What is De Novo Autoimmune Hepatitis?
Up to five percent of liver transplant recipients develop chronic allograft hepatitis (inflammation of the transplanted liver) in which a person's immune system attacks parts of his or her own liver, this is called De Novo Autoimmune Hepatitis (d-AIH). This is an important problem because d-AIH is often progressive and can lead to severe dysfunction of the new liver and result in liver failure.
Why is research needed on De Novo Autoimmune Hepatitis?
Physicians do not have a good understanding of why some patients develop d-AIH. At Children's Memorial Hospital researchers are conducting studies in order to get a better understanding of why some patients are more likely to get d-AIH so that prevention and treatment strategies can be developed in order to reduce the frequency of loss of the liver and the need for re-transplantation.
What have researchers learned so far?
At Children's Memorial Hospital researchers have encouraging preliminary results from their research on d-AIH. The preliminary data suggests that certain cells (called regulatory T cells) in our body which help control inflammation are less likely to be found in liver transplant patients who develop d-AIH. Researchers have also found that the use of certain immunosuppressive drugs to treat d-AIH appears to result in improvements in the number of regulatory T cells in the blood and resolve the inflammation in the transplanted liver.
What are the plans for future research?
Future research studies at Children's Memorial Hospital are looking to develop tools which reliably detect differences between liver transplant recipients that predispose them to develop d-AIH. They are also seeking to develop a "bio-profile" that can be used in a strategy for prevention of d-AIH. The results of this research are expected to substantially close the gap in knowledge related to d-AIH and improve the long-term survival and well being of patients requiring a liver transplant.
Abstracts/Manuscripts from research completed
Udeme D. Ekong, MD; James Mathew, PhD;
Hector Melin-Aldana, MD; Leslie Wolfson; Deli Wang, MD, PhD; Maurice O'Gorman, PhD; Estella M. Alonso, MD. Increase in Regulatory T Cell Phenotypes with Successful Resolution of Inflammation in Rapamycin Treated Post Transplant Autoimmune Hepatitis. Hepatology October 2010, (suppl)52; 4:279a*