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We read with great interest the practice guidelines for the diagnosis and management of autoimmune hepatitis recently issued by the American Association for the Study of Liver Diseases (AASLD). 1 In particular, we appreciate the new definition of biochemical remission, which now requires not only normal bilirubin and gamma-globulin levels but also normal serum aminotransferases; this is at variance with the 2002 definition, 2 which considers aminotransferase levels lower than twice the upper limits of normal to be sufficient. According to the 2002 criteria, nearly 80% of patients with autoimmune hepatitis enter remission within 3 years. The recently coined new definition will result in a tremendous change in the rate of response to immunosuppressive treatment for autoimmune hepatitis. Here we present our own experience, which has already been published in part, 3 and compare the different response rates according to the 2002 and 2010 definitions of remission. Among 163 consecutive Italian patients with autoimmune hepatitis diagnosed at a single center, 119 (73%) entered remission according to the 2002 AASLD criteria, whereas only 42 patients (26%) of the same cohort fulfilled the 2010 AASLD criteria. Among 89 patients with a follow-up longer than 60 months, 65 (73%) had aminotransferase levels lower than twice the upper limit of normal (2002 criteria), but only 23 (25.8%) consistently maintained normal aminotransferase levels (2010 criteria) with low steroid doses (2-4 mg of methylprednisolone daily or every other day). Interestingly, from a clinical standpoint, after a mean follow-up longer than 100 months, only 1 of the 23 patients (4%) fulfilling the 2010 criteria of remission experienced histological worsening of the disease (mild to severe liver histology), whereas 36 of the 66 patients (54.5%) whose aminotransferase levels did not normalize had histological (14 with severe histology and 9 with cirrhosis) or clinical evidence (11 with endstage liver disease, 1 with decompensated cirrhosis, and 1 with hepatocellular carcinoma) of uncontrolled and evolving liver disease. In summary, in our experience, the application of the 2010 criteria flips the previously codified remission rate from 73% to 26%. Complete-response patients have a very good long-term prognosis virtually free of significant clinical events, whereas patients whose serum aminotransferases are unable to be stably normalized are those with the highest probability of developing long-term complications, which not rarely may prove to be lethal. These are the patients most likely to benefit from new pharmacological, cellular, and molecular therapies. 4,5

ABSTRACT. Although gerbils have been widely used in many areas of biological research over many years, there is currently no effective genetic quality control system available. In the present study, we sought to establish a microsatellite marker system for quality control and conducted an optimized analysis of 137 microsatellite loci in two laboratory gerbil populations and one wild population. Independent sample t-tests on the mean effective allele number, mean of Shannon's information index, and mean H E suggested that 28 of the 137 microsatellite markers were informative for gerbil genetic control. Analysis of 4 laboratory gerbil populations and 1 wild population using the 28 microsatellite loci indicated that allele numbers varied from 1.9639 (Guangzhou, GZ) to 6.6071 (North-West wild, NW). (2015) tions, respectively. The GZ population showed the greatest differentiation, having higher R ST and Nei's standard genetic distances. An AMO-VA revealed high genetic differentiation among the five populations (F ST = 0.296). The microsatellite system established here is effective and will be important in future studies for genetic quality control and monitoring of gerbil breeds.

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