VIDEO: Underlying cause of PBC remains unknown despite genetic insights

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It arises in people for a number of reasons. One is their own genetic risk of developing autoimmunity, and then a environmental trigger, and then some kind of localization to the small bile ducts, the biliary epithelium. So the way I think about it is someone is predisposed, and that predisposition is in genes that make them more immunoreactive, and the genome studies have found that to be HLA, IL-12, STAT4, other signaling pathways, and then some kind of trigger environmentally, presumably expressed in the bile ducts, and then it comes together and that individual then basically loses the ability or so-called loses tolerance against the biliary epithelium and you get a lymphocytic cholangitis. And that to me is that the idea of genes and environment is where I see PBC coming from. We don't know the cause. That is still a major problem when we treat patients.