The use of biologics in the treatment of autoimmune liver disease

Christopher Chang, Atsushi Tanaka, Christopher Bowlus, M. Eric Gershwin

Research output: Contribution to journalReview article

Abstract

Introduction: Autoimmune liver diseases include autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC) and juvenile autoimmune hepatitis (JAIH). The pathophysiologic features of each disease vary, but generally include presence of autoantibodies, cytokine abnormalities, and/or T and B cell autoreactivity. Areas covered: This article compares conventional therapy with newer biologics available for treatment of autoimmune liver diseases. Conventional therapy involves the use of immunosuppressive agents, or other treatment modalities for specific autoimmune liver diseases such as ursodeoxycholic acid and fibrates for PBC. Biologics were developed to target the production of autoantibodies by B cells, the presence of proinflammatory cytokines, adhesion molecules or T and B cell activation. Expert opinion: Despite the promise of biologics being able to target specific cellular and humoral pathways, results have been generally poor, and safety has not been as expected. Cases of autoimmune hepatitis have also developed with the use of these biologicals. Reasons for the lack of success of biologics in treating autoimmune liver disease has led to a reevaluation of our understanding of underlying pathogenesis, demonstrating that while our knowledge of the immunity has improved over the past two decades, it is far from complete.

Original languageEnglish (US)
Pages (from-to)385-398
Number of pages14
JournalExpert Opinion on Investigational Drugs
Volume29
Issue number4
DOIs
StatePublished - Apr 2 2020

Keywords

  • autoantibodies
  • Autoimmune hepatitis
  • biological modifiers
  • immunosuppressive agents
  • monoclonal antibodies
  • primary biliary cholangitis
  • primary biliary cirrhosis
  • primary sclerosing cholangitis

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

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