposure and present some of the supporting epidemiologic data.

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Section: Epidemiologymentioning

confidence: 63%

“…Since then many studies continue to show geographic clustering of PBC [8,9,[11][12][13][14][15][16][17][18]. McNally et al showed space-time clustering in a population from Northeast England [19].…”

Section: Epidemiologymentioning

confidence: 99%

Primary Biliary Cirrhosis: Environmental Risk Factors

2010

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“…Data from Canada have provided intriguing observations on subjects from British Columbia of Native Canadian ancestry for whom PBC has strikingly high prevalence and incidence rates [61]. Whether these ethnic differences reflect solely the effects of genetics or include a role for migratory fluxes still needs to be determined while anecdotal data are fascinating in suggesting that pollutants may enhance the incidence of PBC in specific areas [62]. The role of genetics in PBC appears well established, yet data from association studies in candidate genes including human leukocyte antigens [63] have been inconclusive or limited to specific geographical areas [56] and a genome-wide study is awaited [64].…”

Section: The Epidemiology Of Pbc Suggests a Crucial Role For The Envimentioning

confidence: 99%

“…The diagnosis of PBC at the same time or within a short period of time among members of the same family [81], the reported cases of non familial clustering [55,62,82], and the concordance rates among monozygotic twins [4] suggest the need for a common environmental factor. Moreover, it has been described a changing risk of PBC in subjects moving from areas with high risk of PBC to areas with lower risk and vice versa [58,83].…”

Section: Infectious Agents: Numerous Studies Limited Evidencementioning

confidence: 99%

Infectious Agents and Xenobiotics in the Etiology of Primary Biliary Cirrhosis

et al. 2010

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Abstract. Primary biliary cirrhosis (PBC)is a chronic autoimmune cholestatic liver disease that manifests a latitudinal gradient in prevalence and incidence. The mechanisms leading to the initiation and perpetuation of PBC remain largely enigmatic, although it is established that a combination of genetic predisposition and environmental stimulation is required. PBC is also characterized by a high concordance rate in monozygotic twins and is considered a model autoimmune disease because of several features common to other conditions and the relatively homogeneous serological and biochemical features. From a diagnostic standpoint, PBC is characterized by the highest specificity of serum autoantibodies directed at mitochondrial proteins. Several risk factors have been suggested to be associated with PBC, including exposure to infectious agents and chemical xenobiotics that will be critically discussed in the present review article.

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“…Finally, the use of non-systematic methods for selecting zip codes to represent random sampling of controls is highly dependent on population intensity by zip code. 18 In this issue of HEPATOLOGY, Ala et al, 19 utilize methods based on geography and population density to study the prevalence and putative clustering of patients with PBC near superfund toxic waste sites (SFS), in New York City (NYC). These sites have been designated as dangerous toxic waste locations by the Department of Environment and Conservation.…”

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confidence: 99%