新型无创技术在指导自身免疫性肝炎诊疗中的作用

刘怀鄂; 钱建丹; 张驰; 刘艺琪; 李志; 赵鸿; 王贵强

doi:10.3969/j.issn.1001-5256.2022.04.034

新型无创技术在指导自身免疫性肝炎诊疗中的作用

DOI: 10.3969/j.issn.1001-5256.2022.04.034

刘怀鄂^{1, 2},
钱建丹¹,
张驰¹,
刘艺琪¹,
李志¹,
赵鸿^1, , ,,
王贵强^{1, 3, , ,}

1.
北京大学第一医院感染性疾病科，北京 100034
2.
昆明医科大学第一附属医院感染性疾病科，昆明 650032
3.
北京大学国际医院感染性疾病科，北京 100034

基金项目:

云南省高层次卫生人才项目 (H-2017071);

云南省教育厅科学研究基金项目 (2021J0239)

利益冲突声明：所有作者均声明不存在利益冲突。

作者贡献声明: 刘怀鄂负责文献检索及文章撰写; 钱建丹、张弛、刘艺琪、李志负责文献的查找与总结; 赵鸿、王贵强负责文章修改及审定。

详细信息

通信作者:
赵鸿，zhaohong_pufh@btmu.edu.cn

王贵强，john131212@sina.com

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- 被引次数: 0
出版历程
- 收稿日期: 2021-07-29
- 出版日期: 2022-04-20

Role of new noninvasive methods in guiding the diagnosis and treatment of autoimmune hepatitis

Huaie LIU^{1, 2},
Jiandan QIAN¹,
Chi ZHANG¹,
Yiqi LIU¹,
Zhi LI¹,
Hong ZHAO^{1
, ,
,},
Guiqiang WANG^{1, 3
, ,
,}

1.
Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China
2.
Department of Infectious Diseases, The First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
3.
Department of Infectious Diseases, Peking University International Hospital, Beijing 100034, China

Research funding:

Yunnan Province High-level Health Talent Project (H-2017071);

Yunnan Provincial Department of Education Research Fund (2021J0239)

More Information

Corresponding author: ZHAO Hong, zhaohong_pufh@btmu.edu.cn(ORCID: 0000-0002-8069-9901); WANG Guiqiang, john131212@sina.com(ORCID: 0000-0002-0317-7536)

摘要

摘要: 自身免疫性肝炎(AIH)是由自身免疫反应介导的肝脏炎症性疾病。准确评估肝脏炎症进展程度，筛选需要皮质类固醇治疗的患者，评价治疗效果，在AIH的诊疗过程中具有重要意义。本文介绍了近年来临床和实验研究中发现的多种具有潜在评估AIH进展程度价值的新型无创技术，并简述了各项技术的优缺点。总结了新型的无创技术在指导AIH的皮质类固醇诊疗过程中具有更多优势，但仍需进一步开展临床研究验证。
- 肝炎, 自身免疫性 /
- 诊断 /
- 治疗学
Abstract: Autoimmune hepatitis (AIH) is an inflammatory disease of the liver mediated by autoimmune response, and in the diagnosis and treatment of AIH, it is of great importance to accurately assess the progression of liver inflammation, screen out the patients requiring corticosteroid therapy, and evaluate the therapeutic outcome. This article introduces a variety of new noninvasive techniques which have been discovered by clinical and experimental studies in recent years and have the potential to evaluate the progression of AIH, as well as the advantages and disadvantages of each technique. It is concluded that the new noninvasive techniques have more advantages in guiding the corticosteroid therapy for AIH, but further clinical studies are still needed for verification.
- Hepatitis, Autoimmune /
- Diagnosis /
- Therapeutics

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参考文献(40)

[1]	GRØNBÆK 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. DOI: 10.1016/j.jhep.2013.10.020.
[2]	BISCHOFF S, YESMEMBETOV K, ANTONI C, et al. Autoimmune Hepatitis: A review of established and evolving treatments[J]. J Gastrointestin Liver Dis, 2020, 29(3): 429-443. DOI: 10.15403/jgld-2667.
[3]	European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Autoimmune hepatitis[J]. J Hepatol, 2015, 63(4): 971-1004. DOI: 10.1016/j.jhep.2015.06.030.
[4]	MACK CL, ADAMS D, ASSIS DN, et al. Diagnosis and management of autoimmune hepatitis in adults and children: 2019 practice guidance and guidelines from the American Association for the Study of Liver Diseases[J]. Hepatology, 2020, 72(2): 671-722. DOI: 10.1002/hep.31065.
[5]	WANG G, TANAKA A, ZHAO H, et al. The Asian Pacific Association for the Study of the Liver clinical practice guidance: The diagnosis and management of patients with autoimmune hepatitis[J]. Hepatol Int, 2021, 15(2): 223-257. DOI: 10.1007/s12072-021-10170-1.
[6]	YEOMAN AD, WESTBROOK RH, ZEN Y, et al. Early predictors of corticosteroid treatment failure in icteric presentations of autoimmune hepatitis[J]. Hepatology, 2011, 53(3): 926-934. DOI: 10.1002/hep.24141.
[7]	van GERVEN NM, VERWER BJ, WITTE BI, et al. Relapse is almost universal after withdrawal of immunosuppressive medication in patients with autoimmune hepatitis in remission[J]. J Hepatol, 2013, 58(1): 141-147. DOI: 10.1016/j.jhep.2012.09.009.
[8]	DIESTELHORST J, JUNGE N, JONIGK D, et al. Baseline IL-2 and the AIH score can predict the response to standard therapy in paediatric autoimmune hepatitis[J]. Sci Rep, 2018, 8(1): 419. DOI: 10.1038/s41598-017-18818-5.
[9]	ROUAS R, FAYYAD-KAZAN H, EL ZEIN N, et al. Human natural Treg microRNA signature: Role of microRNA-31 and microRNA-21 in FOXP3 expression[J]. Eur J Immunol, 2009, 39(6): 1608-1618. DOI: 10.1002/eji.200838509.
[10]	LIU Y, CHEN H, HAO J, et al. Characterization and functional prediction of the microRNAs differentially expressed in a mouse model of concanavalin A-induced autoimmune hepatitis[J]. Int J Med Sci, 2020, 17(15): 2312-2327. DOI: 10.7150/ijms.47766.
[11]	TU H, CHEN D, CAI C, et al. MicroRNA-143-3p attenuated development of hepatic fibrosis in autoimmune hepatitis through regulation of TAK1 phosphorylation[J]. J Cell Mol Med, 2020, 24(2): 1256-1267. DOI: 10.1111/jcmm.14750.
[12]	MIGITA K, KOMORI A, KOZURU H, et al. Circulating microRNA profiles in patients with type-1 autoimmune hepatitis[J]. PLoS One, 2015, 10(11): e0136908. DOI: 10.1371/journal.pone.0136908.
[13]	CZAJA AJ. Emerging therapeutic biomarkers of autoimmune hepatitis and their impact on current and future management[J]. Expert Rev Gastroenterol Hepatol, 2018, 12(6): 547-564. DOI: 10.1080/17474124.2018.1453356.
[14]	KUNO A, IKEHARA Y, TANAKA Y, et al. A serum "sweet-doughnut" protein facilitates fibrosis evaluation and therapy assessment in patients with viral hepatitis[J]. Sci Rep, 2013, 3: 1065. DOI: 10.1038/srep01065.
[15]	URA K, FURUSYO N, OGAWA E, et al. Serum WFA(+) -M2BP is a non-invasive liver fibrosis marker that can predict the efficacy of direct-acting anti-viral-based triple therapy for chronic hepatitis C[J]. Aliment Pharmacol Ther, 2016, 43(1): 114-124. DOI: 10.1111/apt.13431.
[16]	UMEMURA T, JOSHITA S, SEKIGUCHI T, et al. Serum wisteria floribunda agglutinin-positive mac-2-binding protein level predicts liver fibrosis and prognosis in primary biliary cirrhosis[J]. Am J Gastroenterol, 2015, 110(6): 857-864. DOI: 10.1038/ajg.2015.118.
[17]	NISHIKAWA H, ENOMOTO H, IWATA Y, et al. Clinical significance of serum Wisteria floribunda agglutinin positive Mac-2-binding protein level and high-sensitivity C-reactive protein concentration in autoimmune hepatitis[J]. Hepatol Res, 2016, 46(7): 613-621. DOI: 10.1111/hepr.12596.
[18]	BONGARZONE S, SAVICKAS V, LUZI F, et al. Targeting the Receptor for Advanced Glycation Endproducts (RAGE): A medicinal chemistry perspective[J]. J Med Chem, 2017, 60(17): 7213-7232. DOI: 10.1021/acs.jmedchem.7b00058.
[19]	HUDSON BI, LIPPMAN ME. Targeting RAGE signaling in inflammatory disease[J]. Annu Rev Med, 2018, 69: 349-364. DOI: 10.1146/annurev-med-041316-085215.
[20]	WU R, LIU Y, YAN R, et al. Assessment of EN-RAGE, sRAGE and EN-RAGE/sRAGE as potential biomarkers in patients with autoimmune hepatitis[J]. J Transl Med, 2020, 18(1): 384. DOI: 10.1186/s12967-020-02556-w.
[21]	CHEN YY, JEFFERY HC, HUNTER S, et al. Human intrahepatic regulatory T cells are functional, require IL-2 from effector cells for survival, and are susceptible to Fas ligand-mediated apoptosis[J]. Hepatology, 2016, 64(1): 138-150. DOI: 10.1002/hep.28517.
[22]	HUANG H, DENG Z. Adoptive transfer of regulatory T cells stimulated by Allogeneic Hepatic Stellate Cells mitigates liver injury in mice with concanavalin A-induced autoimmune hepatitis[J]. Biochem Biophys Res Commun, 2019, 512(1): 14-21. DOI: 10.1016/j.bbrc.2019.02.147.
[23]	MATAKI N, KIKUCHI K, KAWAI T, et al. Expression of PD-1, PD-L1, and PD-L2 in the liver in autoimmune liver diseases[J]. Am J Gastroenterol, 2007, 102(2): 302-312. DOI: 10.1111/j.1572-0241.2006.00948.x.
[24]	XIONG KG, KE KY, CHEN LF, et al. The relationship between programmed death 1 and inflammatory response in autoimmune hepatitis[J]. Chin J Hepatol, 2017, 25(4): 263-267. DOI: 10.3760/cma.j.issn.1007-3418.2017.04.006. 熊克宫, 柯坤宇, 陈丽芳, 等. 自身免疫性肝炎患者肝内程序性死亡受体1高表达与肝脏炎症活动相关[J]. 中华肝脏病杂志, 2017, 25(4): 263-267. DOI: 10.3760/cma.j.issn.1007-3418.2017.04.006.
[25]	AGINA HA, EHSAN NA, ABD-ELAZIZ TA, et al. Hepatic expression of programmed death-1 (PD-1) and its ligand, PD-L1, in children with autoimmune hepatitis: Relation to treatment response[J]. Clin Exp Hepatol, 2019, 5(3): 256-264. DOI: 10.5114/ceh.2019.87642.
[26]	AARSLEV K, DIGE A, GREISEN SR, et al. Soluble programmed death-1 levels are associated with disease activity and treatment response in patients with autoimmune hepatitis[J]. Scand J Gastroenterol, 2017, 52(1): 93-99. DOI: 10.1080/00365521.2016.1233576.
[27]	MATSUMOTO K, MIYAKE Y, MATSUSHITA H, et al. Anti-programmed cell death-1 antibody as a new serological marker for type 1 autoimmune hepatitis[J]. J Gastroenterol Hepatol, 2014, 29(1): 110-115. DOI: 10.1111/jgh.12340.
[28]	BREWER S, NAIR-GILL E, WEI B, et al. Epithelial uptake of[18F]1-(2'-deoxy-2'-arabinofuranosyl) cytosine indicates intestinal inflammation in mice[J]. Gastroenterology, 2010, 138(4): 1266-1275. DOI: 10.1053/j.gastro.2010.01.003.
[29]	SALAS JR, CHEN BY, WONG A, et al. (18)F-FAC PET selectively images liver-infiltrating CD4 and CD8 T Cells in a mouse model of autoimmune hepatitis[J]. J Nucl Med, 2018, 59(10): 1616-1623. DOI: 10.2967/jnumed.118.210328.
[30]	European Association for Study of Liver; Asociacion Latinoamericana para el Estudio del Higado. EASL-ALEH Clinical Practice Guidelines: Non-invasive tests for evaluation of liver disease severity and prognosis[J]. J Hepatol, 2015, 63(1): 237-264. DOI: 10.1016/j.jhep.2015.04.006.
[31]	YANG Q, LIU HE, YOU J, et al. Noninvasive diagnotisc models for chronic hepatitis B liver fibrosis[J]. J Clin Hepatol, 2021, 37(10): 113-117. DOI: 10.3969/j.issn.1001-5256.2021.10. 杨琴, 刘怀鄂, 游晶, 等. 慢性乙型肝炎肝纤维化的无创诊断模型[J]. 临床肝胆病杂志, 2021, 37(10): 113-117. DOI: 10.3969/j.issn.1001-5256.2021.10.
[32]	MAHMUD N, DOSHI SD, FORDE KA, et al. Transient elastography reliably estimates liver fibrosis in autoimmune hepatitis[J]. Clin Exp Hepatol, 2019, 5(3): 244-249. DOI: 10.5114/ceh.2019.87639.
[33]	WU S, YANG Z, ZHOU J, et al. Systematic review: Diagnostic accuracy of non-invasive tests for staging liver fibrosis in autoimmune hepatitis[J]. Hepatol Int, 2019, 13(1): 91-101. DOI: 10.1007/s12072-018-9907-5.
[34]	GUO L, ZHENG L, HU L, et al. Transient elastography (FibroScan) performs better than non-invasive markers in assessing liver fibrosis and cirrhosis in autoimmune hepatitis patients[J]. Med Sci Monit, 2017, 23: 5106-5112. DOI: 10.12659/msm.907300.
[35]	HARTL J, EHLKEN H, SEBODE M, et al. Usefulness of biochemical remission and transient elastography in monitoring disease course in autoimmune hepatitis[J]. J Hepatol, 2018, 68(4): 754-763. DOI: 10.1016/j.jhep.2017.11.020.
[36]	JANIK MK, KRUK B, SZCZEPANKIEWICZ B, et al. Measurement of liver and spleen stiffness as complementary methods for assessment of liver fibrosis in autoimmune hepatitis[J]. Liver Int, 2021, 41(2): 348-356. DOI: 10.1111/liv.14726.
[37]	LEFEBVRE T, WARTELLE-BLADOU C, WONG P, et al. Prospective comparison of transient, point shear wave, and magnetic resonance elastography for staging liver fibrosis[J]. Eur Radiol, 2019, 29(12): 6477-6488. DOI: 10.1007/s00330-019-06331-4.
[38]	MENDIZABAL M, MARCIANO S, VIDELA MG, et al. Fulminant presentation of autoimmune hepatitis: Clinical features and early predictors of corticosteroid treatment failure[J]. Eur J Gastroenterol Hepatol, 2015, 27(6): 644-648. DOI: 10.1097/MEG.0000000000000353.
[39]	ZIZZO AN, JIMENEZ-RIVERA C, KIM J, et al. A national retrospective study of paediatric end-stage liver disease as a predictor of change to second-line therapy in children with autoimmune hepatitis[J]. Liver Int, 2017, 37(10): 1562-1570. DOI: 10.1111/liv.13387.
[40]	BIEWENGA M, INDERSON A, TUSHUIZEN ME, et al. Early predictors of short-term prognosis in acute and acute severe autoimmune hepatitis[J]. Liver Transpl, 2020, 26(12): 1573-1581. DOI: 10.1002/lt.25906.