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Breaking tolerance to the natural human liver autoantigen cytochrome P450 2D6 by virus infection
(2009)
Autoimmune hepatitis (AIH) is a chronic liver disease of unknown etiology, characterized by a loss of tolerance against hepatocytes leading to the progressive destruction of hepatic parenchyma and cirrhosis. Clinical signs for AIH are interface hepatitis and portal plasma cell infiltration, hypergammaglobulinemia, and autoantibodies. Based on serological markers AIH is defined in subtypes. The hallmark of AIH type 2 are type 1 liver/kidney microsomal autoantibodies (LKM-1), whereas AIH type 1 is characterized by the presence of anti-nuclear (ANA) and/or anti-smooth muscular (SMA) autoantibodies. The major autoantigen recognized specifically by LKM-1 autoantibodies was identified as the 2D6 isoform of the cytochrome P450 enzyme family (CYP2D6). Not much is known about the etiology and pathogenic mechanisms of AIH so far and most animal models available result in only transient hepatic liver damage after a rather complex initiation method. It was the aim of my project to generate a novel animal model for AIH that reflects the chronic and progressive destruction of the liver characteristic for the human disease while using a defined and feasible initiating event to further analyze the pathogenic mechanisms leading to the autoimmune-mediated destruction of the liver. Therefore, mice transgenically expressing the human CYP2D6 in the liver and wild-type mice were infected with a liver-tropic adenovirus expressing the human CYP2D6 (Ad-2D6). Selftolerance to CYP2D6 was broken in Ad-2D6-infected mice, resulting in persistent autoimmune liver damage, apparent by cellular infiltration, hepatic fibrosis and necrosis. Similar to type 2 AIH patients, Ad-2D6-infected mice generated LKM-1-like antibodies recognizing the same immunodominant epitope of CYP2D6. Taken together, we could introduce a new animal model that reflects the persistent autoimmune-mediated liver damage as well as the serological marker characteristic for AIH type 2 and we could demonstrate that chronic autoimmune diseases targeting the liver can be triggered by molecular mimicry occurring in the context of a hepatotropic viral infection.