Autoimmune hepatitis: evolving concepts

Autoimmun Rev. 2004 Mar;3(3):207-14. doi: 10.1016/j.autrev.2003.09.003.

Abstract

The liver is continuously exposed to a large antigenic load that includes pathogens, toxins, tumor cells and dietary antigens. A loss of tolerance against its own antigens may result in autoimmune hepatitis (AIH). The current paradigm holds that the disease is the result of self-perpetuating autoimmune process triggered by yet unknown factors (infections, chemicals, drugs) in a genetically susceptible host. To date, several putative hepatocellular surface antigens have been identified: P450-IID6 (recognized by the anti-LKM-1 autoantibodies) a membrane bound asialoglycoprotein receptor (a liver-specific membrane protein), a cytosolic UGA-suppressor tRNA associated protein (recognized by anti-SMA and anti-LP antibodies) and argininosuccinate lysate and formiminotransferase cyclodeaminase (recognized by ant-LC1 antibodies). In contrast to other chronic hepatitides patients with AIH display significant T cell hypereactivity to autologous liver antigens. Tissue injury seems to be mediated by CD4+ or CD8+ T cells and/or by antibody-dependent cell mediated cytotoxicity.

Publication types

  • Review

MeSH terms

  • Ammonia-Lyases / immunology
  • Antibody-Dependent Cell Cytotoxicity / immunology*
  • Argininosuccinate Lyase / immunology
  • Aryl Hydrocarbon Hydroxylases / immunology
  • Asialoglycoprotein Receptor / immunology
  • Autoantibodies / immunology
  • Autoantigens / immunology*
  • CD4-Positive T-Lymphocytes / immunology*
  • CD8-Positive T-Lymphocytes / immunology*
  • Hepatitis, Autoimmune / etiology
  • Hepatitis, Autoimmune / genetics
  • Hepatitis, Autoimmune / immunology*
  • Hepatitis, Autoimmune / pathology
  • Humans
  • Liver / immunology*
  • Liver / pathology
  • RNA, Transfer / immunology

Substances

  • Asialoglycoprotein Receptor
  • Autoantibodies
  • Autoantigens
  • RNA, Transfer
  • Aryl Hydrocarbon Hydroxylases
  • Ammonia-Lyases
  • formiminotetrahydrofolate cyclodeaminase
  • Argininosuccinate Lyase