Autoimmune Hepatitis-Immunologically Triggered Liver Pathogenesis-Diagnostic and Therapeutic Strategies

被引:121
作者
Sucher, Elisabeth [1 ]
Sucher, Robert [2 ]
Gradistanac, Tanja [3 ]
Brandacher, Gerald [4 ]
Schneeberger, Stefan [5 ]
Berg, Thomas [1 ]
机构
[1] Univ Clin Leipzig, Div Hepatol, Clin & Polyclin Gastroenterol Hepatol Infectiol &, Leipzig, Germany
[2] Univ Clin Leipzig, Dept Visceral Transplant Thorac & Vasc Surg, Div Hepatobiliary Surg & Visceral Transplant Surg, Leipzig, Germany
[3] Univ Clin Leipzig, Dept Pathol, Leipzig, Germany
[4] Johns Hopkins Univ, Dept Plast & Reconstruct Surg, Vascularized Composite Allotransplantat VCA Lab, Baltimore, MD USA
[5] Univ Clin Innsbruck, Dept Visceral Transplant & Thorac Surg, Tyrol, Austria
关键词
CHRONIC ACTIVE HEPATITIS; PRIMARY BILIARY-CIRRHOSIS; MICROSOMAL ANTIBODY TYPE-1; REGULATORY T-CELLS; DE-NOVO; URSODEOXYCHOLIC ACID; CLINICAL-FEATURES; JAPANESE PATIENTS; OVERLAP SYNDROME; CONTROLLED-TRIAL;
D O I
10.1155/2019/9437043
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Autoimmune hepatitis (AIH) is a severe liver disease that arises in genetically predisposed male and female individuals worldwide. Diagnosis of AIH is made clinically applying diagnostic scores; however, the heterotopic disease phenotype often makes a rapid determination of disease challenging. AIH responds favorably to steroids and pharmacologic immunosuppression, and liver transplantation is only necessary in cases with acute liver failure or end-stage liver cirrhosis. Recurrence or development of de novo AIH after transplantation is possible, and treatment is similar to standard AIH therapy. Current experimental investigations of T cell-mediated autoimmune pathways and analysis of changes within the intestinal microbiome might advance our knowledge on the pathogenesis of AIH and trigger a spark of hope for novel therapeutic strategies.
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页数:19
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