Diagnosis and therapy of autoimmune hepatitis

Mini-Reviews in Medicinal Chemistry

Volumn 9, Issue 7, 2009, Pages 847-860

  Granito, Alessandro ^a   Muratori, Paolo ^a   Ferri, Silvia ^a   Pappas, Georgios ^a   Quarneti, Chiara ^a   Lenzi, Marco ^a   Bianchi, Francesco B ^a   Muratori, Luigi ^a  

^a UNIVERSITY OF BOLOGNA   (Italy)

Author keywords

Autoantibodies; Autoimmune hepatitis; Autoimmune liver disease; Immunosuppressive treatment

Indexed keywords

ANTINUCLEAR ANTIBODY; AZATHIOPRINE; BUDESONIDE; CORTICOSTEROID; CYCLOSPORIN; DEFLAZACORT; GLUCOCORTICOID; MICROSOME ANTIBODY; MYCOPHENOLIC ACID 2 MORPHOLINOETHYL ESTER; NEUTROPHIL CYTOPLASMIC ANTIBODY; PREDNISOLONE; PREDNISONE; SMOOTH MUSCLE ANTIBODY; TACROLIMUS; THIOPURINE METHYLTRANSFERASE; URSODEOXYCHOLIC ACID; IMMUNOSUPPRESSIVE AGENT;

ABSENCE OF SIDE EFFECTS; ACNE; ARTHRALGIA; ARTICLE; AUTOIMMUNE DISEASE; AUTOIMMUNE HEPATITIS; BONE MARROW SUPPRESSION; CATARACT; CLINICAL TRIAL; CORTICOSTEROID INDUCED OSTEOPOROSIS; CYTOPENIA; DECOMPENSATED LIVER CIRRHOSIS; DIABETES MELLITUS; DRUG DOSE REDUCTION; DRUG EFFICACY; DRUG ERUPTION; DRUG FEVER; DRUG MECHANISM; DRUG RECEPTOR BINDING; DRUG STRUCTURE; DRUG SUBSTITUTION; DRUG TOLERABILITY; DRUG WITHDRAWAL; ENTERITIS; HEMATOLOGIC MALIGNANCY; HIRSUTISM; HUMAN; HYPERBILIRUBINEMIA; HYPERTENSION; HYPOALBUMINEMIA; IMMUNOSUPPRESSIVE TREATMENT; INTRAHEPATIC CHOLESTASIS; LIVER TOXICITY; LIVER TRANSPLANTATION; LOW DRUG DOSE; MENTAL DISEASE; NAUSEA; NONHUMAN; OPPORTUNISTIC INFECTION; PANCREATITIS; RELAPSE; REMISSION; SCORING SYSTEM; SIDE EFFECT; VOMITING; WEIGHT GAIN; ANIMAL; CHEMISTRY; IMMUNOLOGY; REVIEW;

ANIMALS; HEPATITIS, AUTOIMMUNE; HUMANS; IMMUNOSUPPRESSIVE AGENTS;

EID: 68849086868     PISSN: 13895575     EISSN: None     Source Type: Journal    
DOI: 10.2174/138955709788452676     Document Type: Article

References (98)

1. Krawitt, E. L. Autoimmune hepatitis. N. Engl. J. Med., 2006, 354, 54-66.
2. Boberg, K. M. Prevalence and epidemiology of autoimmune hepatitis. Clin. Liver Dis., 2002, 6, 635-47.
3. Werner, M.; Prytz, H.; Ohlsson, B.; Almer, S.; Bjornsson, E.; Bergquist, A.; Wallerstedt, S.; Sandberg-Gertzen, H.; Hultcrantz, R.; Sangfelt, P.; Weiland, O.; Danielsson, A. Epidemiology and the initial presentation of autoimmune hepatitis in Sweden: a nationwide study. Scand. J. Gastroenterol., 2008, 43, 1232-40.
4. Czaja, A. J.; Donaldson, P. T. Gender effects and synergisms with histocompatibility leukocyte antigens in type 1 autoimmune hepatitis. Am. J. Gastroenterol., 2002, 97, 2051-7.
5. Rafeey, M.; Kianrad, M.; Hasani, A. Autoimmune hepatitis in Iranian children. Indian J. Gastroenterol., 2007, 26, 11-3.
6. Seki, T.; Ota, M.; Furuta, S.; Fukushima, H.; Kondo, T.; Hino, K.; Mizuki, N.; Ando, A.; Tsuji, K.; Inoko, H.; Kiyosava, K. HLA class II molecules and autoimmune hepatitis susceptibility in Japanese patients. Gastroenterology, 1992, 103, 1041-7.
7. Gupta, R.; Agarwal, S. R.; Jain, M.; Malhotra, V.; Sarin, S. K. Autoimmune hepatitis in the Indian subcontinent: 7 years experience. J. Gastroenterol. Hepatol., 2001, 16, 1144-8.
8. Lim, K. N.; Casanova, R. L.; Boyer, T. D.; Bruno, C. J. Autoimmune hepatitis in African Americans: presenting features and response to therapy. Am. J. Gastroenterol., 2001, 96, 3390-4.
9. Czaja, A. J.; Cassani, F.; Cataleta, M.; Valentini, P.; Bianchi, F. B. Frequency and significance of antibodies to actin in type 1 autoimmune hepatitis. Hepatology, 1996, 24, 1068-73.
10. Muratori, L.; Cataleta, M.; Muratori, P.; Lenzi, M.; Bianchi, F. B. Liver/kidney microsomal antibody type 1 and liver cytosol antibody type 1 concentrations in type 2 autoimmune hepatitis. Gut, 1998, 42, 721-6.
11. Czaja, A. J.; Strettell, M. D.; Thomson, L. J.; Santrach, P. J.; Moore, S. B.; Donaldson, P. T.; Williams, R. Associations between alleles of the major histocompatibility complex and type 1 autoimmune hepatitis. Hepatology, 1997, 25, 317-23.
12. Muratori, P.; Czaja, A. J.; Muratori, L.; Pappas, G.; Maccariello, S.; Cassani, F.; Granito, A.; Ferrari, R.; Mantovani, V.; Lenzi, M.; Bianchi, F.B. Genetic distinctions between autoimmune hepatitis in Italy and North America. World J. Gastroenterol., 2005, 11, 1862-6.
13. Vazquez-Garcia, M. N.; Alaez, C.; Olivo, A.; Debaz, H.; Perez-Luque, E.; Burguete, A.; Cano, S.; de la Rosa, G.; Bautista, N.; Hernandez, A.; Bandera, J.;Torres, L. F.; Kershenobich, D.; Alvarez, F.; Gorodezky, C. MHC class II sequences of susceptibility and protection in Mexicans with autoimmune hepatitis. J. Hepatol., 1998, 28, 985-90.
14. Czaja, A. J.; Kruger, M.; Santrach, P. J.; Moore, S. B.; Manns, M. P. Genetic distinctions between types 1 and 2 autoimmune hepatitis. Am. J. Gastroenterol., 1997, 92, 2197-200.
15. Bittencourt, P. L.; Goldberg, A. C.; Cancado, E. L.; Porta, G.; Carrilho, F. J.; Farias, A. Q.; Palacios, S. A.; Chiarella, J. M.; Abrantes-Lemos, C. P.; Baggio, V. L.; Laudanna, A. A.; Kalil, J. Genetic heterogeneity in susceptibility to autoimmune hepatitis types 1 and 2. Am. J. Gastroenterol., 1999, 94, 1906-13.
16. Cassinotti A, Birindelli S, Clerici M, Trabattoni D, Lazzaroni M, Ardizzone S, Colombo R, Rossi E, Porro GB. HLA and autoimmune digestive disease: a clinically oriented review for gastroenterologists. Am. J. Gastroenterol., 2009;104:195-217.
17. Granito, A.; Muratori, L.; Pappas, G.; Muratori, P.; Ferri, S.; Cassani, F.; Lenzi, M.; Bianchi, F. B. Clinical features of type 1 autoimmune hepatitis in elderly Italian patients. Aliment. Pharmacol. Ther., 2005, 21, 1273-7.
18. Skoog SM, Rivard RE, Batts KP, Smith CI. Autoimmune hepatitis preceded by acute hepatitis A infection. Am. J. Gastroenterol., 2002;97:1568-1569.
19. Vento S, Cainelli F, Renzini C, Concia E. Autoimmune hepatitis type 2 induced by HCV and persisting after viral clearance. Lancet, 1997, 350, 1298-1299.
20. Lewis JL, Zimmerman HJ. Drug-induced autoimmune liver disease. In: Autoimmune liver diseases; Krawitt EL, Wiesner RH, Nishioka M; Elsevier: Amsterdam, 1998; pp. 627-49.
21. Longhi, M. S.; Ma, Y.; Bogdanos, D. P.; Cheeseman, P.; Mieli-Vergani, G.; Vergani, D. Impairment of CD4(+)CD25(+) regulatory T-cells in autoimmune liver disease. J. Hepatol., 2004, 41, 31-7.
22. Longhi, M. S.; Ma, Y.; Mitry, R. R.; Bogdanos, D. P.; Heneghan, M.; Cheeseman, P.; Mieli-Vergani, G.; Vergani, D. Effect of CD4+ CD25+ regulatory T-cells on CD8 T-cell function in patients with autoimmune hepatitis. J. Autoimmun., 2005, 25, 63-71.
23. Longhi, M. S.; Hussain, M. J.; Mitry, R. R.; Arora, S. K.; Mieli-Vergani, G.; Vergani, D.; Ma, Y. Functional study of CD4+CD25+ regulatory T cells in health and autoimmune hepatitis. J. Immunol., 2006, 176, 4484-91.
24. Schreuder TC, Hübscher SG, Neuberger J. Autoimmune liver diseases and recurrence after orthotopic liver transplantation: what have we learned so far? Transpl. Int., 2009, 22, 144-52
25. Ratziu V, Samuel D, Sebagh M, Farges O, Saliba F, Ichai P, Farahmand H, Gigou M, Féray C, Reynès M, Bismuth H. Long-term follow-up after liver transplantation for autoimmune hepatitis: evidence of recurrence of primary disease. J. Hepatol., 1999, 30, 131-41.
26. Kerkar N, Hadzić N, Davies ET, Portmann B, Donaldson PT, Rela M, Heaton ND, Vergani D, Mieli-Vergani G. De-novo autoimmune hepatitis after liver transplantation. Lancet, 1998, 351, 409-13.
27. Heneghan MA, Portmann BC, Norris SM, Williams R, Muiesan P, Rela M, Heaton ND, O'Grady JG. Graft dysfunction mimicking autoimmune hepatitis following liver transplantation in adults. Hepatology, 2001, 34, 464-70.
28. Tomás JF, Pinilla I, García-Buey ML, García A, Figuera A, Gómez-García de Soria VGG, Moreno R, Fernández-Rañada JM. Long-term liver dysfunction after allogeneic bone marrow transplantation: clinical features and course in 61 patients. Bone Marrow Transplant., 2000, 26, 649-55.
29. Granito A, Stanzani M, Muratori L, Bogdanos DP, Muratori P, Pappas G, Quarneti C, Lenzi M, Vergani D, Bianchi FB. LKM1-positive type 2 autoimmune hepatitis following allogenic hematopoietic stem-cell transplantation. Am. J. Gastroenterol., 2008, 103, 1313-4.
30. Johnson, P. J.; McFarlane, I. G. Meeting report: International Autoimmune Hepatitis Group. Hepatology, 1993, 18, 998-1005.
31. Alvarez, F.; Berg, P. A.; Bianchi, F. B.; Bianchi, L.; Burroughs, A. K.; Cancado, E. L.; Chapman, R. W.; Cooksley, W. G.; Czaja, A. J.; Desmet, V. J.; Donaldson, P. T.; Eddleston, A. L.; Fainboim, L.; Heathcote, J.; Homberg, J. C.; Hoofnagle, J.H.; Kakumu, S.; Krawitt, E. L.; Mackay, I. R.; MacSween, R. N.; Maddrey, W. C.; Manns, M. P.; McFarlane, I. G.; Meyer zum Buschenfelde, K. H.; Zeniya, M. International Autoimmune Hepatitis Group Report: review of criteria for diagnosis of autoimmune hepatitis. J. Hepatol., 1999, 31, 929-38.
32. Hennes, E. M.; Zeniya, M.; Czaja, A. J.; Pares, A.; Dalekos, G. N.; Krawitt, E. L.; Bittencourt, P. L.; Porta, G.; Boberg, K. M.; Hofer, H.; Bianchi, F. B.; Shibata, M.; Schramm, C.; Eisenmann de Torres, B.; Galle, P. R.; McFarlane, I.; Dienes, H. P.; Lohse, A. W. Simplified criteria for the diagnosis of autoimmune hepatitis. Hepatology, 2008, 48, 169-76.
33. Czaja AJ. Performance parameters of the diagnostic scoring systems for autoimmune hepatitis. Hepatology, 2008, 48, 1540-8.
34. Vergani D, Alvarez F, Bianchi FB, Cançado EL, Mackay IR, Manns MP, Nishioka M, Penner E; International Autoimmune Hepatitis Group. Liver autoimmune serology: a consensus statement from the committee for autoimmune serology of the International Autoimmune Hepatitis Group. J. Hepatol., 2004, 41, 677-83.
35. Muratori P, Muratori L, Agostinelli D, Pappas G, Veronesi L, Granito A, Cassani F, Terlizzi P, Lenzi M, Bianchi FB. Smooth muscle antibodies and type 1 autoimmune hepatitis. Autoimmunity, 2002, 35, 497-500.
36. Bottazzo GF, Florin-Christensen A, Fairfax A, Swana G, Doniach D, Groeschel-Stewart U. Classification of smooth muscle autoantibodies detected by immunofluorescence. J. Clin. Pathol., 1976, 29, 403-10.
37. Granito, A.; Muratori, L.; Muratori, P.; Pappas, G.; Guidi, M.; Cassani, F.; Volta, U.; Ferri, A.; Lenzi, M.; Bianchi, F. B. Antibodies to filamentous actin (F-actin) in type 1 autoimmune hepatitis. J. Clin. Pathol., 2006, 59, 280-4.
38. Czaja AJ, Nishioka M, Morshed SA, Hachiya T. Patterns of nuclear immunofluorescence and reactivities to recombinant nuclear antigens in autoimmune hepatitis. Gastroenterology, 1994, 107, 200-7.
39. Czaja AJ, Cassani F, Cataleta M, Valentini P, Bianchi FB. Antinuclear antibodies and patterns of nuclear immunofluorescence in type 1 autoimmune hepatitis. Dig. Dis. Sci., 1997, 42, 1688-96.
40. Manns, M. P.; Johnson, E. F.; Griffin, K. J.; Tan, E. M.; Sullivan, K. F. Major antigen of liver kidney microsomal autoantibodies in idiopathic autoimmune hepatitis is cytochrome P450db1. J. Clin. Invest., 1989, 83, 1066-72.
41. Manns, M.; Gerken, G.; Kyriatsoulis, A.; Staritz, M.; Meyer zum Buschenfelde, K. H. Characterisation of a new subgroup of autoimmune chronic active hepatitis by autoantibodies against a soluble liver antigen. Lancet, 1987, 1, 292-4.
42. Kanzler, S.; Weidemann, C.; Gerken, G.; Lohr, H. F.; Galle, P. R.; Meyer zum Buschenfelde, K. H.; Lohse, A. W. Clinical significance of autoantibodies to soluble liver antigen in autoimmune hepatitis. J. Hepatol., 1999, 31, 635-40.
43. Zauli D, Ghetti S, Grassi A, Descovich C, Cassani F, Ballardini G, Muratori L, Bianchi FB. Anti-neutrophil cytoplasmic antibodies in type 1 and 2 autoimmune hepatitis. Hepatology, 1997, 25, 1105-7.
44. Pappas G, Granito A, Bianchi FB. Systemic lupus erythematosus. N. Engl. J. Med., 2008;358:2412; author reply 2413.
45. Czaja AJ. The variant forms of autoimmune hepatitis. Ann. Intern. Med., 1996;125:588-98.
46. Muratori P, Granito A, Quarneti C, Ferri S, Menichella R, Cassani F, Pappas G, Bianchi FB, Lenzi M, Muratori L. Autoimmune hepatitis in Italy: The Bologna experience. J. Hepatol., 2009, in press
47. Ferrari, R.; Pappas, G.; Agostinelli, D.; Muratori, P.; Muratori, L.; Lenzi, M.; Verucchi, G.; Cassani, F.; Chiodo, F.; Bianchi, F. B. Type 1 autoimmune hepatitis: patterns of clinical presentation and differential diagnosis of the 'acute' type. QJM 2004, 97, 407-12.
48. Czaja, A. J. Corticosteroids or not in severe acute or fulminant autoimmune hepatitis: therapeutic brinksmanship and the point beyond salvation. Liver Transpl., 2007, 13, 953-5.
49. Homberg, J. C.; Abuaf, N.; Bernard, O.; Islam, S.; Alvarez, F.; Khalil, S. H.; Poupon, R.; Darnis, F.; Levy, V. G.; Grippon, P.; et al. Chronic active hepatitis associated with antiliver/kidney microsome antibody type 1: a second type of "autoimmune" hepatitis. Hepatology, 1987, 7, 1333-9.
50. Gregorio, G. V.; Portmann, B.; Reid, F.; Donaldson, P. T.; Doherty, D. G.; McCartney, M.; Mowat, A. P.; Vergani, D.; Mieli-Vergani, G. Autoimmune hepatitis in childhood: a 20-year experience. Hepatology, 1997, 25, 541-7.
51. Czaja, A. J.; Carpenter, H. A. Distinctive clinical phenotype and treatment outcome of type 1 autoimmune hepatitis in the elderly. Hepatology, 2006, 43, 532-8.
52. Volta U. Pathogenesis and clinical significance of liver injury in celiac disease. Clin. Rev. Allergy Immunol., 2009; 36:62-70.
53. Muratori P, Granito A, Pappas G, Muratori L, Lenzi M, Bianchi FB. Autoimmune liver disease 2007. Mol. Aspects Med., 2008, 29, 96-102
54. Montano-Loza AJ, Carpenter HA, Czaja AJ. Predictive factors for hepatocellular carcinoma in type 1 autoimmune hepatitis. Am. J. Gastroenterol., 2008, 103, 1944-51.
55. Krawitt, E. L. Clinical features and management of autoimmune hepatitis. World J. Gastroenterol., 2008, 14, 3301-5.
56. Cook, G. C.; Mulligan, R.; Sherlock, S. Controlled prospective trial of corticosteroid therapy in active chronic hepatitis. QJM, 1971, 40, 159-85.
57. Soloway, R. D.; Summerskill, W. H.; Baggenstoss, A. H.; Geall, M. G.; Gitnick, G. L.; Elveback, I. R.; Schoenfield, L. J. Clinical, biochemical, and histological remission of severe chronic active liver disease: a controlled study of treatments and early prognosis. Gastroenterology, 1972, 63, 820-33.
58. Murray-Lyon, I. M.; Stern, R. B.; Williams, R. Controlled trial of prednisone and azathioprine in active chronic hepatitis. Lancet, 1973, 1, 735-7.
59. Roberts, S. K.; Therneau, T. M.; Czaja, A. J. Prognosis of histological cirrhosis in type 1 autoimmune hepatitis. Gastroenterology, 1996, 110, 848-57.
60. Czaja, A. J.; Freese, D. K. Diagnosis and treatment of autoimmune hepatitis. Hepatology, 2002, 36, 479-97.
61. Heathcote, J. Treatment strategies for autoimmune hepatitis. Am. J. Gastroenterol., 2006, 101, S630-2.
62. Czaja AJ. Features and consequences of untreated type 1 autoimmune hepatitis. Liver Int., 2008 Oct 14. [Epub ahead of print]
63. Salcedo M, Vaquero J, Bañares R, Rodríguez-Mahou M, Alvarez E, Vicario JL, Hernández-Albújar A, Tíscar JL, Rincón D, Alonso S, De Diego A, Clemente G. Response to steroids in de novo autoimmune hepatitis after liver transplantation. Hepatology, 2002, 35, 349-56.
64. Barnes, P. J. Anti-inflammatory actions of glucocorticoids: molecular mechanisms. Clin. Sci. (Lond), 1998, 94, 557-72.
65. Tanner, A. R.; Powell, L. W. Corticosteroids in liver disease: possible mechanisms of action, pharmacology, and rational use. Gut, 1979, 20, 1109-24.
66. Rhen, T.; Cidlowski, J. A. Antiinflammatory action of glucocorticoids - new mechanisms for old drugs. N. Engl. J. Med., 2005, 353, 1711-23.
67. Ito, K.; Chung, K. F.; Adcock, I. M. Update on glucocorticoid action and resistance. J. Allergy Clin. Immunol., 2006, 117, 522-43.
68. Brattsand, R.; Linden, M. Cytokine modulation by glucocorticoids: mechanisms and actions in cellular studies. Aliment. Pharmacol. Ther., 1996, 10(Suppl 2), 81-90; discussion 91-2.
69. Dostert, A.; Heinzel, T. Negative glucocorticoid receptor response elements and their role in glucocorticoid action. Curr. Pharm. Des., 2004, 10, 2807-16.
70. Scheinman, R. I.; Cogswell, P. C.; Lofquist, A. K.; Baldwin, A. S., Jr. Role of transcriptional activation of I kappa B alpha in mediation of immunosuppression by glucocorticoids. Science, 1995, 270, 283-6.
71. Almawi, W. Y.; Melemedjian, O. K. Molecular mechanisms of glucocorticoid antiproliferative effects: antagonism of transcription factor activity by glucocorticoid receptor. J. Leukoc. Biol., 2002, 71, 9-15.
72. Nouri-Aria, K. T.; Lobo-Yeo, A.; Vergani, D.; Mieli-Vergani, G.; Eddleston, A. L.; Mowat, A. P. T suppressor cell function and number in children with liver disease. Clin. Exp. Immunol., 1985, 61, 283-9.
73. Nouri-Aria, K. T.; Hegarty, J. E.; Alexander, G. J.; Eddleston, A. L.; Williams, R. Effect of corticosteroids on suppressor-cell activity in "autoimmune" and viral chronic active hepatitis. N. Engl. J. Med., 1982, 307, 1301-4.
74. Sahasranaman, S.; Howard, D.; Roy, S. Clinical pharmacology and pharmacogenetics of thiopurines. Eur. J. Clin. Pharmacol., 2008, 64, 753-67.
75. Lennard, L. The clinical pharmacology of 6-mercaptopurine. Eur. J. Clin. Pharmacol., 1992, 43, 329-39.
76. Tiede, I.; Fritz, G.; Strand, S.; Poppe, D.; Dvorsky, R.; Strand, D.; Lehr, H. A.; Wirtz, S.; Becker, C.; Atreya, R.; Mudter, J.; Hildner, K.; Bartsch, B.; Holtmann, M.; Blumberg, R.; Walczak, H.; Iven, H.; Galle, P. R.; Ahmadian, M. R.; Neurath, M. F. CD28-dependent Rac1 activation is the molecular target of azathioprine in primary human CD4+ T lymphocytes. J. Clin. Invest., 2003, 111, 1133-45.
77. Langagergaard V, Pedersen L, Gislum M, Nørgard B, Sørensen HT. Birth outcome in women treated with azathioprine or mercaptopurine during pregnancy: A Danish nationwide cohort study. Aliment. Pharmacol. Ther., 2007, 25, 73-81.
78. Heneghan, M. A.; McFarlane, I. G. Current and novel immunosuppressive therapy for autoimmune hepatitis. Hepatology, 2002, 35, 7-13.
79. Czaja, A. J. Safety issues in the management of autoimmune hepatitis. Expert Opin. Drug Saf., 2008, 7, 319-33.
80. Geissler EK, Schlitt HJ. Immunosuppression for liver transplantation. Gut, 2009, 58, 452-63
81. Malekzadeh R, Nasseri-Moghaddam S, Kaviani MJ, Taheri H, Kamalian N, Sotoudeh M. Cyclosporin A is a promising alternative to corticosteroids in autoimmune hepatitis. Dig. Dis. Sci., 2001, 46, 1321-7.
82. Alvarez F, Ciocca M, Cañero-Velasco C, Ramonet M, de Davila MT, Cuarterolo M, Gonzalez T, Jara-Vega P, Camarena C, Brochu P, Drut R, Alvarez E. Short-term cyclosporine induces a remission of autoimmune hepatitis in children. J. Hepatol., 1999, 30, 222-7.
83. Aqel, B. A.; Machicao, V.; Rosser, B.; Satyanarayana, R.; Harnois, D. M.; Dickson, R. C. J. Clin. Gastroenterol., 2004, 38, 805-9.
84. Larsen, F. S.; Vainer, B.; Eefsen, M.; Bjerring, P. N.; Adel Hansen, B. World J. Gastroenterol., 2007, 13, 3232-6.
85. Ransom JT. Mechanism of action of mycophenolate mofetil. Ther. Drug Monit., 1995, 17, 681-4.
86. Inductivo-Yu, I.; Adams, A.; Gish, R. G.; Wakil, A.; Bzowej, N. H.; Frederick, R. T.; Bonacini, M. Clin. Gastroenterol. Hepatol., 2007, 5, 799-802
87. Hlivko JT, Shiffman ML, Stravitz RT, Luketic VA, Sanyal AJ, Fuchs M, Sterling RK. A single center review of the use of mycophenolate mofetil in the treatment of autoimmune hepatitis. Clin. Gastroenterol. Hepatol., 2008, 6, 1036-40.
88. Hennes EM, Oo YH, Schramm C, Denzer U, Buggisch P, Wiegard C, Kanzler S, Schuchmann M, Boecher W, Galle PR, Adams DH, Lohse AW. Mycophenolate mofetil as second line therapy in autoimmune hepatitis? Am. J. Gastroenterol., 2008, 103, 3063-70.
89. Czaja AJ, Lindor KD. Failure of budesonide in a pilot study of treatment-dependent autoimmune hepatitis. Gastroenterology, 2000, 119, 1312-6.
90. Csepregi, A.; Rocken, C.; Treiber, G.; Malfertheiner, P. World J. Gastroenterol., 2006, 12, 1362-6.
91. Wiegand, J.; Schuler, A.; Kanzler, S.; Lohse, A.; Beuers, U.; Kreisel, W.; Spengler, U.; Koletzko, S.; Jansen, P. L.; Hochhaus, G.; Mollmann, H. W.; Prols, M.; Manns, M. P. Liver Int., 2005, 25, 927-34.
92. Zandieh I, Krygier D, Wong V, Howard J, Worobetz L, Minuk G, Witt-Sullivan H, Yoshida EM. The use of budesonide in the treatment of autoimmune hepatitis in Canada. Can. J. Gastroenterol., 2008, 22 388-92.
93. Czaja, A. J.; Carpenter, H. A.; Lindor, K. D. Ursodeoxycholic acid as adjunctive therapy for problematic type 1 autoimmune hepatitis: a randomized placebo-controlled treatment trial. Hepatology, 1999, 30, 1381-6.
94. Burak, K. W.; Urbanski, S. J.; Swain, M. G. Successful treatment of refractory type 1 autoimmune hepatitis with methotrexate. J. Hepatol., 1998, 29, 990-3.
95. Venkataramani, A.; Jones, M. B.; Sorrell, M. F. Methotrexate therapy for refractory chronic active autoimmune hepatitis. Am. J. Gastroenterol., 2001, 96, 3432-4.
96. Kanzler, S.; Gerken, G.; Dienes, H. P.; Meyer zum Buschenfelde, K. H.; Lohse, A. W. Cyclophosphamide as alternative immunosup pressive therapy for autoimmune hepatitis - report of three cases. Z. Gastroenterol., 1997, 35, 571-8.
97. Rebollo Bernárdez J, Cifuentes Mimoso C, Piñar Moreno A, Caunedo Alvarez A, Salas Herrero E, Jiménez-Séenz M, Herrerías Gutiérrez J. Deflazacort for long-term maintenance of remission in type I autoimmune hepatitis. Rev. Esp. Enferm. Dig., 1999, 91, 630-8.
98. Longhi MS, Meda F, Wang P, Samyn M, Mieli-Vergani G, Vergani D, Ma Y. Expansion and de novo generation of potentially therapeutic regulatory T cells in patients with autoimmune hepatitis. Hepatology, 2008, 47, 581-91.