ABSTRACT
Due to limited options and modalities for the etiological treatment of autoimmune liver diseases, it is urgent to seek new therapeutic methods for liver autoimmune diseases. As the most common source of cells for stem cell therapy, mesenchymal stem cells (MSCs) play an important role in regulating innate and adaptive immune responses and have been widely used in clinical trials for the treatment of autoimmune diseases and inflammatory diseases. Recent experimental and clinical studies have shown that MSCs and MSC-EVs can inhibit the activation and proliferation of a variety of liver proinflammatory cells (such as Th1, Th17, and M1 macrophages), regulate the differentiation of different subsets of T and B cells, reduce the secretion of proinflammatory cytokines, and promote the proliferation of anti-inflammatory cells, thereby playing an immunoregulatory role. This article reviews the clinical trials of MSCs and MSC-EVs in the treatment of autoimmune liver diseases and their mechanism in regulating immune function and promoting hepatocyte regeneration and briefly describes the potential application and limitations of MSCs and MSC-EVs in clinical practice.
ABSTRACT
Autoimmune hepatitis (AIH) is an inflammatory disease of the liver mediated by autoimmune response, and in the diagnosis and treatment of AIH, it is of great importance to accurately assess the progression of liver inflammation, screen out the patients requiring corticosteroid therapy, and evaluate the therapeutic outcome. This article introduces a variety of new noninvasive techniques which have been discovered by clinical and experimental studies in recent years and have the potential to evaluate the progression of AIH, as well as the advantages and disadvantages of each technique. It is concluded that the new noninvasive techniques have more advantages in guiding the corticosteroid therapy for AIH, but further clinical studies are still needed for verification.
ABSTRACT
Chronic hepatitis B (CHB) liver fibrosis is the process of liver tissue damage and repair caused by hepatitis B virus (HBV) infection and may develop into liver cirrhosis in severe cases, and there are still no specific drugs for the treatment of this disease. This article summarizes the main targets involved in the development and progression of CHB liver fibrosis, such as hepatic stellate cell activation, inflammation, and gut-liver axis, as well as the signal transduction pathways associated with fibrosis, and targeting these targets may have a certain anti-fibrogenic effect. At present, anti-HBV therapy combined with or followed by anti-fibrotic therapy can delay or even reverse liver fibrosis/cirrhosis in some patients; however, the reversal of advanced liver fibrosis/cirrhosis still faces great challenges, and there is still no consensus on the timing of combined or sequential therapy. It is believed that identification of therapeutic targets highly associated with CHB liver fibrosis/cirrhosis and combination therapy with compounds targeting multiple pathways associated with liver fibrosis will become the focus of future research.
ABSTRACT
Autoimmune cholangitis (AIC) was first reported in 1987 as a chronic cholestatic disease that occurs predominantly in middle-aged women and has a common clinical manifestations, biochemical abnormalities and pathological changes with primary biliary cholangitis (PBC). However, serum anti-mitochondrial antibodies (AMA) are negative, and ANA and/or smooth muscle antibody positive rates are higher. The treatment response and prognosis with ursodeoxycholic acid and steroids is poor, thus it needs to be treated with immunosuppressive agents. Presently, the exact pathological mechanism of AIC is still unclear, and there is no unified assertion that classifies it as a new autoimmune liver disease or AMA-negative PBC. This article reviews the worldwide published work on AIC and compares them with PBC.