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©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 14, 2016; 22(42): 9257-9278
Published online Nov 14, 2016. doi: 10.3748/wjg.v22.i42.9257
Published online Nov 14, 2016. doi: 10.3748/wjg.v22.i42.9257
Factoring the intestinal microbiome into the pathogenesis of autoimmune hepatitis
Albert J Czaja, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55905, United States
Author contributions: Czaja AJ researched, designed, and wrote this article specifically for this journal, and it has never been published previously; The tables are original, constructed by Dr. Czaja, fully referenced, and developed solely for this article; The one color figure is also original, drawn by Dr. Czaja, and never published previously; The entire presentation is original, current, comprehensive.
Conflict-of-interest statement: Albert J Czaja has not received fees for serving as a speaker, consultant, or advisory board member for any commercial organization. He has not received research funding from, been employed by, or received stocks and/or shares from such an organization.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Albert J Czaja, MD, Professor Emeritus, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, 200 First Street S.W., Rochester, MN 55905, United States. czaja.albert@mayo.edu
Telephone: +1-507-2842691 Fax: +1-507-2840538
Received: August 13, 2016
Peer-review started: August 14, 2016
First decision: September 12, 2016
Revised: October 7, 2016
Accepted: October 30, 2016
Article in press: October 31, 2016
Published online: November 14, 2016
Processing time: 91 Days and 10.7 Hours
Peer-review started: August 14, 2016
First decision: September 12, 2016
Revised: October 7, 2016
Accepted: October 30, 2016
Article in press: October 31, 2016
Published online: November 14, 2016
Processing time: 91 Days and 10.7 Hours
Core Tip
Core tip: The intestinal microbiome is a reservoir of microbial antigens and activated immune cells that have been implicated in the pathogenesis of diverse systemic immune-mediated diseases. Dysbiosis, increased intestinal permeability, and molecular mimicry between microbial and self-antigens may initiate or sustain autoimmune hepatitis. Multiple drug, molecular, dietary, and probiotic interventions can modify the intestinal microbiome and attenuate the immune response. The role of the intestinal microbiome in autoimmune hepatitis warrants rigorous study, and new therapies may emerge that strengthen current treatment regimens.