A 40-year-old woman presents with an 8-month history of progressive generalized itching, weight loss, fatigue, and yellow sclera. Physical examination reveals mild jaundice.The antimitochondrial antibody test is positive. A liver biopsy discloses periductal inflammation and bile duct injury (shown in the image). Which of the following inflammatory cells is the principal mediator of destructive cholangitis in this patient?
Answer : C T lymphocytes
Primary biliary cirrhosis (PBC) is a chronic progressive cholestatic liver disease characterized by destruction of intrahepatic bile ducts (nonsuppurative destructive cholangitis).
PBC occurs principally in middle-aged women and is an autoimmune disease. Most patients with PBChave at least one other disease usually classed as autoimmune (e.g., thyroiditis, rheumatoid arthritis, scleroderma, Sjögren syndrome, or systemic lupus erythematosus).
More than 95% of patients with PBC have circulating antimitochondrialAntibodies.
The cells surrounding and infiltrating the sites of bile duct damage are predominantly suppressor/cytotoxic (CD8+) T lymphocytes, suggesting that they mediate the destruction of the ductal epithelium. Macrophages and B lymphocytes are associated with periductal inflammation but do not mediate epithelial cytotoxicity. Eosinophils have no role in primary immune-related mechanisms. The Other inflammatory cells do not participate in the pathogenesis of PBC.