Autoimmune hepatitis
Autoimmune hepatitis
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DOI：
10.1016/s0140-6736(12)62163-1
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发表时间：
2013-10-26
期刊：
影响因子：
168.9
通讯作者：
Longhi, Maria Serena
中科院分区：
文献类型：
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作者：
Heneghan, Michael A.;Yeoman, Andrew D.;Longhi, Maria Serena
自身免疫性肝炎是一种肝实质疾病，可以急性或慢性形式出现。与许多自身免疫性疾病一样，自身免疫性肝炎与肝脏自身免疫背景下的非器官特异性抗体相关。尽管过去 8 年的数据引起了人们对调节性 T 细胞作用的关注，但这种二分法使得该疾病的病理生理学的统一假设的定义变得困难。已经确定了几种触发因素，并且这种疾病发生在遗传易感个体中。高达 85% 的病例可实现临床和生化缓解。对于其余患者，替代免疫抑制策略是一种选择。肝移植为患有急性肝功能衰竭或终末期肝病（包括肝细胞癌）并发症的患者提供了良好的结果。当出现意外的疾病特征时，变异或重叠的综合征值得考虑。
Autoimmune hepatitis is a disease of the hepatic parenchyma that can present in acute or chronic forms. In common with many autoimmune diseases, autoimmune hepatitis is associated with non-organ-specific antibodies in the context of hepatic autoimmunity. This dichotomy has made definition of a unifying hypothesis in the pathophysiology of the disease difficult, although data from the past 8 years have drawn attention to the role of regulatory T cells. Several triggers have been identified, and the disease arises in genetically susceptible individuals. Clinical and biochemical remission is achievable in up to 85% of cases. For the remaining patients, alternative immunosuppression strategies are an option. Liver transplantation provides an excellent outcome for patients with acute liver failure or complications of end-stage liver disease, including hepatocellular carcinoma. Variant or overlapping syndromes are worthy of consideration when unexpected disease features arise.