Clinical Gastroenterology Vol.26 No.11(2-2)

Theme Liver and Immunity
Title Pathogenesis of Autoimmune Hepatitis with Reference to Pathological Aspects
Publish Date 2011/10
Author Yasuni Nakanuma Department of Human Pathology, Kanazawa University Graduate School of Medicine
Author Kenichi Harada Department of Human Pathology, Kanazawa University Graduate School of Medicine
Author Yuko Kakuda Department of Human Pathology, Kanazawa University Graduate School of Medicine
Author Hiroko Ikeda Pathology Diagnosis Service Section, Kanazawa University Hospital
[ Summary ] Autoimmune hepatitis is an organ-specific autoimmune disease targeting hepatocytes. Chronic hepatitis with marked lymphoplasmacytic infiltration at limiting plates (interface hepatitis)and progressive fibrosis is the pathologic prototype. The etiopathogenesis of this condition is linked to, disturbance in regulatory T cells with a loss of immunetolerance to autoantigens (hepatocyte peptide) eventually leading to activation of uncommitted, autoreactive CD4+ T cells toward hepatocyte-antigens followed by their differentiation to Th1 and Th2 cells and their active proliferation. The former reaction is associated with the release of IL-1 and TNF-α and activation of cytotoxic T cells against hepatocytes and the resultant liver damage. The latter causes the release of IL-4, IL-10 and IL-13 followed by stimulation of B cells, secretion of autoantibodies and resultant liver damage. In the liver, activation of these immunocystes with participation of non-immune cells may be responsible for the development of autoimmune hepatitis.
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