Advances in the evaluation and treatment of autoimmune hepatitis.

IF 2.6 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Current Opinion in Gastroenterology Pub Date : 2024-05-01 Epub Date: 2024-02-16 DOI:10.1097/MOG.0000000000001014
M R Pedersen, Marlyn J Mayo
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Abstract

Purpose of review: The primary therapy of autoimmune hepatitis (AIH) has been established for over three decades. This review focuses on updates in the evaluation and management of patients with AIH.

Recent findings: The evaluation of patients has recently been updated to include more definitive screening for other autoimmune diseases, including thyroid disease and celiac disease. Antibody detection by ELISA, an easier and more commonly available method, has been incorporated into the latest iteration of the AIH scoring system. Corticosteroids and AZA remain the backbone of AIH treatment, but there is growing evidence for mycophenolate mofetil as both first-line and second-line therapy, and growing inquiry into calcineurin inhibitors. Noninvasive markers of liver disease have now been validated in AIH, with the strongest evidence for VCTE in patients with minimal hepatic inflammation.

Summary: Recent research of alternative immunosuppressant therapies, noninvasive markers of fibrosis, and updated society guidelines, have improved our ability to evaluate, treat, and follow patients with AIH.

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自身免疫性肝炎的评估和治疗进展。
综述的目的:自身免疫性肝炎(AIH)的主要治疗方法已经确立了三十多年。本综述重点介绍自身免疫性肝炎患者评估和管理方面的最新进展:最近对患者的评估进行了更新,包括更明确地筛查其他自身免疫性疾病,包括甲状腺疾病和乳糜泻。通过酶联免疫吸附试验(ELISA)检测抗体是一种更简便、更常见的方法,已被纳入最新版的 AIH 评分系统。皮质类固醇和AZA仍是AIH治疗的主要手段,但越来越多的证据表明霉酚酸酯可作为一线和二线治疗手段,对钙神经蛋白抑制剂的研究也在不断深入。肝脏疾病的非侵入性标志物现已在 AIH 中得到验证,在肝脏炎症轻微的患者中,VCTE 的证据最为充分:近期对替代性免疫抑制剂疗法、纤维化的无创标记物的研究以及更新的社会指南,提高了我们评估、治疗和随访 AIH 患者的能力。
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来源期刊
Current Opinion in Gastroenterology
Current Opinion in Gastroenterology 医学-胃肠肝病学
CiteScore
5.30
自引率
0.00%
发文量
137
审稿时长
6-12 weeks
期刊介绍: ​​​​​​​Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in Gastroenterology features hand-picked review articles from our team of expert editors. With twelve disciplines published across the year – including gastrointestinal infections, nutrition and inflammatory bowel disease – every issue also contains annotated references detailing the merits of the most important papers.
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