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Autoimmune hepatitis

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《医学前沿（英文）》 2015年第9卷第2期页码 187-219 doi: 10.1007/s11684-015-0386-y

摘要：

Autoimmune hepatitis is a chronic liver disease putatively caused by loss of tolerance to hepatocyte-specific autoantigens. It is characterized by female predilection, elevated aminotransferase levels, autoantibodies, increased γ-globulin or IgG levels and biopsy evidence of interface hepatitis. It is currently divided into types 1 and 2, based on expression of autoantibodies. Autoantigenic epitopes have been identified only for the less frequent type 2. Although autoimmune hepatitis occurs in childhood, this review focuses on disease in adults. In the absence of pathognomonic biomarkers, diagnosis requires consideration of clinical, biochemical, serological and histological features, which have been codified into validated diagnostic scoring systems. Since many features also occur in other chronic liver diseases, these scoring systems aid evaluation of the differential diagnosis. New practice guidelines have redefined criteria for remission to include complete biochemical and histological normalization on immunosuppressive therapy. Immunosuppression is most often successful using prednisone or prednisolone and azathioprine; however, the combination of budesonide and azathioprine for non-cirrhotic patients offers distinct advantages. Patients failing standard immunosuppression are candidates for alternative immunosuppressive regimens, yet none of the options has been studied in a randomized, controlled trial. Overlap syndromes with either primary sclerosing cholangitis or primary biliary cirrhosis occur in a minority. Liver transplantation represents a life-saving option for patients presenting with acute liver failure, severely decompensated cirrhosis or hepatocellular carcinoma. Transplant recipients are at risk for recurrent autoimmune hepatitis in the allograft, and de novo disease may occur in patients transplanted for other indications. Patients transplanted for AIH are also at risk for recurrent or de novo inflammatory bowel disease. Progress in our understanding of the immunopathogenesis should lead to identification of specific diagnostic and prognostic biomarkers and new therapeutic strategies.

关键词： autoimmune hepatitis autoantibodies diagnosis immunological diseases drug-induced liver injury therapy immunosuppression outcomes hepatocellular carcinoma liver transplantation

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Diagnostic criteria of latent autoimmune diabetes in adults (LADA): a review and reflection

Yu Liao, Yufei Xiang, Zhiguang Zhou

《医学前沿（英文）》 2012年第6卷第3期页码 243-247 doi: 10.1007/s11684-012-0201-y

摘要： Diabetes has become a major public health problem in China nowadays. There are almost 97 million diabetic patients nationwide. Latent autoimmune diabetes in adults (LADA) is a subtype of autoimmune diabetes. Although it has been reported for about 20 years, the diagnostic criteria of this disease remain controversial. The discussion mainly focused on serum autoantibodies, period of insulin need and age of diagnosis. Besides, β cell function, metabolic parameters, genetic factors and cell immunity may also contribute to the formulation of the criteria. Here, we aim to review and discuss the diagnostic criteria of latent autoimmune diabetes in adults.

关键词： LADA diagnostic criteria autoantibodies insulin independence age of diagnosis

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从结直肠癌细胞和组织样本释放的外泌体中检测肿瘤相关抗原自身抗体的多路生物传感诊断平台展示了对结直肠癌的高诊断能力 Article

Ana Montero-Calle, Itziar Aranguren-Abeigon, María Garranzo-Asensio, Carmen Poves, María Jesús Fernández-Aceñero, Javier Martínez-Useros, Rodrigo Sanz, Jana Dziaková, Javier Rodriguez-Cobos, Guillermo Solís-Fernández, Eloy Povedano, Maria Gamella, Rebeca Magnolia Torrente-Rodríguez, Miren Alonso-Navarro, Vivian de los Ríos, J. Ignacio Casal, Gemma Domínguez, Ana Guzman-Aranguez, Alberto Peláez-García, José Manuel Pingarrón, Susana Campuzano, Rodrigo Barderas

《工程（英文）》 2021年第7卷第10期页码 1393-1412 doi: 10.1016/j.eng.2021.04.026

摘要：

结直肠癌（CRC）是全球导致癌症相关死亡的第二大原因。CRC患者的5年生存率与诊断分期息息相关。CRC早期诊断患者的5年生存率高于80%，CRC晚期诊断患者的5年生存率低于10%。大量研究表明，患者血清中特定CRC自身抗原[肿瘤相关抗原（TAA）]对应的自身抗体有助于早期诊断。因此，本文旨在识别CRC特异性自身抗体的自身抗原靶点，借助液体活检技术有效筛查CRC患者和健康个体。为此，我们从CRC患者体内提取5个CRC细胞系和组织样本，通过免疫沉淀-质谱分析法测量其分泌的外泌体的蛋白质含量，共鉴定出103种蛋白质为潜在的CRC特异性自身抗原。采用生物信息学技术和荟萃分析，我们选定了15种与实际CRC自身抗原类似度更高的蛋白质，以便后续借助蛋白质印迹法（WB）和免疫组织化学技术（IHC）评估它们在CRC预后中的作用。结果发现，在患者的组织和血浆外泌体样本中，有11种蛋白质发生蛋白质水平失调，有9种蛋白质与CRC预后有关。经验证发现，除一例外，所有研究均显示出具有统计学意义的高诊断能力，采用荧光Halotag磁珠，或者借助多路生物传感平台（磁性微载体为固相载体，由用于CRC细胞检测的共价固定Halotag融合蛋白修饰），能够有效筛查区分CRC患者、癌前病变个体与健康个体。综上所述，本文的研究结果突出了此研究方法在识别慢性疾病特征TAA时的有效性；此外，本文采用的测量血浆中TAA对应的自身抗体水平的方法可以应用到具有高诊断能力的CRC检测即时医疗（POC）设备中。

关键词：自身抗体诊断结直肠癌外泌体肿瘤微环境体液免疫应答即时医疗生物传感器