Viruses have been proposed as triggers for several autoimmune diseases-the most cited examples being B3 Coxsackie virus for myocarditis and B4 Coxsackie virus, cytomegalovirus (CMV) and rubella for type 1 diabetes mellitus. Autoimmune hepatitis is no exception, but a role for a few viruses has been convincingly shown only in rare cases of AH type 1, and is unconvincing in AH type 2-the very form where one of the most held views in modern immunology, that is molecular mimicry, has been repeatedly invoked in the latest 14 years. This chapter argues that even in patients with a genetic predisposition, a trigger must intervene at the "fight" time for the disease to develop; perhaps this "fight" time has to do with sexual hormones fluctuations or with concurrent drug administration; however, no clues are available in this respect.
ASJC Scopus subject areas
- Immunology and Microbiology(all)