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

Autoimmune Hepatitis: Pathophysiology

Zhou Yuming  1 , Tang Ruqi  1 , Merrill Eric Gershwin  2 , Ma Xiong  3
Affiliations
Review

Autoimmune Hepatitis: Pathophysiology

Zhou Yuming et al. Clin Liver Dis. 2024 Feb.

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.

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