Cytokines with autoimmune hepatitis

Those interested in the management of autoimmune hepatitis as a condition in itself or as a complication of infectious hepatitis will appreciate a study just published in the journal Hepatology Research.

"This study investigated the relationship between circulating cytokines in the pretreatment phase and remission following corticosteroid therapy phase in Japanese AIH [autoimmune hepatitis] patients."

The authors measured 28 cytokines by multiple bead array technology in 40 patients with AIH during pretreatment and remission phases. A particular pattern stood out:

"Interleukin (IL)-12p40, interferon-γ-inducible protein (IP-10), macrophage inflammatory protein (MIP)-1α, MIP-1β, IL-17F and IL-18 were significantly decreased during remission from pretreatment stage levels. The level of IP-10 in the pretreatment phase was correlated with serum levels of alanine aminotransferase."

An assay of these cytokines can help to answer two important questions: (1) does this patient have an autoimmune component to their hepatitis, and (2) are they responding to treatment? The authors' conclusion is worth bearing in mind when these kinds of cases come up:

"Our results suggest that a complex interplay of several cytokines, especially pro-inflammatory and T-helper 17 cytokines and regulatory T-cell suppression by IL-12p40 may play a pivotal role in the pathogenesis of AIH."