Autoimmune Hepatitis: Pathophysiology

Zhou Yuming; Tang Ruqi; Merrill Eric Gershwin; Ma Xiong

doi:10.1016/j.cld.2023.06.003

Autoimmune Hepatitis: Pathophysiology

Clin Liver Dis. 2024 Feb;28(1):15-35. doi: 10.1016/j.cld.2023.06.003. Epub 2023 Aug 12.

Authors

Zhou Yuming¹, Tang Ruqi¹, Merrill Eric Gershwin², Ma Xiong³

Affiliations

¹ Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, NHC Key Laboratory of Digestive Diseases, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, 145 Middle Shandong Road, Shanghai, China.
² Division of Rheumatology, Department of Medicine, Allergy and Clinical Immunology, University of California at Davis, 451 Health Sciences Drive, Suite 6510, Davis, CA 95616, USA. Electronic address: megershwin@ucdavis.edu.
³ Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, NHC Key Laboratory of Digestive Diseases, State Key Laboratory for Oncogenes and Related Genes, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Institute of Digestive Disease, 145 Middle Shandong Road, Shanghai, China; Institute of Aging & Tissue Regeneration, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China. Electronic address: maxiongmd@hotmail.com.

PMID: 37945156
DOI: 10.1016/j.cld.2023.06.003

Abstract

Genome-wide association analyses suggest that HLA genes including HLA-DRB*0301, HLA-DRB*0401, and HLA-B*3501 as well as non-HLA genes including CD28/CTLA4/ICOS and SYNPR increased AIH susceptibility. The destruction of hepatocytes is the result of the imbalance between proinflammatory cells and immunosuppressive cells, especially the imbalance between Tregs and Th17 cells. The microbiome in patients with AIH is decreased in diversity with a specific decline in Bifidobacterium and enrichment in Veillonella and Faecalibacterium. Recent evidence has demonstrated the pathogenic role of E. gallinarum and L.reuteri in inducing autoimmunity in the liver.

Keywords: Autoantibodies; Autoimmune hepatitis; Autoimmunity; Immune regulation; Microbiome; Molecular mimicry; T cells.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Autoimmunity
Genome-Wide Association Study
Hepatitis, Autoimmune*
Humans
Immunosuppressive Agents

Substances

Immunosuppressive Agents