Guidelines for Therapy of Autoimmune Liver Disease

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Guidelines for Therapy of Autoimmune Liver Disease

Hiromi Ishibashi,

Atsumasa Komor,

Shinji Shimoda, M. Gershwin

Clinical Research Center, National Hospital Organization (NHO), Nagasaki Medical Center, and Department of Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan

Medicine and Biosystemic

Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan

Division of Rheumatology, Allergy, and Clinical Immunology, University of

California at School of Medicine, Genome and Biomedical Sciences

Facility, , California

ABSTRACT

The

principle of therapy for chronic inflammatory liver diseases is the removal of

causal agents. For autoimmune liver diseases, however,

total removal of causal agents and immune cells is impossible.

Therefore, autoimmune liver diseases are presently treated by

suppression of the immune response. Autoimmune

hepatitis is characteristically responsive to corticosteroids, often used in

combination with azathioprine to obtain a

steroid-sparing effect. For primary biliary cirrhosis,

ursodeoxycholic acid is safe and is the first choice

for treatment. Treatment of this autoimmune liver

disease should also address various symptoms and complications arising from any

associated autoimmune diseases, particularly cholestasis

and cirrhosis-related complications. For primary sclerosing cholangitis there are

no established immunomodulatory therapies, but

medical, endoscopic, and surgical treatments are applicable

to this disease. Liver transplantation becomes

indicated during the eventual end stages of each of these immune-mediated liver

diseases.

Barb in Texas - Together in the Fight, Whatever it Takes!

Son Ken (33) UC 91 - PSC 99 Listed 7/21 @ Baylor Dallas

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Thanks for posting this Barb.Doesn't it make you mad to see that treatment for AH is steroids, treatment for PBC is URSO and for PSC "there are no established immunomodulatory therapies" ?To quote Huey , "I want a new drug"!!One to treat PSC !Dang, we need that research.Thanks for keeping us up on things,LeePS Best wishes for Ken , I am thinking about your family.For primary sclerosing cholangitis there are no established immunomodulatory therapies, but medical,endoscopic, and surgical treatments are applicable to this disease. Liver transplantation becomes indicated during the eventual end stages of each of these immune-mediated liver diseases.Barb in Texas - Together in the Fight, Whatever it Takes!Son Ken (33) UC 91 - PSC 99 Listed 7/21 @ Baylor Dallas