Mikio Zeniya1, Hiroki Takahashi2. 1. The Jikei University Graduate School of Medicine Gastroenterology, Tokyo, Japan. zeniya@jikei.ac.jp. 2. The Jikei University Graduate School of Medicine Gastroenterology, Tokyo, Japan.
Abstract
BACKGROUND: Autoimmune hepatitis (AIH) has been considered a relatively rare disease in Asia, including Japan, where there is a high frequency of infection with hepatitis viruses. METHOD: We reviewd the ethnic differences of clinical features of autoimmume hepatitis by reported paper. RESULT: Immunogenetic predisposition, especially differences in human leukocyte antigens (HLAs), has been pointed out as one of the factors for the occurrence of AIH. In other words, HLA-DR3, which is the first disease-susceptibility gene for AIH discovered in UK and the USA, is extremely rare in Asia including Japan. Moreover, HLA-DR4, which is more frequent than HLA-DR3 in Asia, is associated with a favorable response to treatment and improved prognosis. This also explains why diagnosis and treatment of AIH have not drawn as much attention as viral hepatitis. However, as a survey conducted in Japan shows, the number of patients diagnosed with AIH is increasing. However, the number of elderly patients positive for HLA-DR4 is also increasing in UK and the USA. CONCLUSION: In the era of genome-wide association studies, further progress of studies on AIH, a typical disease model for immunological liver cell damage, is expected.
BACKGROUND:Autoimmune hepatitis (AIH) has been considered a relatively rare disease in Asia, including Japan, where there is a high frequency of infection with hepatitis viruses. METHOD: We reviewd the ethnic differences of clinical features of autoimmume hepatitis by reported paper. RESULT: Immunogenetic predisposition, especially differences in human leukocyte antigens (HLAs), has been pointed out as one of the factors for the occurrence of AIH. In other words, HLA-DR3, which is the first disease-susceptibility gene for AIH discovered in UK and the USA, is extremely rare in Asia including Japan. Moreover, HLA-DR4, which is more frequent than HLA-DR3 in Asia, is associated with a favorable response to treatment and improved prognosis. This also explains why diagnosis and treatment of AIH have not drawn as much attention as viral hepatitis. However, as a survey conducted in Japan shows, the number of patients diagnosed with AIH is increasing. However, the number of elderly patients positive for HLA-DR4 is also increasing in UK and the USA. CONCLUSION: In the era of genome-wide association studies, further progress of studies on AIH, a typical disease model for immunological liver cell damage, is expected.
Authors: Michael P Manns; Albert J Czaja; James D Gorham; Edward L Krawitt; Giorgina Mieli-Vergani; Diego Vergani; John M Vierling Journal: Hepatology Date: 2010-06 Impact factor: 17.425
Authors: F Alvarez; P A Berg; F B Bianchi; L Bianchi; A K Burroughs; E L Cancado; R W Chapman; W G Cooksley; A J Czaja; V J Desmet; P T Donaldson; A L Eddleston; L Fainboim; J Heathcote; J C Homberg; J H Hoofnagle; S Kakumu; E L Krawitt; I R Mackay; R N MacSween; W C Maddrey; M P Manns; I G McFarlane; K H Meyer zum Büschenfelde; M Zeniya Journal: J Hepatol Date: 1999-11 Impact factor: 25.083
Authors: D G Doherty; P T Donaldson; J A Underhill; J M Farrant; A Duthie; G Mieli-Vergani; I G McFarlane; P J Johnson; A L Eddleston; A P Mowat Journal: Hepatology Date: 1994-03 Impact factor: 17.425
Authors: David N Assis; Hiroki Takahashi; Lin Leng; Mikio Zeniya; James L Boyer; Richard Bucala Journal: Dig Dis Sci Date: 2016-10-01 Impact factor: 3.199