0724 Maternal microchimerism in biliary atresia

A previous summary in this series (2004/21) discussed the appearance of antibodies in the circulation years before clinical expression of various auto-immune diseases (e.g. thyroid, rheumatoid) and also covered data showing that in several cases pregnant women with gestational diabetes had diabetes-related antibodies and went on to develop type 1 diabetes. The above data might tie in with data presented in a recent article in the Journal of Pediatric Surgery that pertain to microchimerism, both foetal microchimerism persisting in mothers, and maternal microchimerism that might have implications for the neonate and beyond. Foetal cell lines persisting in mothers have been implicated in the development of auto-immune diseases along the lines of chronic graft-vs-host disease. One example of such disease is primary biliary cirrhosis, and high numbers of fetal Y chromosomes have been found in liver specimens from women with this disease. The reverse situation of maternal cell lines persisting in the neonate and causing auto-immune disease has been shown to occur with dermatomyositis, systemic sclerosis, and idiopathic myositis. Researchers in Japan studied liver specimens taken at the time of Kasai procedures in 6 boys and 11 girls. Controls had other forms of paediatric liver disease (e.g. neonatal hepatitis, Alagille’s syndrome). All the males had mixtures of XX and XY cells, and all the females had varying intensities of anti-maternal HLA antibodies. These results strongly suggest an immune component in the aetiopathogenesis of biliary atresia, but there is probably more to the association because microchimerism alone would not account for geographic variations in incidence of biliary atresia.

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Journal of Pediatric Surgery 2007; 42: 987-991
Am J Med Genet 2000; 91: 22-28
Trends Mol Med 2002; 8: 109-113