炎性小体在肝脏疾病和自身免疫性肝炎与传染性肝炎中的作用:一个广泛的综述

E. Gadour, Dr. Bogdan Miutescu
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引用次数: 0

摘要

自身免疫性肝炎(AIH)是一种以门静脉周围炎症、免疫球蛋白和自身抗体升高以及对免疫抑制的显著反应为特征的慢性炎症。在遗传易感人群中,一种环境污染物被认为会诱发针对肝脏抗原的免疫介导攻击。可以检测到从慢性惰性疾病到暴发性肝功能衰竭的广泛临床表现,诊断需要排除肝脏疾病的其他原因。皮质类固醇治疗必须及早开始,并因人而异。临床症状的多样性、自然史的不确定性、治疗终点的发展概念以及许多替代免疫抑制药物的存在,都可能混淆治疗决策。所需治疗的最终目的是实现正常的肝脏检查和组织;然而,这必须与副作用的危险相平衡。早期肝移植可能对失代偿患者有益。当治疗开始迅速和积极,长期预后是很好的。本文就AIH的临床表现、危险因素、免疫发病机制、现代诊断标准、最新治疗进展、妊娠期AIH的简要讨论以及AIH患者对肝硬化和肝细胞癌的长期影响进行了综述。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Role of Inflammasomes in Liver Disease and Autoimmune Hepatitis vs. Infectious Hepatitis: An Extensive Review
Autoimmune hepatitis (AIH) is a chronic inflammatory condition characterized by periportal inflammation, increased immunoglobulins and autoantibodies, and a significant response to immunosuppression. In genetically predisposed people, an environmental contaminant is thought to induce an immune-mediated attack against liver antigens. A wide range of clinical manifestations, from chronic indolent illness to fulminant hepatic failure, can be detected, and the diagnosis necessitates the exclusion of other causes of liver disease. Corticosteroid therapy must be started early and tailored to the person. The variety of clinical symptoms, uncertainty regarding the natural history, developing notions about therapeutic end targets, and the existence of many alternative immunosuppressive drugs can confound therapeutic decisions. The ultimate aim of the desired therapy is to achieve normal liver tests and tissue; however, this must be balanced against the danger of side effects. Early liver transplantation may be beneficial for decompensated patients. When therapy is started quickly and aggressively, the long-term prognosis is excellent. Our article addresses AIH and provides a thorough overview of its clinical presentation, risk factors, immunopathogenesis, modern diagnostic criteria, recent advancements in therapy, a brief discussion of AIH during pregnancy, and long-term effects on cirrhosis and hepatocellular carcinoma in patients with AIH.
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