Autoimmune Hepatitis: 2019 Update

Tanaka, Atsushi

doi:10.5009/gnl19261

Cited by 65 publications

(58 citation statements)

References 86 publications

(133 reference statements)

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“…Autoimmune hepatitis is an immune-mediated, chronic, inflammatory disease of the liver is characterized by circulating autoantibodies, hypergammaglobulinemia and distinctive features on liver biopsy [3] . AIH has a wide spectrum of clinical presentation and can vary from asymptomatic disease to liver failure.…”

Section: Discussionmentioning

confidence: 99%

Autoimmune Hepatitis–Primary Biliary Cholangitis Overlap Syndrome Triggered by COVID-19

Singh

Kaur

Maroules

2021

European Journal of Case Reports in Internal Medicine

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COVID-19, caused by severe acute respiratory syndrome coronavirus 2 infection, has caused the ongoing global pandemic. Initially considered a respiratory disease, it can manifest with a wide range of complications (gastrointestinal, neurological, thromboembolic and cardiovascular) leading to multiple organ dysfunction. A range of immune complications have also been described. We report the case of a 57-year-old man with a medical history of hypertension, prediabetes and beta thalassemia minor, who was diagnosed with COVID-19 and subsequently developed fatigue and arthralgias, and whose blood work showed hyperferritinemia, elevated liver enzymes (AST/ALT/GGT), hypergammaglobulinemia, anti-smooth muscle antibody, anti-mitochondrial antibody, and anti-double-stranded DNA antibodies. The patient was diagnosed with autoimmune hepatitis–primary biliary cholangitis overlap syndrome triggered by COVID-19. To our knowledge, this is the first such case reported.

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Section: Discussionmentioning

confidence: 99%

Autoimmune Hepatitis–Primary Biliary Cholangitis Overlap Syndrome Triggered by COVID-19

Singh

Kaur

Maroules

2021

European Journal of Case Reports in Internal Medicine

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“…Autoimmune diseases of the liver typically affect either the liver parenchyma, which is termed autoimmune hepatitis, or alternatively the bile ducts provoking primary biliary cholangitis (PBC) or primary sclerosing cholangitis (PSC) ( Weiskirchen, 2016 ). Immunosuppressive treatment consisting of either corticosteroids alone or in combination with the purine analog azathioprine is the recommended first-line medical treatment in autoimmune hepatitis ( Tanaka, 2020 ).…”

Section: Therapy Of Hepatic Fibrosismentioning

confidence: 99%

Cellular Mechanisms of Liver Fibrosis

et al. 2021

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The liver is a central organ in the human body, coordinating several key metabolic roles. The structure of the liver which consists of the distinctive arrangement of hepatocytes, hepatic sinusoids, the hepatic artery, portal vein and the central vein, is critical for its function. Due to its unique position in the human body, the liver interacts with components of circulation targeted for the rest of the body and in the process, it is exposed to a vast array of external agents such as dietary metabolites and compounds absorbed through the intestine, including alcohol and drugs, as well as pathogens. Some of these agents may result in injury to the cellular components of liver leading to the activation of the natural wound healing response of the body or fibrogenesis. Long-term injury to liver cells and consistent activation of the fibrogenic response can lead to liver fibrosis such as that seen in chronic alcoholics or clinically obese individuals. Unidentified fibrosis can evolve into more severe consequences over a period of time such as cirrhosis and hepatocellular carcinoma. It is well recognized now that in addition to external agents, genetic predisposition also plays a role in the development of liver fibrosis. An improved understanding of the cellular pathways of fibrosis can illuminate our understanding of this process, and uncover potential therapeutic targets. Here we summarized recent aspects in the understanding of relevant pathways, cellular and molecular drivers of hepatic fibrosis and discuss how this knowledge impact the therapy of respective disease.

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“…AIH manifests in all age groups, and its incidence has shown an increasing trend ( 20 ). The disease is now widely known as a consequence of immune tolerance breakdown, leading to an autoimmune response against hepatocytes that induces liver injury ( 21 ). AIH is divided into two main types based on the serological profiles of persistent autoantibodies ( 22 ).…”

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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Autoimmune Hepatitis: 2019 Update

Cited by 65 publications

References 86 publications

Autoimmune Hepatitis–Primary Biliary Cholangitis Overlap Syndrome Triggered by COVID-19

Autoimmune Hepatitis–Primary Biliary Cholangitis Overlap Syndrome Triggered by COVID-19

Cellular Mechanisms of Liver Fibrosis

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

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