Noninvasive biomarkers for the diagnosis and management of autoimmune hepatitis. Hepatology 2022 Dec;76(6):1862-1879
Date
05/26/2022Pubmed ID
35611859Pubmed Central ID
PMC9796683DOI
10.1002/hep.32591Scopus ID
2-s2.0-85131518596 (requires institutional sign-in at Scopus site) 23 CitationsAbstract
Autoimmune hepatitis (AIH) is a rare disease of unclear etiology characterized by loss of self-tolerance that can lead to liver injury, cirrhosis, and acute liver failure. First-line treatment consists of systemic corticosteroids, or budesonide, and azathioprine, to which most patients are initially responsive, although predictors of response are lacking. Relapses are very common, correlate with histological activity despite normal serum transaminases, and increase hepatic fibrosis. Furthermore, current regimens lead to adverse effects and reduced quality of life, whereas medication titration is imprecise. Biomarkers that can predict the clinical course of disease, identify patients at elevated risk for relapse, and improve monitoring and medication dosing beyond current practice would have high clinical value. Herein, we review novel candidate biomarkers in adult and pediatric AIH based on prespecified criteria, including gene expression profiles, proteins, metabolites, and immune cell phenotypes in different stages of AIH. We also discuss biomarkers relevant to AIH from other immune diseases. We conclude with proposed future directions in which biomarker implementation into clinical practice could lead to advances in personalized therapeutic management of AIH.
Author List
Harrington C, Krishnan S, Mack CL, Cravedi P, Assis DN, Levitsky JAuthor
Cara Lynn Mack MD Chief, Professor in the Pediatrics department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AzathioprineBiomarkers
Hepatitis, Autoimmune
Humans
Immunosuppressive Agents
Liver Cirrhosis
Quality of Life