Czaja A J, Manns M P
Division of Gastroenterology and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Am J Gastroenterol. 1995 Aug;90(8):1206-11.
To advocate formal subclassification of autoimmune hepatitis into two types based on the presence of mutually exclusive immunoserological markers, target antigen diversity, contrasting genetic predispositions, and differences in clinical profile and behavior.
Relevant references in English were identified through a Medline Search (1984-1994) and through a personal library of journals and reprints.
Antinuclear antibodies and/or smooth-muscle antibodies are mutually exclusive of antibodies to liver/kidney microsome type 1. The cytochrome monooxygenase P450 IID6 is the target autoantigen for patients with antibodies to liver/kidney microsome type 1, and patients with these autoantibodies are different from others. The human lymphocyte antigens DR3 and DR4 are risk factors for patients with antinuclear and/or smooth-muscle antibodies, whereas the B14, DR3, and C4A-QO antigens are common in patients with antibodies to liver/kidney microsome type 1. Patients with antibodies to liver/kidney type 1 are younger, and they more commonly have concurrent organ-specific autoantibodies and/or immunological diseases than counterparts with antinuclear and/or smooth-muscle antibodies. They also progress to cirrhosis more frequently.
Two distinct types of autoimmune hepatitis can be defined by immunoserological markers, genetic predispositions, autoantigen status, and clinical features. Each should be recognized as a valid and independent entity.
基于相互排斥的免疫血清学标志物、靶抗原多样性、不同的遗传易感性以及临床特征和病程差异，主张将自身免疫性肝炎正式分为两型。
通过医学在线数据库检索（1984 - 1994年）以及个人期刊和重印本库确定相关英文参考文献。
抗核抗体和/或平滑肌抗体与抗肝肾微粒体1型抗体相互排斥。细胞色素单加氧酶P450 IID6是抗肝肾微粒体1型抗体患者的靶自身抗原，且有这些自身抗体的患者与其他患者不同。人类淋巴细胞抗原DR3和DR4是抗核抗体和/或平滑肌抗体患者的危险因素，而B14、DR3和C4A - QO抗原在抗肝肾微粒体1型抗体患者中常见。抗肝肾微粒体1型抗体患者更年轻，与抗核抗体和/或平滑肌抗体患者相比，他们更常并发器官特异性自身抗体和/或免疫性疾病。他们进展为肝硬化的频率也更高。
可通过免疫血清学标志物、遗传易感性、自身抗原状态和临床特征定义两种不同类型的自身免疫性肝炎。每种类型都应被视为一个有效的独立实体。
