Protocol of a prospective study for the combination treatment of Shu-Gan-jian-Pi decoction and steroid standard therapy in autoimmune hepatitis patients

Chi, Xiaoling; Xiao, Hang; Cai, Gui‐Xin; Jiang, J; Tian, Guangjun; Shi, Meijie; Wu, Shuduo; Zhao, Pan; Chen, Huijun

doi:10.1186/s12906-016-1486-1

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…A total of 56 studies were included in the narrative review and data from six of these studies were included in the meta-analysis. A total of 50 studies were excluded due to 34 studies not being RCT studies, four studies evaluating the efficacy of therapy for AIH in children ( 23 – 26 ), six studies evaluating maintenance therapy for AIH ( 27 – 31 ), two studies evaluating traditional Chinese medicine treatment ( 32 , 33 ), one study being unable to extract any reliable data ( 34 ), two studies not reporting the outcome that met inclusion criteria ( 9 , 11 ) and one study where treatment duration was indefinite and may have included the same relapsed patients with AIH as those included in another study performed by the same author ( 6 ).…”

Section: Resultsmentioning

confidence: 99%

Comparative efficacy and tolerability of treatments for adult autoimmune hepatitis: A systematic review and network meta‑analysis

et al. 2018

Exp Ther Med

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The most suitable treatment regimen for autoimmune hepatitis (AIH) in adults remains unknown and requires further investigation. The current study therefore aimed to integrate evidence to provide hierarchies of the comparative efficacies of treatments measured by clinical and biochemical remission. A Bayesian-framework network meta-analysis of randomized controlled trials (RCTs) was preformed to compare eight treatments for AIH. Eligible RCTs were identified by searching Embase, Pubmed and the Cochrane Library for publications between 1966 and April 2017. All outcomes were independently extracted from the included studies by two authors. A total of six RCTs were subsequently included in the current study. The network of comparisons on remission indicated that patients treated with prednisone (pred) experienced significantly increased rates of remission compared with those treated with azathioprine [AZA; odds ratio (OR), 0.21; 95% confidence interval (CI), 0.06–0.71] and budesonide (bude) + AZA significantly increased remission compared with placebo treatment (OR, 36.66; 95% CI, 1.40–962.49) or AZA (OR, 10.30; 95% CI, 1.50–70.70). Based on the cumulative ranking probabilities, bude + AZA (89.4) was ranked first, pred (69.1) was ranked second, pred + AZA (63.2) was ranked third and placebo (7.8) treatment was ranked last. Bude + AZA may be the most appropriate candidate for the treatment of non-cirrhotic patients. However, bude + AZA as frontline therapy for AIH requires more large-scale studies with a longer duration of follow-up histology and a focus on dose-response. Additionally, development of other prospective treatments, which may be used as alternative therapy or first line therapy, and their subsequent evaluation in clinical RCTs is required.

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Section: Resultsmentioning

confidence: 99%

Comparative efficacy and tolerability of treatments for adult autoimmune hepatitis: A systematic review and network meta‑analysis

et al. 2018

Exp Ther Med

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“…To sum up, there is still no comprehensive treatment strategy for those patients unfit for the use of corticosteroids and azathioprine (11,12). Liver transplantation is considered suitable for those patients facing the circumstance that conventional treatment is ineffective or the disease progresses to liver cirrhosis, despite a 5-year recurrence rate (13,14). Therefore, it is vitally important to explore new treatments and drugs that can used to effectively treat AIH with limited side effects.…”

Section: Introductionmentioning

confidence: 99%

Ginsenosides Regulates Innate Immunity to Affect Immune Microenvironment of AIH Through Hippo-YAP/TAZ Signaling Pathway

Zhang

Shi

et al. 2022

Front. Immunol.

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Autoimmune hepatitis (AIH) is characterized by chronic progressive liver inflammatory, but there is still no safe and effective medicine. Therefore, glucocorticoid remains the top choice for AIH treatment. In previous studies, it has been confirmed that ginsenosides (GSS) can produce glucocorticoid-like effects and therapeutic effects on various autoimmune diseases. However, the mechanism of GSS for AIH remains unclear. As an important part of the innate immune system, bone marrow-derived suppressor cells (MDSC) have been identified as an important driver of follow-up acquired immune response in many autoimmune diseases, including AIH. Herein, it was found out that GSS intervention can be effective in regulating the immune microenvironment and liver impairment induced by Con A in AIH mice. In vitro, the MDSCs derived from healthy mice and the T cells deried from AIH mice were co-cultured. Then, different drugs were intervened with to explore the therapeutic mechanism. Besides, the proliferation and differentiation of MDSCs and T cells were analyzed by flow cytometry, while GR, Hippo-YAP signal pathway and the expression of MDSC-related genes and proteins were detected through qRT-PCR and Western Blot. The changes in NO and ROS levels were further analyzed. The trend of related cytokines expression (IFN- γ, TGF- β, IL-10, IL-6, IL-17) was detected by ELISA. Furthermore, an analysis was conducted as to the ALT and liver pathology of mice for evaluating the liver function of mice. It was discovered that MDSCs proliferation was inhibited, and that T cells tended to differentiate into Th17 rather than Treg in AIH mice. Moreover, the intervention of GSS activated GR and Yap, in addition to promoting the proliferation of MDSCs, especially M-MDSCs. This further promoted the differentiation of Treg to enable immune tolerance, thus alleviating liver impairment. Therefore, it was proposed that GSS can alleviate AIH by modulating the innate immunity and adaptive T cell immunity, which may be the underlying mechanism for GSS to mitigate the liver impairment induced by AIH.

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“…Considering the multi‐component and multi‐target characters of TCM, identifying various Chinese herbal prescriptions or natural Chinese medicine extracts is potentially an efficient approach to discovery of novel therapeutics against AIH. Recently, more AIH patients have prefered to take TCM to alleviate their severe symptoms and suppress steroid‐induced side effects 26 . Many experimental studies have illustrated the promising therapeutic effects of several natural products from TCM, including phenols, glycosides, flavonoids, polysaccharides and alkaloids, in the treatment of AIH by activating T/B lymphocytes, inducing helper T (Th2) cell development, promoting T cell proliferation and ultimately regulating T cell‐mediated immunity 27,28 …”

Section: Introductionmentioning

confidence: 99%

“…Recently, more AIH patients have prefered to take TCM to alleviate their severe symptoms and suppress steroidinduced side effects. 26 Many experimental studies have illustrated the promising therapeutic effects of several natural products from TCM, including phenols, glycosides, flavonoids, polysaccharides and alkaloids, in the treatment of AIH by activating T/B lymphocytes, inducing helper T (Th2) cell development, promoting T cell proliferation and ultimately regulating T cell-mediated immunity. 27,28 In the current review, we mainly focus on the hepatoprotective and immunoregulative effects of TCM and its natural products on several kinds of AIH-related animal models.…”

mentioning

confidence: 99%

Chinese medicine in the treatment of autoimmune hepatitis: Progress and future opportunities

Liu

Han

et al. 2022

Anim Models and Exp Med

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Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease occurring in individuals of all ages with a higher incidence in females and characterized by hypergammaglobulinemia, elevated serum autoantibodies and histological features of interface hepatitis. AIH pathogenesis remains obscure and still needs in‐depth study, which is likely associated with genetic susceptibility and the loss of immune homeostasis. Steroids alone and in combination with other immunosuppressant agents are the primary choices of AIH treatment in the clinic, whereas, in some cases, severe adverse effects and disease relapse may occur. Chinese medicine used for the treatment of AIH has proven its merits over many years and is well tolerated. To better understand the pathogenesis of AIH and to evaluate the efficacy of novel therapies, several animal models have been generated to recapitulate the immune microenvironment of patients with AIH. In the current review, we summarize recent advances in the study of animal models for AIH and their application in pharmacological research of Chinese medicine‐based therapies and also discuss current limitations. This review aims to provide novel insights into the discovery of Chinese medicine‐originated therapies for AIH using cutting‐edge animal models.

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Protocol of a prospective study for the combination treatment of Shu-Gan-jian-Pi decoction and steroid standard therapy in autoimmune hepatitis patients

Cited by 4 publications

References 9 publications

Comparative efficacy and tolerability of treatments for adult autoimmune hepatitis: A systematic review and network meta‑analysis

Comparative efficacy and tolerability of treatments for adult autoimmune hepatitis: A systematic review and network meta‑analysis

Ginsenosides Regulates Innate Immunity to Affect Immune Microenvironment of AIH Through Hippo-YAP/TAZ Signaling Pathway

Chinese medicine in the treatment of autoimmune hepatitis: Progress and future opportunities

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