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Advances in immunological treatment of autoimmune hepatitis
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摘要:
近年来自身免疫性肝炎(AIH)以其独特的临床和病理学特征,受到越来越多的关注。但目前其发病率和临床特征仍不十分清楚,尚需对其进行系统深入的研究。探讨了AIH的流行病学、病因和发病机制、临床特征及其诊断和治疗进展。指出TNFα中和性抗体、利妥昔单抗、全反式维甲酸和调节性T淋巴细胞移植在临床试验或AIH动物模型中均被证明对AIH有疗效。
Abstract:In recent years,autoimmune hepatitis( AIH) has attracted more and more attention due to its unique clinicopathological features. However,its incidence and clinical features remain unclear,and systematic and in-depth studies are still needed. This article reviews the epidemiology,etiology,pathogenesis,clinical features,and diagnosis and treatment of AIH and points out that clinical studies or animal models of AIH have proved the effects of TNF-α neutralizing antibody,rituximab,all-trans retinoic acid,and regulatory T cell transplantation in the treatment of AIH.
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Key words:
- hepatitis /
- autoimmune /
- immunology
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[1]CZAJA AJ.Rapidity of treatment response and outcome in type 1 autoimmune hepatitis[J].J Hepatol,2009,51(1):161-167. [2]European Association for the Study of the Liver.EASL clinical practice guidelines:autoimmune hepatitis[J].J Hepatol,2015,63(4):971-1004. [3]GRONBAEK L,VILSTRUP H,JEPSEN P.Autoimmune hepatitis in Denmark:incidence,prevalence,prognosis,and causes of death.A nationwide registry-based cohort study[J].J Hepatol,2014,60(3):612-617. [4]de BOER YS,van GERVEN NM,ZWIERS A,et al.Genomewide association study identifies variants associated with autoimmune hepatitis type 1[J].Gastroenterology,2014,147(2):443-452.e5. [5]FERRI S,LONGHI MS,de MOLO C,et al.A multifaceted imbalance of T cells with regulatory function characterizes type 1 autoimmune hepatitis[J].Hepatology,2010,52(3):999-1007. [6]YEOMAN AD,WESTBROOK RH,ZEN Y,et al.Prognosis of acute severe autoimmune hepatitis(AS-AIH):the role of corticosteroids in modifying outcome[J].J Hepatol,2014,61(4):876-882. [7]KIRSTEIN MM,METZLER F,GEIGER E,et al.Prediction of short-and long-term outcome in patients with autoimmune hepatitis[J].Hepatology,2015,62(5):1524-1535. [8]COUTO CA,BITTENCOURT PL,PIRTA G,et al.Antismooth muscle and antiactin antibodies are indirect markers of histological and biochemical activity of autoimmune hepatitis[J].Hepatology,2014,59(2):592-600. [9]de BOER YS,van NIEUWKERK CM,WITTE BI,et al.Assessment of the histopathological key features in autoimmune hepatitis[J].Histopathology,2015,66(3):351-362. [10]QIU D,WANG Q,WANG H,et al.Validation of the simplified criteria for diagnosis of autoimmune hepatitis in Chinese patients[J].J Hepatol,2011,54(2):340-347. [11]MANNS MP,LOHSE AW,VERGANI D.Autoimmune hepatitis——Update 2015[J].J Hepatol,2015,62(1 Suppl):s100-s111. [12]MANNS MP,WOYNAROWSKI M,KREISEL W,et al.Budesonide induces remission more effectively than prednisone in a controlled trial of patients with autoimmune hepatitis[J].Gastroenterology,2010,139(4):1198-1206. [13]ZACHOU K,GATSELIS N,PAPADAMOU G,et al.Mycophenolate for the treatment of autoimmune hepatitis:prospective assessment of its efficacy and safety for induction and maintenance of remission in a large cohort of treatment-naive patients[J].J Hepatol,2011,55(3):636-646. [14]CZAJA AJ.Current and prospective pharmacotherapy for autoimmune hepatitis[J].Expert Opin Pharmacother,2014,15(12):1715-1736. [15]KERKAR N,DUGAN C,RUMBO C,et al.Rapamycin successfully treats post-transplant autoimmune hepatitis[J].Am J Transplant,2005,5(5):1085-1089. [16]BRUNS H,MEINKEN C,SCHAUENBERG P,et al.Anti-TNF immunotherapy reduces CD8+T cell-mediated antimicrobial activity against Mycobacterium tuberculosis in humans[J].J Clin Invest,2009,119(5):1167-1177. [17]SCHRAMM C,SCHNEIDER A,MARX A,et al.Adalimumab could suppress the activity of non alcoholic steatohepatitis(NASH)[J].Z Gastroenterol,2008,46(12):1369-1371. [18]NAKAYAMA S.Autoimmune hepatitis triggered by anti-TNF-alpha therapy[J].Case Rep Med,2013,2013:561748. [19]BOETTICHER NC,PEINE CJ,KWO P,et al.A randomized,double-blinded,placebo-controlled multicenter trial of etanercept in the treatment of alcoholic hepatitis[J].Gastroenterology,2008,135(6):1953-1960. [20]WEILER-NORMANN C,SCHRAMM C,QUAAS A,et al.Infliximab as a rescue treatment in difficult-to-treat autoimmune hepatitis[J].J Hepatol,2013,58(3):529-534. [21]CAREY EJ,SOMARATNE K,RAKELA J.Successful rituximab therapy in refractory autoimmune hepatitis and Evans syndrome[J].Rev Med Chil,2011,139(11):1484-1487. [22]BARTH E,CLAWSON J.A case of autoimmune hepatitis treated with rituximab[J].Case Rep Gastroenterol,2010,4(3):502-509. [23]BURAK KW,SWAIN MG,SANTODOMINGO-GARZON T,et al.Rituximab for the treatment of patients with autoimmune hepatitis who are refractory or intolerant to standard therapy[J].Can J Gastroenterol,2013,27(5):273-280. [24]TAUBERT R,HARDTKE-WOLENSKI M,NOYAN F,et al.Intrahepatic regulatory T cells in autoimmune hepatitis are associated with treatment response and depleted with current therapies[J].J Hepatol,2014,61(5):1106-1114. [25]GRANT CR,LIBERAL R,HOLDER BS,et al.Dysfunctional CD39(POS)regulatory T cells and aberrant control of T-helper type 17 cells in autoimmune hepatitis[J].Hepatology,2014,59(3):1007-1015. [26]HOLDER BS,GRANT CR,LIBERAL R,et al.Retinoic acid stabilizes antigen-specific regulatory T-cell function in autoimmune hepatitis type 2[J].J Autoimmun,2014,53:26-32. [27]LAPIERRE P,BELAND K,YANG R,et al.Adoptive transfer of ex vivo expanded regulatory T cells in an autoimmune hepatitis murine model restores peripheral tolerance[J].Hepatology,2013,57(1):217-227. [28]LONGHI MS,LIBERAL R,HOLDER B,et al.Inhibition of interleukin-17 promotes differentiation of CD25(-)cells into stable T regulatory cells in patients with autoimmune hepatitis[J].Gastroenterology,2012,142(7):1526-1535.e6. [29]ZHANG H,LIU Y,BIAN Z,et al.The critical role of myeloidderived suppressor cells and FXR activation in immune-mediated liver injury[J].J Autoimmun,2014,53:55-66. -
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