Immunopathogenesis of Primary Biliary Cholangitis, Primary Sclerosing Cholangitis and Autoimmune Hepatitis: Themes and Concepts

被引:42
作者
Trivedi, Palak J. [1 ,2 ,3 ,7 ]
Hirschfield, Gideon M. [4 ]
Adams, David H. [1 ,2 ]
Vierling, John M. [5 ,6 ]
机构
[1] Univ Birmingham, Natl Inst Hlth Res, Ctr Liver & Gastrointestinal Res, Birmingham Biomed Res Ctr, Birmingham, England
[2] Univ Hosp Birmingham, Liver Unit, Birmingham, England
[3] Univ Birmingham, Inst Translat Med, Birmingham, England
[4] Univ Toronto, Toronto Ctr Liver Dis, Div Gastroenterol & Hepatol, Toronto, ON, Canada
[5] Baylor Coll Med, Dept Med, Sect Gastroenterol & Hepatol, Houston, TX USA
[6] Baylor Coll Med, Dept Surg, Div Abdominal Transplantat, Houston, TX USA
[7] Univ Birmingham, Birmingham, England
基金
英国惠康基金; “创新英国”项目;
关键词
Epidemiology; Genetics; Microbiome; Dysbiosis; Bile Acids; Tolerance; Homing; Fibrosis; Transplantation; INFLAMMATORY-BOWEL-DISEASE; REGULATORY T-CELLS; HELPER TYPE 17; D-RECEPTOR POLYMORPHISMS; GENOME-WIDE ASSOCIATION; NATURAL-KILLER-CELLS; FARNESOID-X-RECEPTOR; BILE-ACID; LIVER-DISEASE; GUT MICROBIOTA;
D O I
10.1053/j.gastro.2024.01.049
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Autoimmune liver diseases include primary biliary cholangitis, primary sclerosing cholangitis, and autoimmune hepatitis, a family of chronic immune-mediated disorders that target hepatocytes and cholangiocytes. Treatments remain nonspecific, variably effective, and noncurative, and the need for liver transplantation is disproportionate to their rarity. Development of effective therapies requires better knowledge of pathogenic mechanisms, including the roles of genetic risk, and how the environment and gut dysbiosis cause immune cell dysfunction and aberrant bile acid signaling. This review summarizes key etiologic and pathogenic concepts and themes relevant for clinical practice and how such learning can guide the development of new therapies for people living with autoimmune liver diseases.
引用
收藏
页码:995 / 1019
页数:25
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