Autoimmune Hepatitis Research Progress

Autoimmune hepatitis is a chronic, progressive liver disease that responds well to immunosuppressive therapy, but has a poor prognosis if untreated. The prevalence of the disease is highest in Caucasians, Europeans, Americans and women. Possible triggering factors include viruses, other autoimmune disorders and drugs. The molecular mechanisms contributing to the pathogenesis include: reactions of autoantibodies against their corresponding autoantigens, and aberrant expression of histocompatibility antigen class I and II molecules. The diagnosis criterion of IAIHG is acceptable more and more to doctors. Corticosteroids as monotherapy or in combination with azathioprine are the treatments of choice, different therapeutic schedules and particularities of treatment for pregnant women and children have been established. To avoid treatment-associated adverse effects, alternative therapies have been proposed, including ciclosporin, tacrolimus, ursodeoxycholic acid, 6-mercaptopurine, CTLA~4Ig and traditional Chinese medicine. Liver trans- plantation is indicated for patients refractory to or intolerant of immunosuppressive therapy. The natural history of autoimmune hepatitis shows a poor prognosis, with frequent progression to cirrhosis and hepatic insufficiency in untreated patients. In the last part of this paper, we discusses the experience of professor Guanghua Zhang to diagnose and treat the autoimmune hepatic diseases.