Primary sclerosing cholangitis, autoimmune hepatitis and overlap syndromes in inflammatory bowel disease

Table 4 Evidence for the influence of immune mechanisms on the aetiology of PSC

Humoral immunity	Increased circulating immune complexes
	Elevated immunoglobulin levels (IgG and IgM)
	Low titres of non-organ specific autoantibodies (ANA and SMA)
	High titres of antineutrophil antibodies
	Autoantibodies to BEC surface antigens
Cell mediated immunity	Decreased levels of circulating peripheral CD8+ve Tcells
	Portal T cell and NK cell infiltrate
	Increased activated and memory T cells
	Restricted T cell receptor repertoire (Vβ3)
	Aberrant expression of HLA-DR on BEC
	Coexpression of costimulatory molecules and HLA-DR on BECs
	Increased circulating and tissue bound adhesion molecules
Immune effector mechanisms	Enhanced cytokine expression in the liver
Immunogenetic mechanisms	HLA associations