Autoimmune Hepatitis: Progress from Global Immunosuppression to Personalised Regulatory T Cell Therapy
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 effect...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2016/7181685 |
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| author | Nwe Ni Than Hannah C. Jeffery Ye H. Oo |
| author_facet | Nwe Ni Than Hannah C. Jeffery Ye H. Oo |
| author_sort | Nwe Ni Than |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-fb5d973ec9374fe89a2c9bcb3724bc84 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-fb5d973ec9374fe89a2c9bcb3724bc842025-02-03T06:13:25ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972016-01-01201610.1155/2016/71816857181685Autoimmune Hepatitis: Progress from Global Immunosuppression to Personalised Regulatory T Cell TherapyNwe Ni Than0Hannah C. Jeffery1Ye H. Oo2Centre for Liver Research and NIHR Liver BRU, University of Birmingham, Edgbaston, Birmingham B15 2TT, UKCentre for Liver Research and NIHR Liver BRU, University of Birmingham, Edgbaston, Birmingham B15 2TT, UKCentre for Liver Research and NIHR Liver BRU, University of Birmingham, Edgbaston, Birmingham B15 2TT, UKAutoimmune 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.http://dx.doi.org/10.1155/2016/7181685 |
| spellingShingle | Nwe Ni Than Hannah C. Jeffery Ye H. Oo Autoimmune Hepatitis: Progress from Global Immunosuppression to Personalised Regulatory T Cell Therapy Canadian Journal of Gastroenterology and Hepatology |
| title | Autoimmune Hepatitis: Progress from Global Immunosuppression to Personalised Regulatory T Cell Therapy |
| title_full | Autoimmune Hepatitis: Progress from Global Immunosuppression to Personalised Regulatory T Cell Therapy |
| title_fullStr | Autoimmune Hepatitis: Progress from Global Immunosuppression to Personalised Regulatory T Cell Therapy |
| title_full_unstemmed | Autoimmune Hepatitis: Progress from Global Immunosuppression to Personalised Regulatory T Cell Therapy |
| title_short | Autoimmune Hepatitis: Progress from Global Immunosuppression to Personalised Regulatory T Cell Therapy |
| title_sort | autoimmune hepatitis progress from global immunosuppression to personalised regulatory t cell therapy |
| url | http://dx.doi.org/10.1155/2016/7181685 |
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