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2016 ; 2016
(ä): 7181685
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gab.com Text
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Autoimmune Hepatitis: Progress from Global Immunosuppression to Personalised
Regulatory T Cell Therapy
#MMPMID27446862
Than NN
; Jeffery HC
; Oo YH
Can J Gastroenterol Hepatol
2016[]; 2016
(ä): 7181685
PMID27446862
show ga
Autoimmune hepatitis (AIH) is an immune mediated liver injury. The precise
aetiology of AIH is still unknown but current evidence suggests both genetic and
environmental factors are involved. Breakdown in peripheral self-tolerance, and
impaired functions of FOXP3(+) regulatory T cell along with effector cell
resistance to suppression at the tissue level seem to play an important role in
AIH immunopathogenesis. AIH is predominantly a T lymphocytes driven disease but B
lymphocytes are also involved in the immunopathology. Innate immune cells are
crucial in the initial onset of disease and their response is followed by
adaptive T (Th1, Th17, and cytotoxic T cells) and B cell responses evidenced by
liver histology and peripheral blood serology. Standard treatment regimens
involving steroid and immunosuppressive medications lead to global immune
suppression requiring life-long therapy with many side effects. Biologic
therapies have been attempted but duration of remission is short-lived. Future
direction of diagnosis and treatment for AIH should be guided by "omics" and the
immunology profile of the individual patient and clinicians should aim to deliver
personalised medicine for their patients. Cell therapy such as infusion of
autologous, antigen-specific, and liver-homing regulatory T cells to restore
hepatic immune tolerance may soon be a potential future treatment for AIH
patients.