Are Transient Environmental Agents Involved in the Aetiology of Primary Biliary Cirrhosis?

Recently a space-time clustering analysis of cases of primary biliary cirrhosis (PBC) was carried out, using population-based data from a defined geographical region of northeast England. Space-time clustering analysis is a specialised descriptive statistical technique and is observed when excess cases are found in highly localised geographical areas for very limited periods of time. The analyses revealed the presence of highly statistically significant space-time clustering which could not be attributed to an artefactual occurrence. This finding was interpreted as providing supportive evidence for the involvement of transient environmental agents in aetiology [1]. This Special Issue of Disease Markers is dedicated to PBC and specifically the role that transient environmental factors may play in aetiology. Current knowledge is reviewed by seven selected invited experts (and associates) in the field. The aetiology of PBC is far from clear. In this Special Issue of Disease Markers, the role of transient environmental agents is reviewed by the seven invited contributors. They each provide their own perspective to the ongoing debate. The possibility that the putative transient agent might be an infection is considered by some of the reviewers. Epidemiological studies have indicated that infections may either trigger PBC or lead to progression. Reviewers also examine the putative role of other transient environmental factors, including chemical exposures, contaminated drinking water and lifestyle factors.