药物诱导的自身免疫样肝炎的研究进展

李勤荣; 尧颖; 徐智媛

doi:10.12449/JCH240628

药物诱导的自身免疫样肝炎的研究进展

DOI: 10.12449/JCH240628

李勤荣¹,
尧颖²,
徐智媛^1, , ,

1.
昆明医科大学第二附属医院消化内科，昆明 650000
2.
昆明医科大学附属延安医院消化内科，昆明 650051

基金项目:

国家自然科学基金 (82160106)

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：李勤荣负责课题设计，资料分析，撰写论文；尧颖负责指导撰写文章；徐智媛负责指导撰写文章并最后定稿。

详细信息

通信作者:
徐智媛， xuzhiyuan0109@163.com （ORCID： 0000-0003-0289-5947）

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- 被引次数: 0
出版历程
- 收稿日期: 2023-10-14
- 录用日期: 2023-10-30
- 出版日期: 2024-06-25

Research advances in drug-induced autoimmune-like hepatitis

Qinrong LI¹,
Ying YAO²,
Zhiyuan XU^{1
, ,
,}

1.
Department of Gastroenterology，The Second Affiliated Hospital of Kunming Medical University，Kunming 650000，China
2.
Department of Gastroenterology，Yan’an Hospital Affiliated to Kunming Medical University，Kunming 650051，China

Research funding:

National Natural Science Foundation of China (82160106)

More Information

Corresponding author: XU Zhiyuan， xuzhiyuan0109@163.com （ORCID： 0000-0003-0289-5947）

摘要

摘要: 药物诱导的自身免疫样肝炎（DI-ALH）是药物性肝损伤的一种特殊临床表型，与自身免疫性肝炎有相似的临床特征和实验室检查，多数时候通过肝组织活检也无法直接区分，因此正确鉴别DI-ALH与自身免疫性肝炎是临床实践中的重难点。本文总结了DI-ALH的发病机制、临床特点、诊治、预后的研究进展，为临床医生提供此类疾病的诊治思路。
- 化学性与药物性肝损伤 /
- 肝炎，自身免疫性 /
- 诊断 /
- 治疗学
Abstract: Drug-induced autoimmune-like hepatitis （DI-ALH） is a special clinical phenotype of drug-induced liver injury and has similar clinical features and laboratory test results to autoimmune hepatitis， and it is often difficult to distinguish them through liver biopsy. Therefore， correct differential diagnosis DI-ALH and autoimmune hepatitis is a crucial and difficult point in clinical practice. This article analyzes the research advances in the pathogenesis， clinical features， diagnosis and treatment， and prognosis of DI-ALH， in order to provide ideas for the diagnosis and treatment of such diseases among clinicians.
- Chemical and Drug Induced Liver Injury /
- Hepatitis， Autoimmune /
- Diagnosis /
- Therapeutics

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参考文献(35)

[1]	Technology Committee on DILI Prevention and Management, Chinese Medical Biotechnology Association; Study Group of Drug-Induced Liver Disease, Chinese Medical Association for the Study of Liver Diseases. Chinese guideline for diagnosis and management of drug-induced liver injury(2023 version)[J]. Chin J Gastroenterol, 2022, 27( 6): 341- 375. DOI: 10.3760/cma.j.cn501113-20230419-00176-1. 中国医药生物技术协会药物性肝损伤防治技术专业委员会, 中华医学会肝病学分会药物性肝病学组. 中国药物性肝损伤诊治指南(2023年版)[J]. 胃肠病学, 2022, 27( 6): 341- 375. DOI: 10.3760/cma.j.cn501113-20230419-00176-1.
[2]	HOOFNAGLE JH, BJÖRNSSON ES. Drug-induced liver injury-Types and phenotypes[J]. N Engl J Med, 2019, 381( 3): 264- 273. DOI: 10.1056/nejmra1816149.
[3]	QIN TT, MUHAMMAD H, ZHOU Y, et al. Macrophage malfunction in Triptolide-induced indirect hepatotoxicity[J]. Front Pharmacol, 2022, 13: 981996. DOI: 10.3389/fphar.2022.981996.
[4]	BRUNO CD, FREMD B, CHURCH RJ, et al. HLA associations with infliximab-induced liver injury[J]. Pharmacogenomics J, 2020, 20( 5): 681- 686. DOI: 10.1038/s41397-020-0159-0.
[5]	GUO CQ, LIU WJ, LIU Z, et al. Scavenger receptor a is a major homeostatic regulator that restrains drug-induced liver injury[J]. Hepatology, 2023, 78( 1): 45- 57. DOI: 10.1097/HEP.0000000000000044.
[6]	ANDRADE RJ, AITHAL GP, de BOER YS, et al. Nomenclature, diagnosis and management of drug-induced autoimmune-like hepatitis(DI-ALH): An expert opinion meeting report[J]. J Hepatol, 2023, 79( 3): 853- 866. DOI: 10.1016/j.jhep.2023.04.033.
[7]	BESSONE F, FERRARI A, HERNANDEZ N, et al. Nitrofurantoin-induced liver injury: Long-term follow-up in two prospective DILI registries[J]. Arch Toxicol, 2023, 97( 2): 593- 602. DOI: 10.1007/s00204-022-03419-7.
[8]	de BOER YS, KOSINSKI AS, URBAN TJ, et al. Features of autoimmune hepatitis in patients with drug-induced liver injury[J]. Clin Gastroenterol Hepatol, 2017, 15( 1): 103- 112. e 2. DOI: 10.1016/j.cgh.2016.05.043.
[9]	BJÖRNSSON ES, MEDINA-CALIZ I, ANDRADE RJ, et al. Setting up criteria for drug-induced autoimmune-like hepatitis through a systematic analysis of published reports[J]. Hepatol Commun, 2022, 6( 8): 1895- 1909. DOI: 10.1002/hep4.1959.
[10]	MIKIEWICZ M, OTROCKA-DOMAGAŁA I, PAŹDZIOR-CZAPULA K. Influence of simvastatin on hepatocytes-histopathological and immunohistochemical study[J]. Pol J Vet Sci, 2019, 22( 2): 263- 270. DOI: 10.24425/pjvs.2019.127095.
[11]	SHAO YM, ZHANG Y, YIN X, et al. Herb-induced autoimmune-like hepatitis associated with Xiang-Tian-Guo(Swietenia macrophylla seeds): A case report and literature review[J]. Medicine, 2021, 100( 2): e24045. DOI: 10.1097/MD.0000000000024045.
[12]	BRIL F, DIFFALHA S AL, DEAN M, et al. Autoimmune hepatitis developing after coronavirus disease 2019(COVID-19) vaccine: Causality or casualty?[J]. J Hepatol, 2021, 75( 1): 222- 224. DOI: 10.1016/j.jhep.2021.04.003.
[13]	EFE C, KULKARNI AV, TERZIROLI BERETTA-PICCOLI B, et al. Liver injury after SARS-CoV-2 vaccination: Features of immune-mediated hepatitis, role of corticosteroid therapy and outcome[J]. Hepatology, 2022, 76( 6): 1576- 1586. DOI: 10.1002/hep.32572.
[14]	MACK CL, ADAMS D, ASSIS DN, et al. Diagnosis and management of autoimmune hepatitis in adults and children: 2019 practice guidance and guidelines from the American association for the study of liver diseases[J]. Hepatology, 2020, 72( 2): 671- 722. DOI: 10.1002/hep.31065.
[15]	BJÖRNSSON E, TALWALKAR J, TREEPRASERTSUK S, et al. Drug-induced autoimmune hepatitis: Clinical characteristics and prognosis[J]. Hepatology, 2010, 51( 6): 2040- 2048. DOI: 10.1002/hep.23588.
[16]	STEPHENS C, ROBLES-DIAZ M, MEDINA-CALIZ I, et al. Comprehensive analysis and insights gained from long-term experience of the Spanish DILI Registry[J]. J Hepatol, 2021, 75( 1): 86- 97. DOI: 10.1016/j.jhep.2021.01.029.
[17]	GARCÍA-CORTÉS M, ORTEGA-ALONSO A, MATILLA-CABELLO G, et al. Clinical presentation, causative drugs and outcome of patients with autoimmune features in two prospective DILI registries[J]. Liver Int, 2023, 43( 8): 1749- 1760. DOI: 10.1111/liv.15623.
[18]	SUN Y, ZENG Z, YANG L, et al. Clinical characteristics of drug-induced liver injury combined with autoimmune disease[J/CD]. Chin J Liver Dis(Electronic Version), 2023, 15( 4): 28- 32. DOI: 10.3969/j.issn.1674-7380.2023.04.006. 孙月, 曾湛, 杨柳, 等. 药物性肝损伤合并自身免疫病患者的临床特点[J/CD]. 中国肝脏病杂志(电子版), 2023, 15( 4): 28- 32. DOI: 10.3969/j.issn.1674-7380.2023.04.006.
[19]	WEBER S, BENESIC A, BUCHHOLTZ ML, et al. Antimitochondrial rather than antinuclear antibodies correlate with severe drug-induced liver injury[J]. Dig Dis, 2021, 39( 3): 275- 282. DOI: 10.1159/000511635.
[20]	SUZUKI A, BRUNT EM, KLEINER DE, et al. The use of liver biopsy evaluation in discrimination of idiopathic autoimmune hepatitis versus drug-induced liver injury[J]. Hepatology, 2011, 54( 3): 931- 939. DOI: 10.1002/hep.24481.
[21]	FEBRES-ALDANA CA, ALGHAMDI S, KRISHNAMURTHY K, et al. Liver fibrosis helps to distinguish autoimmune hepatitis from DILI with autoimmune features: A review of twenty cases[J]. J Clin Transl Hepatol, 2019, 7( 1): 21- 26. DOI: 10.14218/JCTH.2018.00053.
[22]	LAMMERT C, ZHU CS, LIAN Y, et al. Exploratory study of autoantibody profiling in drug-induced liver injury with an autoimmune phenotype[J]. Hepatol Commun, 2020, 4( 11): 1651- 1663. DOI: 10.1002/hep4.1582.
[23]	TAUBERT R, ENGEL B, DIESTELHORST J, et al. Quantification of polyreactive immunoglobulin G facilitates the diagnosis of autoimmune hepatitis[J]. Hepatology, 2022, 75( 1): 13- 27. DOI: 10.1002/hep.32134.
[24]	TESCHKE R, DANAN G. Advances in idiosyncratic drug-induced liver injury issues: New clinical and mechanistic analysis due to roussel uclaf causality assessment method use[J]. Int J Mol Sci, 2023, 24( 13): 10855. DOI: 10.3390/ijms241310855.
[25]	WEBER S, GERBES AL. Relapse and need for extended immunosuppression: Novel features of drug-induced autoimmune hepatitis[J]. Digestion, 2023, 104( 3): 243- 248. DOI: 10.1159/000528329.
[26]	European Association for the Study of the Liver. EASL clinical practice guidelines: Drug-induced liver injury[J]. J Hepatol, 2019, 70( 6): 1222- 1261. DOI: 10.1016/j.jhep.2019.02.014.
[27]	BJÖRNSSON HK, GUDBJORNSSON B, BJÖRNSSON ES. Infliximab-induced liver injury: Clinical phenotypes, autoimmunity and the role of corticosteroid treatment[J]. J Hepatol, 2022, 76( 1): 86- 92. DOI: 10.1016/j.jhep.2021.08.024.
[28]	KUZU UB, ÖZTAŞ E, TURHAN N, et al. Clinical and histological features of idiosyncratic liver injury: Dilemma in diagnosis of autoimmune hepatitis[J]. Hepatol Res, 2016, 46( 4): 277- 291. DOI: 10.1111/hepr.12530.
[29]	MARTÍNEZ-CASAS OY, DÍAZ-RAMÍREZ GS, MARÍN-ZULUAGA JI, et al. Differential characteristics in drug-induced autoimmune hepatitis[J]. JGH Open, 2018, 2( 3): 97- 104. DOI: 10.1002/jgh3.12054.
[30]	BJÖRNSSON ES, BERGMANN O, JONASSON JG, et al. Drug-induced autoimmune hepatitis: Response to corticosteroids and lack of relapse after cessation of steroids[J]. Clin Gastroenterol Hepatol, 2017, 15( 10): 1635- 1636. DOI: 10.1016/j.cgh.2017.05.027.
[31]	UENO M, TAKABATAKE H, KAYAHARA T, et al. Long-term outcomes of drug-induced autoimmune-like hepatitis after pulse steroid therapy[J]. Hepatol Res, 2023, 53( 11): 1073- 1083. DOI: 10.1111/hepr.13940.
[32]	LUCENA MI, KAPLOWITZ N, HALLAL H, et al. Recurrent drug-induced liver injury(DILI) with different drugs in the Spanish Registry: The dilemma of the relationship to autoimmune hepatitis[J]. J Hepatol, 2011, 55( 4): 820- 827. DOI: 10.1016/j.jhep.2010.12.041.
[33]	ROBLES-DIAZ M, LUCENA MI, KAPLOWITZ N, et al. Use of Hy’s law and a new composite algorithm to predict acute liver failure in patients with drug-induced liver injury[J]. Gastroenterology, 2014, 147( 1): 109- 118. e 5. DOI: 10.1053/j.gastro.2014.03.050.
[34]	LO RE V 3, HAYNES K, FORDE KA, et al. Risk of acute liver failure in patients with drug-induced liver injury: Evaluation of hy’s law and a new prognostic model[J]. Clin Gastroenterol Hepatol, 2015, 13( 13): 2360- 2368. DOI: 10.1016/j.cgh.2015.06.020.
[35]	DEVARBHAVI H, ASRANI SK, ARAB JP, et al. Global burden of liver disease: 2023 update[J]. J Hepatol, 2023, 79( 2): 516- 537. DOI: 10.1016/j.jhep.2023.03.017.