1
|
Wang C, Han M, Li X, Lv J, Zhuang W, Xie L, Liu G, Saimaier K, Han S, Shi C, Hua Q, Zhang R, Jiang X, Wang G, Du C. TPN10475 alleviates concanavalin A-induced autoimmune hepatitis by limiting T cell development and function through inhibition of PI3K-AKT pathway. Int Immunopharmacol 2023; 125:111110. [PMID: 37883813 DOI: 10.1016/j.intimp.2023.111110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/15/2023] [Accepted: 10/19/2023] [Indexed: 10/28/2023]
Abstract
Autoimmune hepatitis (AIH) is an inflammatory liver disease in which the autoimmune system instigates an attack on the liver, causing inflammation and liver injury, and its incidence has increased worldwide in recent years. The mouse model of acute hepatitis established by concanavalin A (Con A) is a typical and recognized mouse model for the study of T-cell-dependent liver injury. In this study, we aimed to investigate whether the artemisinin derivative TPN10475 could alleviate AIH and its possible mechanisms. TPN10475 effectively inhibited lymphocyte proliferation and IFN-γ+ T cells production in vitro, alleviated liver injury by decreasing infiltrating inflammatory T cells producing IFN-γ in the liver and peripheral immune tissues, and demonstrated that TPN10475 weakened the activation and function of T cells by inhibiting PI3K-AKT signaling pathway. These results suggested that TPN10475 may be a potential drug for the treatment of AIH, and the inhibition of PI3K-AKT signaling pathway may provide new ideas for the study of the pathogenesis of AIH.
Collapse
Affiliation(s)
- Chun Wang
- Putuo People's Hospital, Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai 200092, China
| | - Mengyao Han
- Putuo People's Hospital, Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai 200092, China
| | - Xinhang Li
- Putuo People's Hospital, Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai 200092, China
| | - Jie Lv
- Putuo People's Hospital, Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai 200092, China
| | - Wei Zhuang
- Putuo People's Hospital, Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai 200092, China; University of Chinese Academy of Sciences, No.19A Yuquan Road, Beijing 100049, China; National Laboratory of Biomacromolecules, CAS Center for Excellence in Biomacromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China
| | - Ling Xie
- Putuo People's Hospital, Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai 200092, China
| | - Guangyu Liu
- Putuo People's Hospital, Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai 200092, China
| | - Kaidireya Saimaier
- Putuo People's Hospital, Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai 200092, China
| | - Sanxing Han
- Putuo People's Hospital, Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai 200092, China
| | - Changjie Shi
- Putuo People's Hospital, Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai 200092, China
| | - Qiuhong Hua
- Putuo People's Hospital, Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai 200092, China
| | - Ru Zhang
- Putuo People's Hospital, Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai 200092, China
| | - Xiangrui Jiang
- University of Chinese Academy of Sciences, No.19A Yuquan Road, Beijing 100049, China; CAS Key Laboratory for Receptor Research, Shanghai Institute of Materia, Medica, Chinese Academy of Sciences, 555 Zuchongzhi Road, Shanghai 201203, China
| | - Guiying Wang
- Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, Shanghai Key Laboratory of Signaling and Disease Research, Frontier Science Center for Stem Cell Research, National Stem Cell Translational Resource Center, School of Life Sciences and Technology, Tongji University, Shanghai 200092, China.
| | - Changsheng Du
- Putuo People's Hospital, Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Tongji University, Shanghai 200092, China.
| |
Collapse
|
2
|
Clinical Characteristics of Autoimmune Hepatitis in a Middle Eastern Population: A Tertiary Care Center Experience. J Clin Med 2023; 12:jcm12020629. [PMID: 36675558 PMCID: PMC9861091 DOI: 10.3390/jcm12020629] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/07/2023] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
Autoimmune hepatitis (AIH) is an immune-mediated inflammatory liver disease of uncertain cause, and its manifestations appear to vary by race and ethnicity. The literature on AIH in the Middle East, including Jordan, is scarce; therefore, this study aimed to determine the clinical characteristics of AIH in an understudied population. This retrospective chart review study was conducted on AIH patients who presented to Jordan University Hospital over a seven-year period (2014-2020). Retrieved data included sociodemographics, liver function tests, autoimmune serologic markers, viral hepatitis serology, findings on liver biopsies, treatment regimens, post-therapy outcomes and treatment-related complications. The total number of AIH patients included in the study was 30, divided as follows: type 1 AIH (n = 17, 56.7%), type 2 AIH (n = 2, 6.7%), seronegative AIH (n = 9, 30.0%), and two patients who had AIH-primary biliary cirrhosis overlap syndrome (6.7%). The mean age at diagnosis was 44 years (standard deviation: 17 years), with a female predominance (n = 25, 83.3%). Acute presentation was seen among 18 patients (60.0%). Mild to moderate fibrosis (F1 and F2 on METAVIR scoring system) without cirrhosis was observed among patients who underwent liver biopsies (10/19, 52.6%). The majority of patients (73.3%) were initially treated with prednisone, with azathioprine combination in 16.7% of the patients. At 6 months post initial treatment, twenty patients (66.7%) achieved biochemical remission, four patients had incomplete response, two patients failed to improve (one died during the induction of remission period due to AIH-related complications), and four patients were lost to follow-up. This study provided an updated overview of AIH in Jordan. The results showed typical female predominance, and interestingly high rates of acute presentation and seronegative disease. Future longitudinal studies are recommended to address the nature and long-term prognosis of AIH in Jordan.
Collapse
|
3
|
Carroll G, Dyson JK. Editorial: autoimmune hepatitis and metabolic syndrome-associated disease development-an important question but only part of the answer? Aliment Pharmacol Ther 2022; 56:1499-1500. [PMID: 36271479 DOI: 10.1111/apt.17208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Geraldine Carroll
- Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Jessica Katharine Dyson
- Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| |
Collapse
|
4
|
Ueda K, Aizawa Y, Kinoshita C, Nagano T, Ishida J, Saeki C, Oikawa T, Harada T, Hokari A, Saruta M. Centrilobular zonal necrosis is a unique subtype of autoimmune hepatitis: A cohort study. Medicine (Baltimore) 2022; 101:e29484. [PMID: 35866813 PMCID: PMC9302312 DOI: 10.1097/md.0000000000029484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 04/12/2022] [Accepted: 05/02/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUNDS Centrilobular zonal necrosis (CZN) is described as a histological feature present in a small number of autoimmune hepatitis (CZN-AIH) patients. CZN may be detected in the absence of significant interface hepatitis, which is the most important histological finding of AIH. The clinical and histopathological spectra of CZN-AIH were not homogeneous, and the concept of CZN-AIH as a distinctive subtype of AIH remains controversial, due to the rarity of CZN-AIH and the ambiguous definition of CZN. METHODS To elucidate the clinical and immunogenetic features of CZN-AIH, a total of 102 biopsy samples of AIH, obtained at The Jikei University Katsushika Medical Center and Jikei University Hospital from 2000 to 2018, were reviewed. The 32 patients whose biopsies showed CZN were selected as the CZN-AIH group, and the remaining 70 were grouped as the non-CZN-AIH controls (control AIH). Data on clinical, histopathologic, and immunogenetic features were statistically compared between the CZN-AIH and the control AIH group. Additionally, the impact of the onset pattern (acute or chronic) and coexistent significant interface hepatitis in CZN-AIH was determined. RESULTS In CZN-AIH, the frequency of acute-onset cases was significantly higher than that in control AIH (56.2% vs 32.9%; P < .05), and the number of cases with moderate-to-severe interface hepatitis in liver histology was significantly lower (37.5% vs 87.1%; P < .001). Compared to the control AIH, cases of CZN-AIH had lower immunoglobulin G level (P < .001), lower antinuclear antibodies titer (P < .001), and lower AIH score (P < .001). The immunogenetic disproportionate distribution of HLA-DR phenotypes in control AIH (increased HLA-DR4 and decreased HLA-DR9) was not found in CZN-AIH. Moreover, CZN-AIH was less frequently relapsed (P < .05). For the acute-onset CZN-AIH cases, the clinical features were hardly indistinguishable from the chronic CZN-AIH cases. Similarly, the existence of interface hepatitis did not influence on the pathophysiology of CZN-AIH. Moreover, the acute-onset CZN-AIH cases is clinically distinguishable from acute-onset control AIH. CONCLUSION CZN can characterize as a distinct AIH subtype, regardless of onset-pattern or coexistence of significant interface hepatitis. To further strengthen this hypothesis, collection of more CZN-AIH cases is needed.
Collapse
Affiliation(s)
- Kaoru Ueda
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University Katsushika Medical Center, Tokyo, Japan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Yoshio Aizawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University Katsushika Medical Center, Tokyo, Japan
- *Correspondence: Yoshio Aizawa, Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University Katsushika Medical Center, Tokyo, Japan (e-mail: )
| | - Chika Kinoshita
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University Katsushika Medical Center, Tokyo, Japan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Tomohisa Nagano
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University Katsushika Medical Center, Tokyo, Japan
| | - Jinya Ishida
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Chisato Saeki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Tsunekazu Oikawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Toru Harada
- Division of Pathology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Atsushi Hokari
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University Katsushika Medical Center, Tokyo, Japan
| | - Masayuki Saruta
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| |
Collapse
|
5
|
Autoimmune Hepatitis Associated With Cryoglobulinemic Vasculitis. ACG Case Rep J 2022; 9:e00804. [PMID: 35800298 PMCID: PMC9257299 DOI: 10.14309/crj.0000000000000804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 03/21/2022] [Indexed: 11/24/2022] Open
Abstract
Cryoglobulinemic vasculitis presents liver abnormalities usually associated with hepatitis C. We report a case of a 27-year-old woman with cryoglobulinemia and liver dysfunction secondary to autoimmune hepatitis. The patient developed purpura on the lower extremities and elevated aminotransferases. The investigation of hepatitis C was negative. Autoimmune hepatitis was confirmed by positive ANA, hypergammaglobulinemia, and compatible histological changes. Treatment with prednisone and azathioprine regressed cutaneous vasculitis and decreased aminotransferases. This case describes a rare association of cryoglobulinemic vasculitis and autoimmune hepatitis.
Collapse
|
6
|
Presence of autoantibodies in serum does not impact the occurrence of immune checkpoint inhibitor-induced hepatitis in a prospective cohort of cancer patients. J Cancer Res Clin Oncol 2021; 148:647-656. [PMID: 34874490 PMCID: PMC8881258 DOI: 10.1007/s00432-021-03870-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/25/2021] [Indexed: 12/02/2022]
Abstract
Purpose Immune checkpoint inhibitor (ICI)-induced hepatitis belongs to the frequently occurring immune-related adverse events (irAEs), particularly with the combination therapy involving ipilimumab and nivolumab. However, predisposing factors predicting the occurrence of ICI-induced hepatitis are barely known. We investigated the association of preexisting autoantibodies in the development of ICI-induced hepatitis in a prospective cohort of cancer patients. Methods Data from a prospective biomarker cohort comprising melanoma and non-small cell lung cancer (NSCLC) patients were used to analyze the incidence of ICI-induced hepatitis, putatively associated factors, and outcome. Results 40 patients with melanoma and 91 patients with NSCLC received ICI between July 2016 and May 2019. 11 patients developed ICI-induced hepatitis (8.4%). Prior to treatment, 45.5% of patients in the hepatitis cohort and 43.8% of the control cohort showed elevated titers of autoantibodies commonly associated with autoimmune liver diseases (p = 0.82). We found two nominally significant associations between the occurrence of ICI-induced hepatitis and HLA alleles associated with autoimmune liver diseases among NSCLC patients. Of note, significantly more patients with ICI-induced hepatitis developed additional irAEs in other organs (p = 0.0001). Neither overall nor progression-free survival was affected in the hepatitis group. Conclusion We found nominally significant associations of ICI-induced hepatitis with two HLA alleles. ICI-induced hepatitis showed no correlation with liver-specific autoantibodies, but frequently co-occurred with irAEs affecting other organs. Unlike other irAEs, ICI-induced hepatitis is not associated with a better prognosis. Supplementary Information The online version contains supplementary material available at 10.1007/s00432-021-03870-6.
Collapse
|
7
|
Gaber Y, AbdAllah M, Salama A, Sayed M, Abdel Alem S, Nafady S. Metabolic-associated fatty liver disease and autoimmune hepatitis: an overlooked interaction. Expert Rev Gastroenterol Hepatol 2021; 15:1181-1189. [PMID: 34263707 DOI: 10.1080/17474124.2021.1952867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Metabolic-associated fatty liver disease (MAFLD) is the most common liver disease globally, and affects about a quarter of the general population. Autoimmune hepatitis (AIH) is a severe (sometimes fatal) liver disease that affects children and adults, with a rising prevalence. Thus, not surprisingly, both conditions can frequently coexist, with potential synergistic impact on the course of the disease and response to therapy of both entities. AREAS COVERED In this work, the authors aimed to provide a narrative updated review on this interaction, diagnosis, and management of MAFLD/AIH and the current challenges. EXPERT OPINION Clarifying the nature of the complex interaction between the two diseases was hampered by a myriad of factors, particularly the previous diagnosis of exclusion for fatty liver disease associated with metabolic dysfunction. The recent redefinition of fatty liver disease that led to the development of positive diagnostic criteria for MAFLD has the premise to help in circumventing some of these challenges.
Collapse
Affiliation(s)
- Yasmine Gaber
- Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed AbdAllah
- Medical Research Division, National Research Center, Giza, Egypt
| | - Asmaa Salama
- Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Beni-Suef University, Beni-suef, Egypt
| | - Manar Sayed
- Tropical Medicine Department, Faculty of Medicine, Fayoum University, Al Fayoum, Egypt
| | - Shereen Abdel Alem
- Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Shaymaa Nafady
- Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Beni-Suef University, Beni-suef, Egypt
| |
Collapse
|
8
|
Behairy OG, El-Shimi OS, Shalan NH, Baghdady SM. Association of the killer immunoglobulin-like receptor genes KIR2DS1 and KIR2DS4 with pediatric autoimmune hepatitis type I in Egypt. EGYPTIAN LIVER JOURNAL 2021. [DOI: 10.1186/s43066-021-00145-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Killer cell immunoglobulin-like receptors (KIR) are considered to be the key receptors that control the development and function of human natural killer cells which play complex mechanisms in autoimmune diseases. We aimed in this study to assess possible associations between killer cell immunoglobulin-like receptors (KIR2DS1 and 2DS4) genes and susceptibility to autoimmune hepatitis type I in Egyptian children.
Results
In the case-control study conducted on eighty children diagnosed as autoimmune hepatitis (AIH) type I and eighty apparently healthy age and sex-matched control, we found that KIR2DS1, -2DS4, KIR2DS4-full length allele, and homozygous KIR2DS4-full/full variant were significantly associated with AIH-I, while the KIR1D allele and homozygous KIR2DS4-del/del variant were significantly observed in controls (P < 0.05 each). Absence of KIR2DS4 gene was significant among ANA positive AIH-I patients, patients on steroid therapy alone, and patients showing complete disease remission (P < 0.05 each). Higher activity and fibrosis indices were found significantly in patients lacking one or both studied genes.
Conclusions
Children carrying KIR2DS1, -2DS4 genes, KIR2DS4-full length allele, and homozygous KIR2DS4-full/full variant could be more susceptible to develop autoimmune hepatitis type I.
Collapse
|
9
|
Olsen K, Hodson J, Ronca V, Bozward AG, Hayden J, Wootton G, Armstrong M, Adams DH, El-Sherif O, Ferguson J, Knox E, Johnston T, Thompson F, Oo YH. Type 2 Autoimmune Hepatitis and Nonadherence to Medication Correlate With Premature Birth and Risk of Postpartum Flare. Hepatol Commun 2021; 5:1252-1264. [PMID: 34278173 PMCID: PMC8279459 DOI: 10.1002/hep4.1714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 02/07/2021] [Indexed: 12/19/2022] Open
Abstract
Autoimmune hepatitis (AIH) is an immune-mediated chronic liver disease that affects all ages, including women of childbearing age. Optimal management during pregnancy is poorly defined. We aimed to explore the clinical and biochemical course of AIH in the antenatal and postpartum periods, and assess factors associated with premature birth and postpartum flares. Pregnant women with AIH reviewed in the autoimmune liver disease clinic at the Queen Elizabeth Hospital Birmingham between 2009 and 2020 were identified retrospectively, and clinical, biochemical, and immunological data 1 year before conception to 1 year postpartum were collected. Analysis was performed to identify trends in blood markers over the antenatal period, with an interrupted time series approach used to assess postpartum trends. Data were available for n = 27 pregnancies (n = 20 women), with median gestation of 38 weeks (30% premature) and most having type 1 AIH (78%) and delivering via caesarean section (63%). Levels of alanine transaminase, aspartate transaminase, and immunoglobulin G all declined significantly during gestation, followed by significant step-change increases after delivery. Postpartum flare developed in 58% of pregnancies. AIH type 2 was associated with a higher rate of premature births (67% vs. 19%, P = 0.044), and a trend toward a higher rate of postpartum flare (100% vs. 48%, P = 0.053). Although not significant, medication nonadherence was associated with almost double the risk of prematurity (40% vs. 24%, P = 0.415) and postpartum flare (80% vs. 44%, P = 0.109). Conclusion: Biochemical and immunological remission of AIH occurs during pregnancy, although subsequent postpartum flare is common. Type 2 AIH is associated with a higher risk of premature birth and postpartum flare, although further research is required to validate and explain this finding.
Collapse
Affiliation(s)
- Kathryn Olsen
- University Hospitals Birmingham National Health Service Foundation TrustBirminghamUnited Kingdom.,Center for Liver and Gastro ResearchInstitute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUnited Kingdom
| | - James Hodson
- University Hospitals Birmingham National Health Service Foundation TrustBirminghamUnited Kingdom
| | - Vincenzo Ronca
- University Hospitals Birmingham National Health Service Foundation TrustBirminghamUnited Kingdom.,Center for Liver and Gastro ResearchInstitute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUnited Kingdom.,National Institute for Health Research Birmingham Biomedical Research CenterEuropean Reference Network Rare-Liver CenterUniversity Hospitals Birmingham National Health Service Foundation Trust and University of BirminghamBirminghamUnited Kingdom
| | - Amber G Bozward
- University Hospitals Birmingham National Health Service Foundation TrustBirminghamUnited Kingdom.,Center for Liver and Gastro ResearchInstitute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUnited Kingdom
| | - Jennifer Hayden
- University Hospitals Birmingham National Health Service Foundation TrustBirminghamUnited Kingdom
| | - Grace Wootton
- University Hospitals Birmingham National Health Service Foundation TrustBirminghamUnited Kingdom.,Center for Liver and Gastro ResearchInstitute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUnited Kingdom
| | - Matthew Armstrong
- University Hospitals Birmingham National Health Service Foundation TrustBirminghamUnited Kingdom.,Center for Liver and Gastro ResearchInstitute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUnited Kingdom.,National Institute for Health Research Birmingham Biomedical Research CenterEuropean Reference Network Rare-Liver CenterUniversity Hospitals Birmingham National Health Service Foundation Trust and University of BirminghamBirminghamUnited Kingdom
| | - David H Adams
- University Hospitals Birmingham National Health Service Foundation TrustBirminghamUnited Kingdom.,Center for Liver and Gastro ResearchInstitute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUnited Kingdom.,National Institute for Health Research Birmingham Biomedical Research CenterEuropean Reference Network Rare-Liver CenterUniversity Hospitals Birmingham National Health Service Foundation Trust and University of BirminghamBirminghamUnited Kingdom
| | - Omar El-Sherif
- University Hospitals Birmingham National Health Service Foundation TrustBirminghamUnited Kingdom
| | - James Ferguson
- University Hospitals Birmingham National Health Service Foundation TrustBirminghamUnited Kingdom.,Center for Liver and Gastro ResearchInstitute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUnited Kingdom.,National Institute for Health Research Birmingham Biomedical Research CenterEuropean Reference Network Rare-Liver CenterUniversity Hospitals Birmingham National Health Service Foundation Trust and University of BirminghamBirminghamUnited Kingdom
| | - Ellen Knox
- Birmingham Women's HospitalBirminghamUnited Kingdom
| | | | - Fiona Thompson
- University Hospitals Birmingham National Health Service Foundation TrustBirminghamUnited Kingdom
| | - Ye Htun Oo
- University Hospitals Birmingham National Health Service Foundation TrustBirminghamUnited Kingdom.,Center for Liver and Gastro ResearchInstitute of Immunology and ImmunotherapyUniversity of BirminghamBirminghamUnited Kingdom.,National Institute for Health Research Birmingham Biomedical Research CenterEuropean Reference Network Rare-Liver CenterUniversity Hospitals Birmingham National Health Service Foundation Trust and University of BirminghamBirminghamUnited Kingdom
| |
Collapse
|
10
|
Hossein-Khannazer N, Zian Z, Bakkach J, Kamali AN, Hosseinzadeh R, Anka AU, Yazdani R, Azizi G. Features and roles of T helper 22 cells in immunological diseases and malignancies. Scand J Immunol 2021; 93:e13030. [PMID: 33576072 DOI: 10.1111/sji.13030] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/08/2021] [Accepted: 02/09/2021] [Indexed: 12/23/2022]
Abstract
T helper 22 (Th22) cell populations are a newly identified subset of CD4+ T cells that primarily mediate biological effects on the epithelial barrier through interleukin (IL)-22. Although, new studies showed that both Th22 and IL-22 are closely associated with the pathogenesis of inflammatory, autoimmune and allergic disease as well as malignancies. In this review, we aim to describe the development and characteristics of Th22 cells as well as their roles in the immunopathogenesis of immune-related disorders and cancer.
Collapse
Affiliation(s)
- Nikoo Hossein-Khannazer
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zeineb Zian
- Biomedical Genomics and Oncogenetics Research Laboratory, Faculty of Sciences and Techniques of Tangier, Abdelmalek Essaadi University, Tetouan, Morocco
| | - Joaira Bakkach
- Biomedical Genomics and Oncogenetics Research Laboratory, Faculty of Sciences and Techniques of Tangier, Abdelmalek Essaadi University, Tetouan, Morocco
| | - Ali N Kamali
- CinnaGen Medical Biotechnology Research Center, Alborz University of Medical Sciences, Karaj, Iran
- CinnaGen Research and Production Co, Alborz, Iran
| | - Ramin Hosseinzadeh
- Department of Medical Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Abubakar Umar Anka
- Department of Medical Laboratory Science, College of Medical Sciences, Ahmadu Bello University, Zaria, Nigeria
| | - Reza Yazdani
- Research Center for Immunodeficiencies, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Azizi
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| |
Collapse
|
11
|
Lonardo A. Renaming NAFLD to MAFLD: Could the LDE System Assist in This Transition? J Clin Med 2021; 10:492. [PMID: 33572544 PMCID: PMC7866816 DOI: 10.3390/jcm10030492] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 12/13/2022] Open
Abstract
Our understanding of fatty liver syndromes and their relationship with the metabolic syndrome has improved over recent decades and, paralleling this, we are now at the dawn of the NAFLD (nonalcoholic fatty liver disease) to MAFLD (metabolic-associated fatty liver disease) transition. The pitfalls of NAFLD diagnosis, together with disappointing results in therapeutic trials, and the inconsistencies and risks inherent in a "negative" definition (such as "nonalcoholic") as opposed to a "positive" one (i.e., "metabolic") are predicted to facilitate the proposed renaming of NAFLD to MAFLD. However, a premature change of terminology would not necessarily address major unmet needs in this area, and may even become counterproductive. As an aid to selecting more homogeneous cohorts of patients, I propose the LDE (Liver, Determinants, Extra-hepatic) classification system which, in principle, may help to assess the natural course of disease as well as the efficacy of novel drugs in patients with NAFLD/MAFLD.
Collapse
Affiliation(s)
- Amedeo Lonardo
- Department of Internal Medicine, Azienda Ospedaliero-Universitaria di Modena, 4110 Modena, Italy
| |
Collapse
|
12
|
DNA Microsystems for Biodiagnosis. MICROMACHINES 2020; 11:mi11040445. [PMID: 32340280 PMCID: PMC7231314 DOI: 10.3390/mi11040445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 12/16/2022]
Abstract
Researchers are continuously making progress towards diagnosis and treatment of numerous diseases. However, there are still major issues that are presenting many challenges for current medical diagnosis. On the other hand, DNA nanotechnology has evolved significantly over the last three decades and is highly interdisciplinary. With many potential technologies derived from the field, it is natural to begin exploring and incorporating its knowledge to develop DNA microsystems for biodiagnosis in order to help address current obstacles, such as disease detection and drug resistance. Here, current challenges in disease detection are presented along with standard methods for diagnosis. Then, a brief overview of DNA nanotechnology is introduced along with its main attractive features for constructing biodiagnostic microsystems. Lastly, suggested DNA-based microsystems are discussed through proof-of-concept demonstrations with improvement strategies for standard diagnostic approaches.
Collapse
|
13
|
An J. Expression and Significance of Th17 Cells and Related Factors in Patients with Autoimmune Hepatitis. Comb Chem High Throughput Screen 2020; 22:232-237. [PMID: 30947662 DOI: 10.2174/1386207322666190402160455] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 11/02/2018] [Accepted: 12/11/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study aims to investigate the expression and clinical significance of Th17 cells and related factors in peripheral blood of patients with Autoimmune Hepatitis (AIH). METHODS A retrospective selection of 100 patients with AIH were included as a study group, and 100 healthy volunteers in the outpatient clinic were selected as the control group. The levels of IL- 17, IL-6, IL-21 and TNF-α in peripheral blood of all subjects were detected by enzyme-linked immunosorbent assay and the frequency of Th17 cells and Treg cells was detected by flow cytometry. RESULTS Results showed that the study group had higher levels of serum total bilirubin (TBil), alkaline phosphatase (ALP), γ -glutamyltranspeptidase (γ-GT), immunoglobulin G (IgG), immunoglobulin M (IgM), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) than the control group, as well as higher levels of IL-17, IL-6, IL-21 and TNF-α in serum. The frequency of Th17 cells in peripheral blood was higher in the study group, while the frequency of Treg cells was lower. Also, serum IL-17, TNF-α levels and Th17 cells frequency were positively correlated with ALT and AST, whereas Treg cells frequency were negatively correlated with ALT and AST levels. CONCLUSION Our finding demonstrates that Th17 cell frequency and their related factors IL-17 and TNF-α, are associated with liver damage, which might be used to monitor AIH disease severity.
Collapse
Affiliation(s)
- Jihong An
- Department of Infectious Diseases, Inner Mongolia People's Hospital, Inner Mongolia 010017, China
| |
Collapse
|
14
|
Diagnostic Value of Serum Adenosine Deaminase and Its Isoenzymes for Autoimmune Liver Disease. HEPATITIS MONTHLY 2020. [DOI: 10.5812/hepatmon.98811] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
|
15
|
Chaiteerakij R, Sanpawat A, Avihingsanon A, Treeprasertsuk S. Autoimmune hepatitis in human immunodeficiency virus-infected patients: A case series and review of the literature. World J Gastroenterol 2019; 25:5388-5402. [PMID: 31558881 PMCID: PMC6761245 DOI: 10.3748/wjg.v25.i35.5388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 08/14/2019] [Accepted: 08/24/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Abnormal liver chemistry is a common problem in human immunodeficiency virus (HIV)-infected patients. Common causes of abnormal liver enzymes in this population include viral hepatitis B/C or opportunistic infection, drug toxicity, and neoplasm. Autoimmune hepatitis is a rare cause of hepatitis in HIV-infected individuals; however, this condition has been increasingly reported over the past few years.
CASE SUMMARY We present 13 HIV-infected patients (5 males and 8 females) who developed autoimmune hepatitis (AIH) after their immune status was restored, i.e. all patients had stable viral suppression with undetectable HIV viral loads, and median CD4+ counts of 557 cells/× 106 L. Eleven patients presented with chronic persistent elevation of aminotransferase enzyme levels. One patient presented with acute hepatitis and the other patient presented with jaundice. The median levels of aspartate aminotransferase and alanine aminotransferase enzymes were 178 and 177 U/mL, respectively. Elevation of immunoglobulin G levels was present in 11 (85%) patients. Antinuclear antibody and anti-smooth muscle antibody were positive in 11 (85%) and 5 (38%) patients. Liver biopsy was performed in all patients. They had histopathological findings compatible with AIH. The patients were started on prednisolone for remission induction, with good response. After improvement of the liver chemistry, the dose of prednisolone was tapered, and azathioprine was added as life-long maintenance therapy. At the last follow-up visit, all were doing well, without HIV viral rebound or infectious complications.
CONCLUSION This report underscores the emergence of autoimmune hepatitis in the context of HIV infection.
Collapse
Affiliation(s)
- Roongruedee Chaiteerakij
- Department of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
| | - Anapat Sanpawat
- Department of Pathology, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
| | - Anchalee Avihingsanon
- Medical Department, The HIV Netherlands Australia Thailand Research Collaboration, Bangkok 10330, Thailand
| | - Sombat Treeprasertsuk
- Department of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand
| |
Collapse
|
16
|
Behfarjam F, Nasseri-Moghaddam S, Jadali Z. Enhanced Th17 Responses in Patients with Autoimmune Hepatitis. Middle East J Dig Dis 2019; 11:98-103. [PMID: 31380006 PMCID: PMC6663287 DOI: 10.15171/mejdd.2018.134] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 03/10/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND T cells are major players in chronic inflammatory diseases such as autoimmune hepatitis (AIH). However, it is not clear which subset of T cells participates in the pathophysiology of the disease. The aim of this study was to assess the expression profile of signature transcription factor and cytokines of T helper 17 (Th17) cells in patients with AIH. METHODS A total of 24 patients with AIH and 24 normal subjects were recruited in the study. Comparison of gene expression patterns between the patients and normal subjects was done by quantitative real-time reverse transcriptase polymerase chain reaction (qRT-PCR). RESULTS
The results showed that retinoic acid receptor-related orphan receptors gamma (RORɣt), interleukin-17A (IL-17A), and interleukin-22 (IL-22) mRNA expression were increased greatly in the patients group compared with the normal controls group (p < 0.05).
CONCLUSION Deregulated production of Th17-related molecules may be associated with the pathogenesis of AIH.
Collapse
Affiliation(s)
- Farinaz Behfarjam
- Ph.D. Student, Clinical Genetics Department, National Institute of Genetic Engineering and Biotechnology Tehran, Iran
| | - Siavash Nasseri-Moghaddam
- Associate Professor, Digestive Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zohreh Jadali
- Ph.D., Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
17
|
Elsaed WM. Amygdalin (Vitamin B17) pretreatment attenuates experimentally induced acute autoimmune hepatitis through reduction of CD4+ cell infiltration. Ann Anat 2019; 224:124-132. [DOI: 10.1016/j.aanat.2019.04.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 04/18/2019] [Accepted: 04/24/2019] [Indexed: 12/11/2022]
|
18
|
Dyson JK, De Martin E, Dalekos GN, Drenth JPH, Herkel J, Hubscher SG, Kelly D, Lenzi M, Milkiewicz P, Oo YH, Heneghan MA, Lohse AW. Review article: unanswered clinical and research questions in autoimmune hepatitis-conclusions of the International Autoimmune Hepatitis Group Research Workshop. Aliment Pharmacol Ther 2019; 49:528-536. [PMID: 30671977 DOI: 10.1111/apt.15111] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 06/29/2018] [Accepted: 12/04/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease that results in substantial morbidity and mortality with many unanswered clinical and research questions. Improved understanding of disease pathogenesis, including the extra-hepatic manifestations of AIH, may allow targeted treatments with greater efficacy and fewer associated adverse events. AIM To identify the spectrum of unanswered clinical and research questions facing care providers in the management of patients with autoimmune hepatitis (AIH). METHODS The International Autoimmune Hepatitis Group initiated a series of research workshops to start to address these questions. Key issues were discussed in small group sessions with collation of all discussions to be summarised in this manuscript. RESULTS Key issues were identified as: the need for better understanding of disease pathogenesis, standardisation of the methods and assays used to evaluate autoantibodies in AIH, refinement of the histopathological criteria for "typical" or "compatible" AIH, focus on the interaction with non-alcohol related fatty liver disease, how to treat acute severe AIH, better assessment of quality of life in adults and paediatrics, standardising use of standard, third-line and experimental therapies in AIH and search for biomarkers early in the disease course that predict outcome. CONCLUSION This workshop has outlined the key unanswered clinical and research questions to help to define the research agenda in AIH.
Collapse
|
19
|
Wang H, Wang G, Ansari GAS, Khan MF. Trichloroethene metabolite dichloroacetyl chloride induces apoptosis and compromises phagocytosis in Kupffer Cells: Activation of inflammasome and MAPKs. PLoS One 2018; 13:e0210200. [PMID: 30596806 PMCID: PMC6312261 DOI: 10.1371/journal.pone.0210200] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 12/18/2018] [Indexed: 12/20/2022] Open
Abstract
Exposure to trichloroethene (TCE), an occupational and ubiquitous environmental contaminant, is associated with the development of several autoimmune diseases, including autoimmune hepatitis (AIH). However, mechanisms contributing to TCE-mediated AIH are not known. Earlier, we have shown that dichloroacetyl chloride (DCAC), one of the reactive metabolites of TCE with strong acylating capability, can elicit an autoimmune response at much lower dose than TCE in female MRL+/+ mice. Furthermore, Kupffer cells (KCs), the liver resident macrophages, are crucial for hepatic homeostasis, but can also participate in the immunopathogenesis of AIH. However, contribution of KCs in TCE-mediated AIH and the underlying mechanisms are not understood. We hypothesized that increased apoptosis and delayed clearance of apoptotic bodies, due to compromised KC function, will result in the breakdown of self-tolerance, autoimmunity, and ultimately AIH. Therefore, using an in vitro model of immortalized mouse KCs, we investigated the contribution of DCAC in TCE-mediated AIH. KCs were treated with different concentrations of DCAC and apoptosis was measured by Annexin V and PI staining. Also, the impact of DCAC on phagocytic potential of KCs was evaluated. Furthermore, markers of inflammasome (NLRP3 and caspase1) were analyzed by real-time PCR and Western blot analysis. DCAC treatment resulted in significantly increased early and late-stage apoptosis, accompanied with inflammasome activation (NLRP3 increases). DCAC treatment resulted in decreased phagocytic function of KCs in a dose-dependent manner, with reduced MFG-E8 levels (phagocytotic function). Furthermore, DCAC exposure led to induction of phos-ERK and phos-AKT signaling. These findings suggest that DCAC induces apoptosis and inflammasome activation, while compromising the phagocytic function of KCs. Our data support that increased apoptosis and impaired KC function by DCAC could be contributory to TCE-mediated AIH.
Collapse
Affiliation(s)
- Hui Wang
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas
| | - Gangduo Wang
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas
| | | | - M. Firoze Khan
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas
| |
Collapse
|
20
|
Alfani R, Vassallo E, De Anseris AG, Nazzaro L, D'Acunzo I, Porfito C, Mandato C, Vajro P. Pediatric Fatty Liver and Obesity: Not Always Justa Matter of Non-Alcoholic Fatty Liver Disease. CHILDREN-BASEL 2018; 5:children5120169. [PMID: 30551665 PMCID: PMC6306738 DOI: 10.3390/children5120169] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 12/10/2018] [Accepted: 12/10/2018] [Indexed: 02/07/2023]
Abstract
Obesity-related non-alcoholic fatty liver disease (NAFLD) represents the most common cause of pediatric liver disease due to overweight/obesity large-scale epidemics. In clinical practice, diagnosis is usually based on clinical features, blood tests, and liver imaging. Here, we underline the need to make a correct differential diagnosis for a number of genetic, metabolic, gastrointestinal, nutritional, endocrine, muscular, and systemic disorders, and for iatrogenic/viral/autoimmune hepatitis as well. This is all the more important for patients who are not in the NAFLD classical age range and for those for whom a satisfactory response of liver test abnormalities to weight loss after dietary counseling and physical activity measures cannot be obtained or verified due to poor compliance. A correct diagnosis may be life-saving, as some of these conditions which appear similar to NAFLD have a specific therapy. In this study, the characteristics of the main conditions which require consideration are summarized, and a practical diagnostic algorithm is discussed.
Collapse
Affiliation(s)
- Renata Alfani
- Pediatrics Residency Joint Programs, University of Naples Federico II, 80131 Naples, Italy.
- Pediatrics Residency Joint Programs, University of Salerno, 84081 Baronissi (Salerno), Italy.
| | - Edoardo Vassallo
- Pediatrics Residency Joint Programs, University of Naples Federico II, 80131 Naples, Italy.
- Pediatrics Residency Joint Programs, University of Salerno, 84081 Baronissi (Salerno), Italy.
| | - Anna Giulia De Anseris
- Clinical Pediatrics Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi D'Aragona, 84131 Salerno, Italy.
| | - Lucia Nazzaro
- Clinical Pediatrics Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi D'Aragona, 84131 Salerno, Italy.
| | - Ida D'Acunzo
- Pediatrics Residency Joint Programs, University of Naples Federico II, 80131 Naples, Italy.
- Pediatrics Residency Joint Programs, University of Salerno, 84081 Baronissi (Salerno), Italy.
| | - Carolina Porfito
- Pediatrics Residency Joint Programs, University of Naples Federico II, 80131 Naples, Italy.
- Pediatrics Residency Joint Programs, University of Salerno, 84081 Baronissi (Salerno), Italy.
| | - Claudia Mandato
- Children's Hospital Santobono-Pausilipon, Department of Pediatrics, 80129 Naples, Italy.
| | - Pietro Vajro
- Pediatrics Residency Joint Programs, University of Naples Federico II, 80131 Naples, Italy.
- Pediatrics Residency Joint Programs, University of Salerno, 84081 Baronissi (Salerno), Italy.
- Clinical Pediatrics Azienda Ospedaliera Universitaria San Giovanni di Dio e Ruggi D'Aragona, 84131 Salerno, Italy.
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, Pediatrics Section, University of Salerno, 84081 Baronissi (Salerno), Italy.
| |
Collapse
|
21
|
Chaouali M, Fernandes V, Ghazouani E, Pereira L, Kochkar R. Association of STAT4, TGFβ1, SH2B3 and PTPN22 polymorphisms with autoimmune hepatitis. Exp Mol Pathol 2018; 105:279-284. [PMID: 30291855 DOI: 10.1016/j.yexmp.2018.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 09/09/2018] [Accepted: 10/01/2018] [Indexed: 12/19/2022]
Abstract
The physiopathology of autoimmune hepatitis (AIH) is complex and still not fully elucidated. The genes localized outside the histocompatibility complex involved in regulation and signal transduction of the immune system SH2B3, TGFβ1, STAT4 and PTPN22 could be associated to the susceptibility and hepatocyte lysis mechanism of this lethal autoimmune disorder. PATIENTS AND METHODS We investigated four polymorphic sites in SH2B3 (rs3184504), TGFβ1 (rs1800471), STAT4 (rs7574865) and PTPN22 (rs2476601) in 45 AIH patients and 150 healthy controls from Tunisia using real-time PCR. RESULTS Significant associations were found for SH2B3 T allele (OR = 1.861; p = 0.015, pc = 0.366) and PTPN22 A allele (OR = 7.070; p = 0.026; pc = 1.00) and AIH with opposite homozygous being protective against the disease (CC genotype with OR = 0.420, p = 0.025; GG genotype with OR = 0.136, p = 0.025, respectively). No statistically significant associations were found for the TGFβ1 and STAT4 polymorphisms with AIH susceptibility. CONCLUSION Our work enlarges information on non-HLA genes that are associated with AIH by focusing in a region of the world that was poorly molecularly characterized for this disease.
Collapse
Affiliation(s)
- Marwa Chaouali
- Department of Immunology, Military Hospital of Tunis, Montfleury 1008, Tunis, Tunisia; Laboratory of Mycology Pathologies and Biomarkers, El Manar University, Tunis 1092, Tunisia.
| | - Veronica Fernandes
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto 4200-135, Portugal; Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto 4200-135, Portugal
| | - Ezzedine Ghazouani
- Department of Immunology, Military Hospital of Tunis, Montfleury 1008, Tunis, Tunisia
| | - Luisa Pereira
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto 4200-135, Portugal; Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto 4200-135, Portugal; Faculdade de Medicina da Universidade do Porto, Portugal
| | - Radhia Kochkar
- Department of Immunology, Military Hospital of Tunis, Montfleury 1008, Tunis, Tunisia
| |
Collapse
|
22
|
Abstract
Primary biliary cholangitis and autoimmune hepatitis are common autoimmune diseases of the liver. Both have typical clinical presentations, including certain autoantibodies on serologic testing. Histologic features are also often typical: primary biliary cholangitis shows bile duct destruction (sometimes with granulomas), and autoimmune hepatitis shows prominent portal and lobular lymphoplasmacytic inflammation. Both have a wide differential diagnosis, including one another; they may also simultaneously occur within the same patient. Careful use of clinical and histologic criteria may be necessary for diagnosis. First-line therapy is immunosuppression for autoimmune hepatitis and ursodeoxycholic acid for primary biliary cholangitis. Both diseases may progress to cirrhosis.
Collapse
Affiliation(s)
- Raul S Gonzalez
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Box 626, Rochester, NY 14642, USA.
| | - Kay Washington
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, 1161 21st Avenue South, C-3316 MCN, Nashville, TN 37232-2561, USA
| |
Collapse
|
23
|
Kosmalski M, Mokros Ł, Kuna P, Witusik A, Pietras T. Changes in the immune system - the key to diagnostics and therapy of patients with non-alcoholic fatty liver disease. Cent Eur J Immunol 2018; 43:231-239. [PMID: 30135638 PMCID: PMC6102613 DOI: 10.5114/ceji.2018.77395] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 06/12/2017] [Indexed: 12/13/2022] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is one of the most common pathologies of that organ. The development of the disease involves a variety of mechanisms, including insulin resistance, oxidative stress, endoplasmic reticulum stress, endotoxins from the intestinal flora and genetic predispositions. Additionally, clinical data suggest that the presence of NAFLD is associated with excessive activation of the immune system. For practical purposes, attention should be paid to the moment when the subjects predisposed to NAFLD develop inflammatory infiltration and signs of fibrosis in the liver (non-alcoholic steatohepatitis - NASH). Their presence is an important risk factor for hepatic cirrhosis, hepatic failure, and hepatocellular carcinoma, as well as for the occurrence of cardiovascular events. Regardless of the diagnostic methods used, including laboratory tests and imaging, liver biopsy remains the gold standard to identify and differentiate patients with NAFLD and NASH. The search for other, safer, cheaper and more readily available diagnostic tests is still being continued. Attention has been drawn to the usefulness of markers of immune status of the organism, not only for the diagnosis of NASH, but also for the identification of NAFLD patients at risk of disease progression. Despite the effectiveness of medication, no recommendations have been established for pharmacotherapy of NAFLD. Data indicate the primary need for non-pharmacological interventions to reduce body weight. However, there is evidence of the applicability of certain drugs and dietary supplements, which, by their effect on the immune system, inhibit its excessive activity, thus preventing the progression of NAFLD to NASH.
Collapse
Affiliation(s)
- Marcin Kosmalski
- Department of Clinical Pharmacology, Medical University of Lodz, Poland
| | - Łukasz Mokros
- Department of Clinical Pharmacology, Medical University of Lodz, Poland
| | - Piotr Kuna
- Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Poland
| | - Andrzej Witusik
- Department of Psychology, Piotrków Trybunalski Branch, Jan Kochanowski University in Kielce, Poland
| | - Tadeusz Pietras
- Department of Clinical Pharmacology, Medical University of Lodz, Poland
| |
Collapse
|
24
|
Takai S, Inoue J, Kogure T, Kakazu E, Ninomiya M, Iwata T, Umetsu T, Nakamura T, Sano A, Shimosegawa T. Acute-onset Autoimmune Hepatitis in a Young Woman with Type 1 Diabetes Mellitus. Intern Med 2018; 57:1591-1596. [PMID: 29321432 PMCID: PMC6028672 DOI: 10.2169/internalmedicine.9728-17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Autoimmune hepatitis (AIH) and type 1 diabetes mellitus (T1DM) are thought to be induced by autoimmunity, but their coexistence has rarely been reported. We herein report a case in which a patient with T1DM developed acute-onset AIH. A 26-year-old woman, who had been diagnosed with T1DM in childhood, was transferred to our hospital because of acute liver failure of unknown etiology. The administration of corticosteroids including steroid pulse therapy was effective. Based on the histological finding of massive centrilobular necrosis and a good response to steroid therapy, we diagnosed the patient with acute-onset AIH. This case indicates that AIH can occur in young T1DM patients.
Collapse
Affiliation(s)
- Satoshi Takai
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Japan
| | - Jun Inoue
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Japan
| | - Takayuki Kogure
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Japan
| | - Eiji Kakazu
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Japan
| | - Masashi Ninomiya
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Japan
| | - Tomoaki Iwata
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Japan
| | - Teruyuki Umetsu
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Japan
| | - Takuya Nakamura
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Japan
| | - Akitoshi Sano
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Japan
| | - Tooru Shimosegawa
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Japan
| |
Collapse
|
25
|
Chaouali M, Azaiez MB, Tezeghdenti A, Lagha A, Yacoubi-Oueslati B, Ghazouani E, Abdallah HB, Kochkar R. Association of TNF-α-308 Polymorphism with Susceptibility to Autoimmune Hepatitis in Tunisians. Biochem Genet 2018; 56:650-662. [PMID: 29845365 DOI: 10.1007/s10528-018-9867-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 05/23/2018] [Indexed: 02/06/2023]
Abstract
Autoimmune hepatitis (AIH) is a chronic hepatitis of unknown etiology and several proinflammatory cytokines are implicated in its pathogenesis. The association of TNF-α gene polymorphism with AIH onset is not fully elucidated especially in the Tunisian population. The aim of this study was to determine the association of TNF-α (-308 G > A) polymorphism with AIH susceptibility and with TNF-α expression or clinical manifestations of AIH. A total of 50 AIH patients and 150 controls were included. Evaluation of TNF-α polymorphism was performed by ARMS PCR method. A significantly higher frequence of the AA genotype was found in AIH patients compared to controls (34 vs. 8%, p = 0.00002, OR 5.88). The frequency of the A-allele was significantly higher in patients with AIH compared to controls (55 vs. 37.3%, p = 0.002, OR 2.05). The G-allele was significantly more frequent in healthy controls compared to AIH patients [43 vs. 61.3%, p = 0.001, OR 0.47 (0.3-0.75)]. There was a positive correlation between the A/A genotype and a higher serum expression of TNF-α. The TNF*A allele confer susceptibility to AIH in the Tunisian patients and is associated with increased production of TNF-α. Anti-TNF antibodies could be an alternative to the use of corticotherapy and may avoid the exacerbated immune response in AIH.
Collapse
Affiliation(s)
- Marwa Chaouali
- Department of Immunology, Military Hospital of Tunis, Montfleury, 1008, Tunis, Tunisia.
- Laboratory of Mycology, Pathologies and Biomarkers, El Manar University, 1092, Tunis, Tunisia.
| | - Mouna Ben Azaiez
- Department of Immunology, Military Hospital of Tunis, Montfleury, 1008, Tunis, Tunisia
| | - Aymen Tezeghdenti
- Department of Immunology, Military Hospital of Tunis, Montfleury, 1008, Tunis, Tunisia
| | - Awatef Lagha
- Department of Immunology, Military Hospital of Tunis, Montfleury, 1008, Tunis, Tunisia
| | - Basma Yacoubi-Oueslati
- Laboratory of Mycology, Pathologies and Biomarkers, El Manar University, 1092, Tunis, Tunisia
| | - Ezzeddine Ghazouani
- Department of Immunology, Military Hospital of Tunis, Montfleury, 1008, Tunis, Tunisia
| | - Hatem Ben Abdallah
- Department of Gastroenterology, Military Hospital of Tunis, Montfleury, 1008, Tunis, Tunisia
| | - Radhia Kochkar
- Department of Immunology, Military Hospital of Tunis, Montfleury, 1008, Tunis, Tunisia
| |
Collapse
|
26
|
Qian BX, Ye Q, Zhao XY, Han T, Wang FM, Yang J. Meta-Analysis of the Relation Between IL10 Promoter Polymorphisms and Autoimmune Liver Disease Risk. Genet Test Mol Biomarkers 2018; 22:302-313. [PMID: 29694797 DOI: 10.1089/gtmb.2018.0010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Single nucleotide polymorphisms of the IL10 gene have been linked to the occurrence of autoimmune liver disease. METHODS We performed a meta-analysis to assess the association between three IL10 promoter polymorphisms (rs1800896, rs1800871, and rs1800872) and the risk of autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis. RESULTS In total, 1420 articles were initially identified through database retrieval. After screening, seven eligible articles were ultimately included in the meta-analysis. A fixed-effect model was used for all Mantel-Haenszel statistics due to the absence of large between-study heterogeneity (all I2 < 50%, p > 0.1). No association between any of the studied polymorphisms and risk of autoimmune liver disease was detected in the allele, homozygote, heterozygote, dominant, recessive, or carrier genetic models (passociation > 0.05). Potential publication bias was excluded using Begg's and Egger's tests. Similar negative results were observed in subgroup analyses and in an analysis of the three haplotypes of rs1800896/rs1800871/rs1800872 (G/C/C, A/C/C, and A/T/A). CONCLUSION Our meta-analysis strongly suggests that the IL10 rs1800896, rs1800871, and rs1800872 polymorphisms are not associated with the risk of autoimmune liver disease.
Collapse
Affiliation(s)
- Bao-Xin Qian
- 1 School of Basic Medical Sciences, Tianjin Medical University , Tianjin, P.R. China .,2 Research Center of Basic Medical Science, Tianjin Medical University , Tianjin, P.R. China .,3 The Third Central Clinical College of Tianjin Medical University , Tianjin, P.R. China .,4 Department of Gastroenterology and Herpetology, Tianjin Third Central Hospital , Tianjin, P.R. China
| | - Qing Ye
- 3 The Third Central Clinical College of Tianjin Medical University , Tianjin, P.R. China .,4 Department of Gastroenterology and Herpetology, Tianjin Third Central Hospital , Tianjin, P.R. China
| | - Xin-Yu Zhao
- 1 School of Basic Medical Sciences, Tianjin Medical University , Tianjin, P.R. China
| | - Tao Han
- 3 The Third Central Clinical College of Tianjin Medical University , Tianjin, P.R. China .,4 Department of Gastroenterology and Herpetology, Tianjin Third Central Hospital , Tianjin, P.R. China
| | - Feng-Mei Wang
- 3 The Third Central Clinical College of Tianjin Medical University , Tianjin, P.R. China .,4 Department of Gastroenterology and Herpetology, Tianjin Third Central Hospital , Tianjin, P.R. China
| | - Jie Yang
- 1 School of Basic Medical Sciences, Tianjin Medical University , Tianjin, P.R. China .,2 Research Center of Basic Medical Science, Tianjin Medical University , Tianjin, P.R. China
| |
Collapse
|
27
|
Buechter M, Manka P, Heinemann FM, Lindemann M, Baba HA, Schlattjan M, Canbay A, Gerken G, Kahraman A. Potential triggering factors of acute liver failure as a first manifestation of autoimmune hepatitis-a single center experience of 52 adult patients. World J Gastroenterol 2018; 24:1410-1418. [PMID: 29632422 PMCID: PMC5889821 DOI: 10.3748/wjg.v24.i13.1410] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 02/21/2018] [Accepted: 03/03/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate potential triggering factors leading to acute liver failure (ALF) as the initial presentation of autoimmune hepatitis (AIH). METHODS A total of 565 patients treated at our Department between 2005 and 2017 for histologically-proven AIH were retrospectively analyzed. However, 52 patients (9.2%) fulfilled the criteria for ALF defined by the "American Association for the Study of the Liver (AASLD)". According to this definition, patients with "acute-on-chronic" or "acute-on-cirrhosis" liver failure were excluded. Following parameters with focus on potential triggering factors were evaluated: Patients' demographics, causation of liver failure, laboratory data (liver enzymes, MELD-score, autoimmune markers, virus serology), liver histology, immunosuppressive regime, and finally, outcome of our patients. RESULTS The majority of patients with ALF were female (84.6%) and mean age was 43.6 ± 14.9 years. Interestingly, none of the patients with ALF was positive for anti-liver kidney microsomal antibody (LKM). We could identify potential triggering factors in 26/52 (50.0%) of previously healthy patients presenting ALF as their first manifestation of AIH. These were drug-induced ALF (57.7%), virus-induced ALF (30.8%), and preceding surgery in general anesthesia (11.5%), respectively. Unfortunately, 6 out of 52 patients (11.5%) did not survive ALF and 3 patients (5.7%) underwent liver transplantation (LT). Comparing data of survivors and patients with non-recovery following treatment, MELD-score (P < 0.001), age (P < 0.05), creatinine (P < 0.01), and finally, ALT-values (P < 0.05) reached statistical significance. CONCLUSION Drugs, viral infections, and previous surgery may trigger ALF as the initial presentation of AIH. Advanced age and high MELD-score were associated with lethal outcome.
Collapse
Affiliation(s)
- Matthias Buechter
- Department of Gastroenterology and Hepatology, University Clinic of Essen, Essen 45147, Germany
| | - Paul Manka
- Department of Gastroenterology and Hepatology, University Clinic of Essen, Essen 45147, Germany
- Division of Transplantation Immunology and Mucosal Biology, King’s College, London SE59RJ, United Kingdom
| | | | - Monika Lindemann
- Institute of Transfusion Medicine, University Clinic of Essen, Essen 45147, Germany
| | - Hideo Andreas Baba
- Institute of Pathology, University Clinic of Essen, Essen 45147, Germany
| | - Martin Schlattjan
- Institute of Pathology, University Clinic of Essen, Essen 45147, Germany
| | - Ali Canbay
- Department of Gastroenterology, Hepatology, and Infectious Diseases, Otto-von-Guericke University, Magdeburg 39120, Germany
| | - Guido Gerken
- Department of Gastroenterology and Hepatology, University Clinic of Essen, Essen 45147, Germany
| | - Alisan Kahraman
- Department of Gastroenterology and Hepatology, University Clinic of Essen, Essen 45147, Germany
| |
Collapse
|
28
|
Qu LM, Wang SH, Yang K, Brigstock DR, Sun L, Gao RP. CD4 +Foxp3 +CD25 +/- Tregs characterize liver tissue specimens of patients suffering from drug-induced autoimmune hepatitis: A clinical-pathological study. Hepatobiliary Pancreat Dis Int 2018; 17:133-139. [PMID: 29551296 DOI: 10.1016/j.hbpd.2018.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Accepted: 12/28/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND The diagnosis of drug-induced autoimmune hepatitis (DIAIH) and its differentiation from idiopathic autoimmune hepatitis (AIH) is challenging. This study aimed to differentiate DIAIH from AIH by comparing the biochemical changes, histological features, and frequencies of CD4+Foxp3+CD25+/- regulatory T cells (Tregs) in liver tissues or peripheral blood lymphocytes. METHODS A total of 15 DIAIH patients and 24 AIH patients who underwent liver biopsies at initial presentation were enrolled in this study. The liver histological changes were assessed by HE staining. The phenotypic recognition and distribution of CD4+Foxp3+CD25+/- Tregs in liver tissues were evaluated by single/double immunostains in serial sections. The CD4+Foxp3+CD25+/- Tregs in peripheral blood were analyzed by flow cytometry. RESULTS The median values of ALT and AST were 404.50 U/L and 454.10 U/L in DIAIH patients and 309.50 U/L and 315.00 U/L in AIH patients, respectively. More importantly, for the first time we found that patients with DIAIH had higher levels of serum ALT and AST, more severe degree of lobular inflammation, higher frequencies of zone 3 necrosis and higher number of lobular CD4+Foxp3+CD25-Tregs compared with AIH (P < 0.05). Furthermore, there were positive correlations in DIAIH between the degree of lobular inflammation and either the AST/ALT level or the number of lobular CD4+Foxp3+CD25- Tregs (P < 0.05). However, the frequency of peripheral blood CD4+Foxp3+CD25+/- Tregs were not significantly different between DIAIH and AIH. CONCLUSIONS The differences of ALT, AST and the number of lobular CD4+Foxp3+CD25- Tregs between patients with DIAIH and those with AIH are clinically helpful in differentiating these two diseases in their early stage.
Collapse
Affiliation(s)
- Li-Mei Qu
- Department of Hepatic-Biliary-Pancreatic Medicine, First Hospital of Jilin University, Changchun 130021, China
| | - Shu-Hua Wang
- Department of Surgical Gastroenterology, First Hospital of Jilin University, Changchun 130021, China
| | - Kun Yang
- Department of Hepatic-Biliary-Pancreatic Medicine, First Hospital of Jilin University, Changchun 130021, China
| | - David R Brigstock
- The Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA; Division of Pediatric Surgery, Department of Surgery, The Ohio State University, Columbus, OH 43205, USA
| | - Li Sun
- Department of Hepatic-Biliary-Pancreatic Medicine, First Hospital of Jilin University, Changchun 130021, China
| | - Run-Ping Gao
- Department of Hepatic-Biliary-Pancreatic Medicine, First Hospital of Jilin University, Changchun 130021, China .
| |
Collapse
|
29
|
Hu ED, Chen DZ, Wu JL, Lu FB, Chen L, Zheng MH, Li H, Huang Y, Li J, Jin XY, Gong YW, Lin Z, Wang XD, Xu LM, Chen YP. High fiber dietary and sodium butyrate attenuate experimental autoimmune hepatitis through regulation of immune regulatory cells and intestinal barrier. Cell Immunol 2018; 328:24-32. [PMID: 29627063 DOI: 10.1016/j.cellimm.2018.03.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 03/12/2018] [Accepted: 03/12/2018] [Indexed: 12/25/2022]
Abstract
Autoimmune hepatitis (AIH) is chronic autoimmune liver disease accompanied with the imbalance of Treg/Th17 and increased intestinal permeability. We investigated the effects of a high fiber diet and sodium butyrate on the Treg/Th17 and intestinal barrier function in an experimental autoimmune hepatitis. Intraperitoneal injection of hepatic antigen (S100) was used to induce experimental autoimmune hepatitis mice model and mice were divided into normal control, S100 model control, S100 plus high fiber diet and S100 plus sodium butyrate. Serum aminotransferases and liver histology were examined. Short chain fatty acids in feces were determined by HPLC. The ratio of CD4 + C25 + Foxp3+ Treg and CD4 + IL-17 + Th17 were evaluated by flow cytometry. Tight junction proteins Zonula ocluden, Occludin and Claudin-1 were used to assess intestinal barrier function, so does Escherichia coli protein in the liver. Mice fed with either high fiber diet or sodium butyrate showed significantly lower levers of serum aminotransferases and minor liver injury compared to that of model control. Moreover, the ratio of Treg/Th17 was significantly higher in high fiber diet and sodium butyrate fed mice than that in model control. Furthermore, high fiber diet and sodium butyrate significantly increased intestinal tight junction proteins and decreased Escherichia Coli protein in the liver. In conclusion, high fiber diet and sodium butyrate can attenuate development of autoimmune hepatitis through regulation of immune regulatory cells and intestinal barrier function.
Collapse
Affiliation(s)
- En-De Hu
- Department of Infectious Diseases, The First Affiliated Hospital of Wenzhou Medical University, Hepatology Institute of Wenzhou Medical University, Wenzhou Key Laboratory of Hepatology, Wenzhou 325000, Zhejiang, China
| | - Da-Zhi Chen
- State Key Laboratory of Infectious Diseases, Medicine School of Zhejiang University, Hangzhou 310003,China
| | - Jin-Lu Wu
- Department of Infectious Diseases, The First Affiliated Hospital of Wenzhou Medical University, Hepatology Institute of Wenzhou Medical University, Wenzhou Key Laboratory of Hepatology, Wenzhou 325000, Zhejiang, China
| | - Feng-Bin Lu
- Department of Infectious Diseases, The First Affiliated Hospital of Wenzhou Medical University, Hepatology Institute of Wenzhou Medical University, Wenzhou Key Laboratory of Hepatology, Wenzhou 325000, Zhejiang, China
| | - Lu Chen
- Department of Infectious Diseases, The First Affiliated Hospital of Wenzhou Medical University, Hepatology Institute of Wenzhou Medical University, Wenzhou Key Laboratory of Hepatology, Wenzhou 325000, Zhejiang, China
| | - Ming-Hua Zheng
- Department of Infectious Diseases, The First Affiliated Hospital of Wenzhou Medical University, Hepatology Institute of Wenzhou Medical University, Wenzhou Key Laboratory of Hepatology, Wenzhou 325000, Zhejiang, China
| | - Hui Li
- Department of Infectious Diseases, The First Affiliated Hospital of Wenzhou Medical University, Hepatology Institute of Wenzhou Medical University, Wenzhou Key Laboratory of Hepatology, Wenzhou 325000, Zhejiang, China
| | - Yu Huang
- Department of Infectious Diseases, The First Affiliated Hospital of Wenzhou Medical University, Hepatology Institute of Wenzhou Medical University, Wenzhou Key Laboratory of Hepatology, Wenzhou 325000, Zhejiang, China
| | - Ji Li
- Department of Infectious Diseases, The First Affiliated Hospital of Wenzhou Medical University, Hepatology Institute of Wenzhou Medical University, Wenzhou Key Laboratory of Hepatology, Wenzhou 325000, Zhejiang, China
| | - Xiao-Ya Jin
- Department of Infectious Diseases, The First Affiliated Hospital of Wenzhou Medical University, Hepatology Institute of Wenzhou Medical University, Wenzhou Key Laboratory of Hepatology, Wenzhou 325000, Zhejiang, China
| | - Yue-Wen Gong
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Canada
| | - Zhuo Lin
- Department of Infectious Diseases, The First Affiliated Hospital of Wenzhou Medical University, Hepatology Institute of Wenzhou Medical University, Wenzhou Key Laboratory of Hepatology, Wenzhou 325000, Zhejiang, China
| | - Xiao-Dong Wang
- Department of Infectious Diseases, The First Affiliated Hospital of Wenzhou Medical University, Hepatology Institute of Wenzhou Medical University, Wenzhou Key Laboratory of Hepatology, Wenzhou 325000, Zhejiang, China
| | - Lan-Man Xu
- Department of Infectious Diseases, The First Affiliated Hospital of Wenzhou Medical University, Hepatology Institute of Wenzhou Medical University, Wenzhou Key Laboratory of Hepatology, Wenzhou 325000, Zhejiang, China.
| | - Yong-Ping Chen
- Department of Infectious Diseases, The First Affiliated Hospital of Wenzhou Medical University, Hepatology Institute of Wenzhou Medical University, Wenzhou Key Laboratory of Hepatology, Wenzhou 325000, Zhejiang, China.
| |
Collapse
|
30
|
|
31
|
[Autoimmune hepatitis in the pediatric age]. BOLETIN MEDICO DEL HOSPITAL INFANTIL DE MEXICO 2018; 74:324-333. [PMID: 29382475 DOI: 10.1016/j.bmhimx.2017.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 04/25/2017] [Accepted: 05/11/2017] [Indexed: 11/23/2022] Open
Abstract
In pediatrics, autoimmune hepatitis and sclerosing cholangitis are liver disorders with an immunological damage mechanism. Autoimmune hepatitis is a disease of unknown etiology characterized by interface hepatitis, hypergammaglobulinemia, circulating autoantibodies and a favorable response to immunosuppression. It is an eminently pediatric disease with a prevalent condition in young women. Therapy should be instituted promptly to prevent rapid deterioration, promote remission of disease and long-term survival. The persistent lack of response or lack of adherence to treatment results in terminal liver failure; these patients, and those with fulminant hepatic insufficiency at the time of diagnosis, will require liver transplantation.
Collapse
|
32
|
Mattingley DW, Papadimos TJ. Undiagnosed autoimmune hepatitis causing prolonged mechanical ventilation. Int J Crit Illn Inj Sci 2018; 8:179-180. [PMID: 30181978 PMCID: PMC6116310 DOI: 10.4103/ijciis.ijciis_4_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- David W. Mattingley
- Department of Anesthesiology, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Thomas J. Papadimos
- Department of Anesthesiology, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA,Address for correspondence: Dr. Thomas J. Papadimos, Department of Anesthesiology, The University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA. E-mail:
| |
Collapse
|
33
|
Chaouali M, Carvalho A, Tezeghdenti A, Ben Azaiez M, Cunha C, Ghazouani E, Kochkar R. Cytotoxic T lymphocyte antigen-4 gene polymorphisms and susceptibility to type 1 autoimmune hepatitis in the Tunisian population. Genes Dis 2017; 5:256-262. [PMID: 30320190 PMCID: PMC6176120 DOI: 10.1016/j.gendis.2017.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 12/15/2017] [Indexed: 02/06/2023] Open
Abstract
Genetic factors and gene polymorphisms leading to the onset of autoimmune response in autoimmune hepatitis (AIH) are still not full elucidated. Since the CTLA-4 molecule is a key modulator of the lymphocytes responses we hypothezied that deficiencies or mutations in the gene encoding CTLA4 protein may be involved in AIH susceptibility and trigger the autoimmune response. We investigated 3 distinct polymorphic sites (+49A > G, CT60 G > A and -318C > T) of the CTLA4 gene in 50 AIH patients and 100 healthy controls using the KASP genotyping technology. A significant positive association with AIH susceptibility was found for the GG genotype in +49 position of the CTLA4 gene which was significantly higher in AIH patients compared to controls (28% vs 9%, p = 0.003, OR = 3.93 [1.56-9.88]). The CTLA4 A/A genotype in position CT60 was more significantly frequent in controls comparing to AIH patients and could be considered as a protective genotype for the tunisian patients. CTLA4 genotyping in position -318 did not show any statistically significant difference in genotype or allele distribution. The CTLA4 gene polymorphism in position +49 is associated to AIH susceptibility in the Tunisian population. Mutation in the CTLA4 gene may lead to a modification of the CTLA4 protein structure that could have functional relevance in AIH pathogenesis and onset.
Collapse
Key Words
- AIH, Autoimmune hepatitis
- AMA-M2, Anti-mitochondrial antibody-M2
- ANA, Anti-nuclear antibodies
- Autoimmune hepatitis
- CMV, Cytomegalovirus
- CTLA4 gene polymorphisms
- CTLA4, Cytotoxic T-lymphocyte antigen 4
- Cytotoxic T-lymphocyte antigen 4
- EBV, Epstein–Barr virus
- HLA, Human leucocyte antigen
- KASP PCR, Competitive allele-specific real-time PCR
- LKM1, Anti-Liver/Kidney Microsomal Antibodies Type 1
- PBC, Primary biliary cirrhosis
- PSC, Primary sclerosing cholangitis
- SLA, Antibodies against soluble liver antigen
- SMA, Smooth-muscle antibodies
Collapse
Affiliation(s)
- Marwa Chaouali
- Department of Immunology, Military Hospital of Tunis, Montfleury 1008, Tunis, Tunisia.,El Manar University, Laboratory of Mycology, Pathologies and Biomarkers 1092, Tunis, Tunisia
| | - Agostinho Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar 4710-057, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Aymen Tezeghdenti
- Department of Immunology, Military Hospital of Tunis, Montfleury 1008, Tunis, Tunisia
| | - Mouna Ben Azaiez
- Department of Immunology, Military Hospital of Tunis, Montfleury 1008, Tunis, Tunisia
| | - Cristina Cunha
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Campus de Gualtar 4710-057, Braga, Portugal
| | - Ezzeddine Ghazouani
- Department of Immunology, Military Hospital of Tunis, Montfleury 1008, Tunis, Tunisia
| | - Radhia Kochkar
- Department of Immunology, Military Hospital of Tunis, Montfleury 1008, Tunis, Tunisia
| |
Collapse
|