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Gastroenterologia Japonica

, Volume 26, Issue 1, pp 102–108 | Cite as

Autoimmune hepatitis: The realities and the uncertainties

  • Ian R. Mackay
Article

Conclusions

The concept of autoimmue hepatitis has developed over the past 35–40 years. Despite continuing debate over the nosologie status of this disease, there are certain “realities” that argue for autoimmune hepatitis as an entity.

The uncertainties include valid criteria for distinguishing the autoimmune from other types of CAH, and the applicability of the marker antibodies for diagnosis. A reliable animal model is lacking. The initiating process, infectious or other, is unknown. The immunological events that determine self-perpetuation need elucidation. These include the identity of the liver membrane autoantigen, the immunogenetic contribution, the respective roles in pathogenesis of helper, suppressor and cytotoxic T lymphocytes, and the identification of a specific liver membrane autoantibody. Clear advances are perceptible on each of these fronts.

Keywords

Hepatitis Primary Biliary Cirrhosis Autoimmune Hepatitis Chronic Active Hepatitis Chronic Active Liver Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Mackay IR: Chronic active hepatitides, In: Van derReis, L. ed. Frontiers of Gastrointestinal Research, Karger, Basel, 1975; vol. 1:142–187Google Scholar
  2. 2.
    Mackay IR, Taft LI, Cowling DC: Lupoid hepatitis. Lancet 1956;ii: 1323–1326CrossRefGoogle Scholar
  3. 3.
    Mackay IR: Treatment of chronic active hepatitis and other liver diseases with cortico steroid agents. Med J Australia 1987; 146: 370–374PubMedGoogle Scholar
  4. 4.
    Mackay IR. O’Brien RM, Whittingham SF and Tait BD: Autoimmune and Other Diseases of the Liver: Immunogenetic Aspects. In: The Immunogenetics of Autoimmune Disease, edited by N Farid CRC Press, in press. 1990Google Scholar
  5. 5.
    Wang KW and Czaja AJ: Hepatocellular carcinoma in corticosteriod-treated severe autoimmune chronic active hepatitis. Hepatology 1989;8:1679–1683CrossRefGoogle Scholar
  6. 6.
    Mackay IR: Autoimmune (lupoid) hepatitis: An entity in the spectrum of chronic active liver disease. J Gastroenterol Hepatol 1990;5:352–359PubMedGoogle Scholar
  7. 7.
    Czaja A: Autoimmune chronic active hepatitis. A specific entity? The negative argument. J Gastroenterol Hepatol 1990;5: 343–351PubMedGoogle Scholar
  8. 8.
    Mackay IR: Autoimmune disease of the liver: chronic active hepatitis and primary biliary cirrhosis. In: Rose, NR and Mackay, IR (Eds),The Auto Immune Diseases, Orlando, Academic Press, 1985;291–337Google Scholar
  9. 9.
    Mackay IR: Mechanisms of Chtonic Hepatitis. In:Modern Concepts of Acute and Chronic Hepatitis Gitnick G Ed Plenum New York 1989;229–246Google Scholar
  10. 10.
    Taguchi O. Nishizuka Y: Self tolerance and localized autoimmunity. Mouse models of autoimmune disease that suggest tissuespecific suppressor T cells are involved in self-tolerancc. J Exp Med 1987;165:146–156PubMedCrossRefGoogle Scholar
  11. 11.
    Morahan G. Brennan FE, Bhatal PS, Allison J, Cox, KO, and Miller JFAP: Expression in transgenic mice of class 1 histocompatibility antigens controlled by the met allothionine promoter. Proc Nat Acad Sci USA 1989;86:3782–3786PubMedCrossRefGoogle Scholar
  12. 12.
    Krams SM, Dorshkind K, and Gershwin ME: Generation of biliary lesions after transfer of human lymphocytes into severe combined immunodeficient mice. J Exp Med 1989; 170:1919–1930PubMedCrossRefGoogle Scholar
  13. 13.
    Esteban JI, Esteban R, Viladomiu et al: Hepatitis virus C antibodies among risk groups in Spain. Lancet 1989;ii:294–297CrossRefGoogle Scholar
  14. 14.
    Lenzi M. Ballardini G, Fusconi M, Cassani F, Selleri L, Volta U, Zauli D, and Bianchi FM: Type 2 autoimmune hepatitis and hepatitis C virus infection. Lancet 1990;i:258–259CrossRefGoogle Scholar
  15. 15.
    Franco A. Barnaba V. Kuberti G. Benvenuto R. Balsano C, and Musca A: Liver-derived T cell clones in autoimmune chronic active hepatitis: accessory function of hepatocytes expressing class 11 major histocompatibility molecules. Clin Immunol Immunopathol 1990;54:382–394PubMedCrossRefGoogle Scholar
  16. 16.
    Frazer I H.Jordan TW, Collins EC, Andrews P, and Mackay IR: Antibody to liver membrane antigens in chronic active hepatitis. Hepatology 1987;7:4–10PubMedCrossRefGoogle Scholar
  17. 17.
    Swanson NR, Reed WD, Yarred LJ. Shilkin KB, and Joske RA: Autoantibodies to isolated plasma membranes in chronic active hepatitis. II Specificity of antibodies. Hepatology 1990;11:613–621PubMedCrossRefGoogle Scholar
  18. 18.
    Hopf U. John HU, Möller B, Stemcrowiez R, Witenbrink C, Klein R. and Berg PA: Liver membrance antibodies (LMA) recognise a 26kD protein on the hepatocellular surface. Clin Exp Immunol 1990;79:54–61PubMedCrossRefGoogle Scholar
  19. 19.
    Frazer IH, Mackay IR. Bell J. and Becker G: Cellular infiltrate in the liver in autoimmune chronic active hepatitis. Liver 1985;5:162–72PubMedGoogle Scholar

Copyright information

© The Japanese Society of Gaslroenterology 1991

Authors and Affiliations

  • Ian R. Mackay
    • 1
  1. 1.Centre for Molecular Biology and MedicineMonash UniversityClaytonAustralia

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