Evolving new therapies of autoimmune hepatitis

Clin Liver Dis. 2002 Aug;6(3):825-50, ix. doi: 10.1016/s1089-3261(02)00029-6.

Abstract

Refinements in the understanding of the mechanisms of immunocyte activation and the emergence of new immunosuppressive agents with highly selective actions has created opportunities for improving the treatment of autoimmune hepatitis. Drugs, such as budesonide and deflazacort, may inhibit immunocyte activation and limit corticosteroid-related side effects. Agents, such as cyclosporine and tacrolimus, can impair calcineurin activity and restrict the generation of transcription factors necessary for T cell responses. Intravenous immunoglobulin can bind anti-idiotype antibodies and reduce interleukin-2 secretion, and monoclonal antibodies directed against critical components of the T cell activation cascade can dampen the immune reaction. Drugs, such as mycophenolate mofetil, cyclophosphamide, methotrexate, and KF20444, can inhibit T cell proliferation, and other interventions promise to deplete activated T cells, impair effector mechanisms, and induce self-tolerance.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / pharmacology
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Autoantibodies / immunology
  • Budesonide / pharmacology
  • Budesonide / therapeutic use
  • Cyclophosphamide / pharmacology
  • Cyclophosphamide / therapeutic use
  • Cyclosporine / pharmacology
  • Cyclosporine / therapeutic use
  • Hepatitis, Autoimmune / drug therapy*
  • Hepatitis, Autoimmune / immunology
  • Humans
  • Immunoglobulins, Intravenous / pharmacology
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunosuppressive Agents / pharmacology
  • Immunosuppressive Agents / therapeutic use*
  • Methotrexate / pharmacology
  • Methotrexate / therapeutic use
  • Mycophenolic Acid / analogs & derivatives
  • Mycophenolic Acid / pharmacology
  • Mycophenolic Acid / therapeutic use
  • Signal Transduction / immunology
  • Tacrolimus / pharmacology
  • Tacrolimus / therapeutic use

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Autoantibodies
  • Immunoglobulins, Intravenous
  • Immunosuppressive Agents
  • Budesonide
  • Cyclosporine
  • Cyclophosphamide
  • Mycophenolic Acid
  • Tacrolimus
  • Methotrexate