Association Between Black Race and Presentation and Liver-Related Outcomes of Patients With Autoimmune Hepatitis

Boer, Ynto S. de; Gerussi, Alessio; Brand, Floris F. van den; Wong, Guan-Wee; Halliday, Neil; Liberal, Rodrigo; Drenth, Joost P.H.; Thorburn, Douglas; Bouma, Gerd; Gerven, Nicole M. van; Beuers, Ulrich; Erpecum, Karel J. van; Buuren, Henk R. van; Ouden, Jannie W. den; Brouwer, J.T.; Vrolijk, Jan Maarten; Verdonk, Robert C.; Hoek, Bart van; Koek, Ger H.; Guichelaar, Maureen M. J.; Bloemena, Elisabeth; Nieuwkerk, C.M.J. van; Schreuder, T.C.M.A.; Wouden, E.J. van der; Meyel, J. J. M. Van; Baak, Lubbertus C.; Stadhouders, P.H.G.M.; Klemt-Kropp, Michael; Verhagen, M. A. M. T.; Bhalla, Anshul; Kuijvenhoven, Johan; Heneghan, Michael A.

doi:10.1016/j.cgh.2018.11.028

Cited by 31 publications

(33 citation statements)

References 32 publications

(38 reference statements)

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“…Type 1 AIH is defined by the presence of antinuclear antibodies (ANAs) and/or anti-smooth muscle antibodies (SMAs), while type 2 AIH is defined by the presence of anti-liver-kidney microsomal 1 (LKM-1) antibody and/or antiliver cytosol type 1 (LC1) antibody (23,24). The pathogenesis of AIH is complicated and unclear, but it likely involves environmental factors (25), genetic factors, epigenetic factors (26,27), and a dynamic immunological microenvironment (28). It is widely accepted that both the initiation of the selfattack and the subsequent dysregulation of the immune system in the liver microenvironment contribute to the progressive process of liver damage.…”

Section: Aih: Current Research Statusmentioning

confidence: 99%

Regulatory T Cells in Autoimmune Hepatitis: Unveiling Their Roles in Mouse Models and Patients

et al. 2020

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Autoimmune hepatitis (AIH) is a severe and chronic liver disease, and its incidence has increased worldwide in recent years. Research into the pathogenesis of AIH remains limited largely owing to the lack of suitable mouse models. The concanavalin A (ConA) mouse model is a typical and well-established model used to investigate T cell-dependent liver injury. However, ConA-induced hepatitis is acute and usually disappears after 48 h; thus, it does not mimic the pathogenesis of AIH in the human body. Several studies have explored various AIH mouse models, but as yet there is no widely accepted and valid mouse model for AIH. Immunosuppression is the standard clinical therapy for AIH, but patient side effects and recurrence limit its use. Regulatory T cells (Tregs) play critical roles in the maintenance of immune homeostasis and in the prevention of autoimmune diseases, which may provide a potential therapeutic target for AIH therapy. However, the role of Tregs in AIH has not yet been clarified, partly because of difficulties in diagnosing AIH and in collecting patient samples. In this review, we discuss the studies related to Treg in various AIH mouse models and patients with AIH and provide some novel insights for this research area.

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Section: Aih: Current Research Statusmentioning

confidence: 99%

Regulatory T Cells in Autoimmune Hepatitis: Unveiling Their Roles in Mouse Models and Patients

et al. 2020

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“…In a single‐center study from the United States, black patients were more likely to present with liver failure compared with nonblack patients . Furthermore, a recent multicenter study showed that black patients with AIH presented at a younger age and had a greater risk of requiring LT when compared with white patients with AIH …”

Section: Epidemiologymentioning

confidence: 99%

“…(46) Furthermore, a recent multicenter study showed that black patients with AIH presented at a younger age and had a greater risk of requiring LT when compared with white patients with AIH. (47) Human leukocyte antigen (HLA) typing has been investigated in different populations with AIH. The…”

Section: Epidemiologymentioning

confidence: 99%

Acute Severe Autoimmune Hepatitis: Corticosteroids or Liver Transplantation?

et al. 2019

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Acute severe presentations of autoimmune hepatitis (AIH) represent a challenge for the transplant community. As a disease, it is poorly characterized, and there is a weak evidence base to guide diagnosis and treatment. Early identification of acute severe AIH is key because it determines the initiation of corticosteroids, which can be lifesaving. However, their use in this setting remains controversial. The Model for End‐Stage Liver Disease score, severity of coagulopathy, and grade of encephalopathy may be predictors of outcome with corticosteroid therapy. The optimal timing of liver transplantation (LT) can be difficult to determine and, as such, the decision to proceed to transplantation should not be delayed by protracted courses of corticosteroids. The aim of this review is to better characterize this subset of patients; to differentiate them clinically, serologically, and histologically from chronic AIH and other causes of acute liver failure; and to present the role, predictors, and optimal timings of corticosteroid therapy and LT. Although this review is specific to adults, many principles hold true for the pediatric population.

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“…The ALFSG showed that blacks were significantly more likely to present with idiosyncratic DILI compared with whites (24.4% versus 14.9%, P = 0.009) . Recent European studies have also demonstrated that black patients with AIH present with more severe liver injury and are more likely to require transplant or die during follow‐up . Prospective studies of idiosyncratic DILI have also suggested that black patients are more likely to have poorer clinical outcomes including higher short‐term mortality compared with whites .…”

Section: Wait‐list Outcomes Among Status 1 Patientsmentioning

confidence: 99%

“…(5) Recent European studies have also demonstrated that black patients with AIH present with more severe liver injury and are more likely to require transplant or die during follow-up. (6) Prospective studies of idiosyncratic DILI have also suggested that black patients are more likely to have poorer clinical outcomes including higher short-term mortality compared with whites. (7,8) The reasons for the poorer outcomes when controlling for disease etiology are unknown but could be mediated by genetic or immunological factors.…”

Section: Wait-list Outcomes Among Status 1 Patientsmentioning

confidence: 99%

A Decline in Status 1 Listings: The Impact of Etiology and Medical Management of Acute Liver Failure

Fontana

Durkalski

2019

Liver Transpl

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Association Between Black Race and Presentation and Liver-Related Outcomes of Patients With Autoimmune Hepatitis

Cited by 31 publications

References 32 publications

Regulatory T Cells in Autoimmune Hepatitis: Unveiling Their Roles in Mouse Models and Patients

Regulatory T Cells in Autoimmune Hepatitis: Unveiling Their Roles in Mouse Models and Patients

Acute Severe Autoimmune Hepatitis: Corticosteroids or Liver Transplantation?

A Decline in Status 1 Listings: The Impact of Etiology and Medical Management of Acute Liver Failure

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