Autoimmune liver disease, autoimmunity and liver transplantation

原发性胆汁性肝硬化 肝移植 免疫学 自身免疫性肝炎 原发性硬化性胆管炎 医学 自身免疫 移植 自身免疫性疾病 肝病 背景(考古学) 疾病 免疫系统 肝炎 生物 内科学 抗体 古生物学
作者
Marco Carbone,James Neuberger
出处
期刊:Journal of Hepatology [Elsevier BV]
卷期号:60 (1): 210-223 被引量:218
标识
DOI:10.1016/j.jhep.2013.09.020
摘要

Primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC) and autoimmune hepatitis (AIH) represent the three major autoimmune liver diseases (AILD). PBC, PSC, and AIH are all complex disorders in that they result from the effects of multiple genes in combination with as yet unidentified environmental factors. Recent genome-wide association studies have identified numerous risk loci for PBC and PSC that host genes involved in innate or acquired immune responses. These loci may provide a clue as to the immune-based pathogenesis of AILD. Moreover, many significant risk loci for PBC and PSC are also risk loci for other autoimmune disorders, such type I diabetes, multiple sclerosis and rheumatoid arthritis, suggesting a shared genetic basis and possibly similar molecular pathways for diverse autoimmune conditions. There is no curative treatment for all three disorders, and a significant number of patients eventually progress to end-stage liver disease requiring liver transplantation (LT). LT in this context has a favourable overall outcome with current patient and graft survival exceeding 80% at 5years. Indications are as for other chronic liver disease although recent data suggest that while lethargy improves after transplantation, the effect is modest and variable so lethargy alone is not an indication. In contrast, pruritus rapidly responds. Cholangiocarcinoma, except under rigorous selection criteria, excludes LT because of the high risk of recurrence. All three conditions may recur after transplantation and are associated with a greater risk of both acute cellular and chronic ductopenic rejection. It is possible that a crosstalk between alloimmune and autoimmune response perpetuate each other. An immunological response toward self- or allo-antigens is well recognised after LT in patients transplanted for non-autoimmune indications and sometimes termed "de novo autoimmune hepatitis". Whether this is part of the spectrum of rejection or an autoimmune process is not clear. In this manuscript, we review novel findings about disease processes and mechanisms that lead to autoimmunity in the liver and their possible involvement in the immune response vs. the graft after LT.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
1秒前
寒冷的绿真完成签到 ,获得积分10
1秒前
2秒前
魚子应助三山五岳采纳,获得20
2秒前
pantutu发布了新的文献求助10
4秒前
可爱的函函应助yls采纳,获得10
4秒前
伊笙完成签到 ,获得积分10
6秒前
二七发布了新的文献求助10
7秒前
7秒前
8秒前
8秒前
Dylan完成签到,获得积分10
10秒前
mutou发布了新的文献求助30
12秒前
爆米花应助曾经不言采纳,获得10
12秒前
三山五岳给三山五岳的求助进行了留言
13秒前
梦里贪乐发布了新的文献求助10
13秒前
14秒前
永曼完成签到,获得积分10
16秒前
拣尽南枝完成签到 ,获得积分10
16秒前
16秒前
汉化完成签到 ,获得积分10
17秒前
17秒前
酷波er应助Jojin采纳,获得10
18秒前
AA完成签到,获得积分10
19秒前
烟花应助vagabond采纳,获得10
21秒前
22秒前
科研通AI5应助自觉醉薇采纳,获得10
22秒前
李小政完成签到,获得积分10
23秒前
JM发布了新的文献求助10
23秒前
科研通AI5应助张靖超采纳,获得30
24秒前
Cclown2777完成签到,获得积分10
24秒前
魔幻的冬寒完成签到,获得积分20
24秒前
25秒前
酷酷酷发布了新的文献求助10
27秒前
科研通AI5应助Jing采纳,获得10
27秒前
彭于晏应助21采纳,获得10
27秒前
机灵的鸣凤完成签到,获得积分10
29秒前
Jojin发布了新的文献求助10
29秒前
顾矜应助自由的语柳采纳,获得10
30秒前
aliaxs发布了新的文献求助10
30秒前
高分求助中
Mass producing individuality 600
Разработка метода ускоренного контроля качества электрохромных устройств 500
A Combined Chronic Toxicity and Carcinogenicity Study of ε-Polylysine in the Rat 400
International standard-setting alliance and its possible negative effect on consumer's technology acceptance and technology progress 200
Erectile dysfunction From bench to bedside 200
Integrated supply chain risk management capabilities and its impact on supply chain demand management - an empirical study 200
Advanced Introduction to Behavioral Law and Economics 200
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 物理 生物化学 纳米技术 计算机科学 化学工程 内科学 复合材料 物理化学 电极 遗传学 量子力学 基因 冶金 催化作用
热门帖子
关注 科研通微信公众号,转发送积分 3824680
求助须知:如何正确求助?哪些是违规求助? 3366960
关于积分的说明 10443806
捐赠科研通 3086316
什么是DOI,文献DOI怎么找? 1697916
邀请新用户注册赠送积分活动 816568
科研通“疑难数据库(出版商)”最低求助积分说明 769826