Hacettepe University, Department of Gastroenterology, Turkey.
Autoimmun Rev. 2013 Jan;12(3):337-9. doi: 10.1016/j.autrev.2012.03.010. Epub 2012 Jul 25.
Hepatotoxicity is an expected side effect of tumour necrosis factor-α (anti-TNF-α) blocking agents including, infliximab, etanercept and adalimumab. Although mild to moderate elevations of liver enzymes have been recognised after the use of these agents, severe hepatitis is rarely reported. Reactivation of viral hepatitis and drug induced liver injury is two main causes of liver dysfunction in these patients. A broad spectrum, ranging from minor immunological alterations to systemic autoimmune disease, has been reported during treatment with anti-TNF-α. Therefore, in recent studies TNF-α blocking agents have been considered a potential cause of drug induced autoimmune hepatitis. Taking into account the advances in the field of hepatology, this review summarizes the general characteristics of anti-TNF-α induced liver injury and autoimmune hepatitis.
肝毒性是肿瘤坏死因子-α（抗 TNF-α）阻断剂的一种预期的副作用，包括英夫利昔单抗、依那西普和阿达木单抗。尽管这些药物使用后会出现轻度至中度的肝酶升高，但严重肝炎很少见。在这些患者中，导致肝功能障碍的两个主要原因是乙型肝炎病毒再激活和药物性肝损伤。在使用抗 TNF-α治疗期间，已报道了广泛的疾病谱，从轻微的免疫改变到全身性自身免疫性疾病。因此，在最近的研究中，TNF-α阻断剂被认为是药物性自身免疫性肝炎的潜在原因。考虑到肝病学领域的进展，本综述总结了抗 TNF-α引起的肝损伤和自身免疫性肝炎的一般特征。
