If I read this correctly, it merely indicates that extracellular ALA may
provoke a certain form of autoimmunity in individuals (mostly women)
already at risk for it.  While this would certainly seem to
contraindicate it for this subset of the population, they're a long way
from proving that ALA can provoke the condition in a general, healthy
population.  This risk may not be fully genetically determined either
but rather may have to do with prior exposure to infectious organisms
and their foreign chemistry.

Does anyone know if propylene glycol falls into the list of suspect
chemicals?  It mentions polyethylene glycol (PEG).  Are the two similar
enough?

People have been taking large doses of ALA for a while now.  I'd expect
a simple statistical survey to reveal an increase in risk for
antimitochondrial antibody diseases.  To my knowledge ALA isn't
implicated in any type of liver failure.  If I'm not mistaken, haven't
the biggest problems been with hypoglycemia and biotin?

Of course, I'm not a youngster into all sorts of freaky things like
6-bromohexanoate bovine serum albumin conjugate mainlining, so the risk
may be greater than I think.

FYI, this doesn't seem to be the first paper these individuals have
published on the topic.

J Immunol. 2003 May 15;170(10):5326-32. Related Articles, Links
   Click here to read
   Immunization with a xenobiotic 6-bromohexanoate bovine serum albumin
conjugate induces antimitochondrial antibodies.

   Leung PS, Quan C, Park O, Van de Water J, Kurth MJ, Nantz MH, Ansari
AA, Coppel RL, Lam KS, Gershwin ME.

   Division of Rheumatology, Allergy and Clinical Immunology, School of
Medicine, University of California, Davis, CA 95616, USA.

   The E2 subunit of pyruvate dehydrogenase complex (PDC-E2) is the
major autoantigen recognized by antimitochondrial Abs (AMA) in primary
biliary cirrhosis (PBC). Recently, we replaced the lipoic acid moiety of
PDC-E2 with a battery of synthetic structures designed to mimic a
xenobiotically modified lipoyl hapten on a 12-aa peptide that was found
within the immunodominant autoepitope of PDC-E2 and demonstrated that
AMA in PBC reacted against several organic modified mimotopes as well
as, or sometimes significantly better than, the native lipoyl domain.
Based on this data, we immunized rabbits with one such xenobiotic
organic compound, 6-bromohexanoate, coupled to BSA. One hundred percent
of immunized rabbits developed AMA that have each and every
characteristic of human AMAs with reactivity against PDC-E2, E2 subunit
of branched chain 2-oxo-acid dehydrogenase, and E2 subunit of
2-oxoglutarate dehydrogenase complex. The rabbit AMA also inhibited
enzymatic function of PDC-E2 and, importantly, binds to peptide
sequences not present in the xenobiotic carrier immunogen. In contrast,
BSA-immunized controls did not produce such activity. Our observation
that animals immunized with a xenobiotic BSA complex produce
autoantibodies that react not only with the xenobiotic, but also with
mitochondrial autoantigens recognized by autoimmune PBC sera, suggests
that environmental xenobiotic agents can be a risk factor for the
induction of PBC.

   PMID: 12734383 [PubMed - indexed for MEDLINE

Autoimmun Rev. 2002 Feb;1(1-2):37-42. Related Articles, Links
   Click here to read
   Antimitochondrial antibodies in primary biliary cirrhosis: the role
of xenobiotics.

   Long SA, Van de Water J, Gershwin ME.

   Division of Rheumatology, Allergy and Clinical Immunology,
University of California at Davis School of Medicine, TB 192, One
Shields Avenue, Davis, CA 95616, USA.

   Primary biliary cirrhosis is an enigmatic autoimmune disease of
women characterized by antimitochondrial antibodies and destruction of
intrahepatic bile ducts. The etiology of PBC is unknown, but we present
data herein that the disease may be induced by xenobiotic (i.e.
chemicals) exposure. In particular, we postulate that halogenated
compounds will bind to the autoantigen, break tolerance, and lead to an
intense mucosal response.

   Publication Types:

       * Review
       * Review, Tutorial

   PMID: 12849056 [PubMed - indexed for MEDLINE]