Chengdu Xinhua Hospital, Chengdu, China.
School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Hepatol Commun. 2023 Sep 11;7(10). doi: 10.1097/HC9.0000000000000269. eCollection 2023 Oct 1.
Autoimmune hepatitis (AIH) is a chronic autoimmune liver disease that can lead to hepatocyte destruction, inflammation, liver fibrosis, cirrhosis, and liver failure. The diagnosis of AIH requires the identification of lymphoblast cell interface hepatitis and serum biochemical abnormalities, as well as the exclusion of related diseases. According to different specific autoantibodies, AIH can be divided into AIH-1 and AIH-2. The first-line treatment for AIH is a corticosteroid and azathioprine regimen, and patients with liver failure require liver transplantation. However, the long-term use of corticosteroids has obvious side effects, and patients are prone to relapse after drug withdrawal. Autoimmune diseases are characterized by an imbalance in immune tolerance of self-antigens, activation of autoreactive T cells, overactivity of B cells, and increased production of autoantibodies. CD4+ T cells are key players in adaptive immunity and can secrete cytokines, activate B cells to produce antibodies, and influence the cytotoxicity of CD8+ T cells. According to their characteristics, CD4+ T cells can be divided into different subsets. In this review, we discuss the changes in T helper (Th)1, Th2, Th17, Th9, Th22, regulatory T cell, T follicular helper, and T peripheral helper cells and their related factors in AIH and discuss the therapeutic potential of targeting CD4+ T-cell subsets in AIH.
自身免疫性肝炎(AIH)是一种慢性自身免疫性肝病,可导致肝细胞破坏、炎症、肝纤维化、肝硬化和肝功能衰竭。AIH 的诊断需要识别淋巴母细胞界面肝炎和血清生化异常,并排除相关疾病。根据不同的特异性自身抗体,AIH 可分为 AIH-1 和 AIH-2。AIH 的一线治疗是皮质类固醇和硫唑嘌呤方案,肝功能衰竭的患者需要进行肝移植。然而,长期使用皮质类固醇有明显的副作用,并且患者在停药后容易复发。自身免疫性疾病的特征是自身抗原免疫耐受失衡、自身反应性 T 细胞激活、B 细胞过度活跃和自身抗体产生增加。CD4+T 细胞是适应性免疫的关键参与者,能够分泌细胞因子、激活 B 细胞产生抗体,并影响 CD8+T 细胞的细胞毒性。根据其特点,CD4+T 细胞可分为不同的亚群。在这篇综述中,我们讨论了 AIH 中 Th1、Th2、Th17、Th9、Th22、调节性 T 细胞、滤泡辅助 T 细胞和外周辅助 T 细胞及其相关因子的变化,并讨论了针对 CD4+T 细胞亚群在 AIH 中的治疗潜力。