Current and novel immunosuppressive therapy for autoimmune hepatitis

Interleukin 22 (IL-22) plays a protective role in T cell-mediated murine hepatitis: IL-22 is a survival factor for hepatocytes via STAT3 activation

“…T cell activation has also been implicated in hepatocellular injury in autoimmune hepatitis and alcoholic liver disease. [5][6][7] It is therefore plausible that activated T cells may also play a protective role in these liver disorders by releasing IL-22. Additionally, we also demonstrate that hydrodynamic gene delivery of IL-22 protects the mouse liver from ConA, CCl 4 , and Fas ligand-induced injury, 47 thus, IL-22 potentially could be a therapeutic drug to treat liver diseases such as acute liver failure.…”

“…T he central role of T cell activation in hepatocellular injury in a variety of human liver disorders [1][2][3][4][5][6][7][8][9] and animal models 10,11 has been well documented. Evidence suggests that T cell-induced liver injury is mediated through multiple mechanisms, including cytolytic pathways (e.g., Fas, perforin) and the release of a wide variety of proinflammatory cytokines such as interferon ␥, tumor necrosis factor ␣, and interleukin (IL) 4.…”

“…Evidence suggests that T cell-induced liver injury is mediated through multiple mechanisms, including cytolytic pathways (e.g., Fas, perforin) and the release of a wide variety of proinflammatory cytokines such as interferon ␥, tumor necrosis factor ␣, and interleukin (IL) 4. [1][2][3][4][5][6][7][8][9][10][11] Conversely, activated T cells also produce anti-inflammatory cytokines such as IL-10 and antiapoptotic cytokines such as IL-6, suggesting that activated T cells may play an important role in repairing liver injury in addition to their central role in hepatocellular injury. 12,13 However, the protective role of T cells in controlling the progression of liver injury has largely been unexplored.…”

Diagnostic value and utility of the simplified International Autoimmune Hepatitis Group (IAIHG) criteria in acute and chronic liver disease

“…This has clinical relevance, because the early use of corticosteroids in this setting may improve outcome. [21][22][23][24][25][26][27][28] The application of the simplified and 1999 criteria to patients with FHF should, however, be interpreted with caution, because these criteria were not developed with this clinical presentation in mind, and their utility in this setting is studied for the first time in this report. Nonetheless, because the simplified criteria reported by the IAIHG aims to improve the diag-nosis of AIH at its initial presentation, it remains important not to ignore the small, but highly significant, proportion of patients with a fulminant course.…”

The management of childhood liver diseases in adulthood

“…Patients who fail azathioprine therapy or with refractory relapsing disease should be considered for treatment with mycophenolate mofetil, which can lead to remission in approximately 10% of children [101]. Calcineurin inhibitors (cyclosporine and tacrolimus) have also been used with good efficacy, but the data is limited to small numbers and limited long-term follow-up [102][103][104][105]. -Disease relapse.…”