Autoimmune hepatitis (AIH), also known as lupoid hepatitis, is a chronic autoimmune disease first described in 1951 in which the immune system attacks the autogenous liver cells causing progressive inflammation. It is an immune-mediated inflammatory disorder characterized by the increased circulating immunoglobulins or autoantibodies and transaminase.
AIH is generally classified into 2 different types according to the nature of the serum autoantibodies, type 1 AIH characterized by the presence of antinuclear antibody (ANA) and/or anti-smooth muscle antibody (SMA), and type 2 AIH characterized by the positivity for anti-liver kidney microsomal type 1 antibody (anti-LKM-1) and/or for anti-liver cytosol type 1 antibody (anti-LC-1). AIH can occur at any age, in all ethnic groups, and both global children and adults, but predominantly in women. It has been reported that AIH affected 4 to 25 individuals per 100,000 population, of which type 1 AIH dominates, about 80%, and type 2 AIH is mainly diagnosed among children and young adults. The AIH pathogenesis, similar to other autoimmune diseases, was thought to be closely related to abnormal immune tolerance mechanisms, which may be caused by viral infections, medication, genetic and environmental factors.
Fig.1 Pathogenesis of autoimmune hepatitis. (Sucher, 2019)
To diagnose AIH, other chronic liver diseases should be excluded according to clinical features, such as drug-induced hepatitis, viral hepatitis, alcohol-induced hepatitis, and idiopathic chronic hepatitis. One of the key diagnostic criteria is the detection of elevated autoantibodies (ANA, SMA, anti-LKM-1, and anti-LC-1). The autoantibody tests are more than helpful for AIH diagnosis, also for a specific classification of AIH. The increased serum transaminase level is another indicator of the AIH diagnosis. The liver biopsy is also a useful method to distinguish AIH from other liver diseases.
Currently, the frontline treatment mainly relies on immunosuppressive therapy, in which corticosteroids and azathioprine are usually used as a standard to suppress inflammation, relieve symptoms and liver functions, and avoid relapse. Alternative therapies are recommended when treatment fails or relapses frequently.
Additionally, other novel therapeutics, such as microRNAs (miRNAs) therapy and PD-1 antibody, are being investigated for AIH treatment. And an array of useful targets and biomarkers have been identified, which also provides clues for the new drug development for the treatment of AIH.
Fig.2 Treatment strategy in autoimmune hepatitis. (Lowe, 2018)
Having been actively exploring effective autoimmune hepatitis treatments for many years, Creative Biolabs has gained significant knowledge and rich experience in autoimmune hepatitis new therapy development. We are now providing novel monoclonal antibody, bispecific antibody, and cell-based therapy development services for the treatment of autoimmune hepatitis, based on the advantages of:
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