Autoimmune Hepatitis: Diagnosis And Therapy

Autoimmune Hepatitis Diagnosis Therapy

Autoimmune hepatitis is a form of hepatitis, which always occurs with chronic inflammation of the liver, which becomes the "target" of the immune system of the organism. The reason why this happens is not yet clear; according to experts could depend dal'assunzione of some drugs, exposure to certain toxins or by the concomitant presence of other diseases. If not diagnosed and treated at the right time can worsen to cirrhosis and eventually liver failure, the stage at which the need for a liver transplant is necessary.


British Study and Diagnosis

The diagnosis of autoimmune hepatitis is based on symptoms and the results of blood tests and liver biopsy. It must be stressed that this disease affects in particular women, over age 40, to about 80%. The tests relate to the assessment of the levels of liver enzymes and the detection of autoantibodies (ANA, antinuclear antibody, the SMA, antibodies anticellule smooth, and LKM1, liver-kidney microsomal antibodies). The symptomatology is characterized by abdominal pain, jaundice, itching, rash, nausea, vomiting, loss of appetite. The diagnosis and then a specific therapy should be timely in order to avoid any kind of complication. The science is studying ways to highlight just the part genetics involved. In order to ascertain the cause that is the basis of this disease, and other autoimmune diseases such as primary biliary cirrhosis (PBC), a group of British researchers conducted a study, whose co-author is Dr. Carl Anderson of the Wellcome Trust Sanger Institute, to identify regions of the genome involved. The researchers found, using a new technology, three genetic regions involved in the development of CBP. What is this innovative method? It is a DNA microchip, called Immunochip. The latter has the advantage to interact and to precisely identify genetic regions involved in the risk of autoimmune diseases. Until now have been identified 25 regions that can be associated with the disease. Thanks to these results and knowing the genetic activity can identify cells having a role in the onset of the disease. They are great steps forward for science that will help the development of a specific therapy and safe.


 Therapy

Up to now there is no real specific therapy, since it depends both on the stage of the disease, both from tolerance to drugs, not to mention the possible side effects. Usually are administered substances that suppress or reduce the activity of the immune system: corticosteroids and azathioprine. To quickly check the disease begins in the first weeks, with moderately high doses of corticosteroids (prednisone or prednisolone). These drugs are associated with azathioprine, also to reduce the doses, especially, if this is well tolerated. In case this does not happen is for the latter is for steroids, then, are used other drugs, such as cyclosporine, mycophenolate mofetil, or tacrolimus, to suppress the immune activity. If hepatitis is identified and treated at the right time you have a remission of this in about three years, with a life expectancy similar to the rest of the population. In severe cases it can happen that, despite the therapeutic treatment, the disease progresses worsened in cirrhosis, or other diseases that cause complications.



 

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