The association between juvenile autoimmune
hepatitis and HLA-DRB1 alleles: Iraqi tertiary
center experience

Ibraheem, Mohammad F.; Ahmed, Shayma`a J.

doi:10.5114/ceh.2021.106865

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…A peculiar finding of our study is the presence of HLA DRB1*11 in three out of six patients with AIH (patients 1, 2, and 5), which is concordant with the observation of Ghielmetti et al [11] in their case report. Although the role of HLA DRB1*11 in liver diseases has been poorly investigated, in the available literature, this allele has been significantly associated with resistance to chronic HBV and HCV infection in Chinese, Brazilian, and European populations [45,46], and with a weak protection to AIH in studies conducted on Iranian and Iraqi groups of patients [47,48]. This may suggest that certain allelic variants play an important role in the immune response against SARS-CoV-2 infection or in AIH pathogenesis, but further data and investigations in the European population are needed to identify an association.…”

Section: Discussionmentioning

confidence: 99%

Investigating Acute Hepatitis after SARS-CoV-2 Vaccination or Infection: A Genetic Case Series

Bernasconi,

Biagi,

Di Agostino

et al. 2023

Biomedicines

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(1) Background: Despite the advantages of COVID-19 vaccination, rare cases of acute hepatitis developing after the administration of the COVID-19 vaccine or the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported. The aim of the study is to describe a case series of patients who experienced the onset of acute hepatitis, with or without autoimmune features, following SARS-CoV-2 vaccination or infection and to hypothesize a genetic susceptibility in the pathogenesis. (2) Methods: A group of patients with acute onset hepatitis following SARS-CoV-2 vaccination or infection were evaluated in our hepatology outpatient clinic, where they underwent biochemical and autoimmune tests. Hepatitis A (HAV), B (HBV), and C virus (HCV), cytomegalovirus (CMV), Epstein–Barr virus (EBV), and human immunodeficiency virus (HIV) infections were excluded. Patients with a diagnosis of autoimmune hepatitis (AIH) or drug-induced liver injury (DILI) underwent HLA typing and histological testing. (3) Results: Five patients experienced new-onset AIH after COVID-19 vaccination, one of which developed mild symptoms after vaccination that strongly worsened during subsequent SARS-CoV-2 infection. One patient had AIH relapse after COVID-19 vaccination while on maintenance immunosuppressive treatment. All of them had HLA DRB1 alleles known to confer susceptibility to AIH (HLA DRB1*03,*07,*13,*14), and in three of them, HLA DRB1*11 was also detected. Two patients developed acute hepatitis without autoimmune hallmarks which resolved spontaneously, both positive for HLA DRB1*11. (4) Conclusions: An association between AIH and COVID-19 vaccine or infection can be hypothesized in individuals with a genetic predisposition. In patients without autoimmune features and spontaneous improvement of hypertransaminasemia, the diagnosis of drug-induced liver injury (DILI) is probable. Further studies are needed to determine the presence of an actual association and identify a possible role of HLA DRB1*11 in the pathogenesis of acute liver injury after SARS-CoV2 vaccination or infection.

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Section: Discussionmentioning

confidence: 99%

Investigating Acute Hepatitis after SARS-CoV-2 Vaccination or Infection: A Genetic Case Series

Bernasconi,

Biagi,

Di Agostino

et al. 2023

Biomedicines

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HLA-DRB5 Overexpression Promotes Platelet Reduction in Immune Thrombocytopenia Mice Model by Facilitating MHC-II-Mediated Antigen Presentation

Ren,

Ying,

Chen

et al. 2024

Acta Haematol

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Introduction: Major histocompatibility complex II (MHC-II)-mediated antigen presentation contributes to the pathogenesis of immune thrombocytopenia (ITP). Human leukocyte antigen (HLA)-DRB5 is an MHC-II molecule and this study aims to investigate its role and mechanisms in ITP development. Methods: Guinea pig anti-mouse platelet (PLT) serum-induced ITP mice received tail vein injection of HLA-DRB5 overexpressing adenoviral vector/immune receptor expressed on myeloid cells-1 (IREM-1) monoclonal antibody (mAb). PLT count changes in mice blood were assessed by a haematology analyzer. MHC-II/CD80/CD86 expression in mice blood was measured by quantitative Real Time (qRT)-PCR and immunofluorescence assay. CD8+ T cell proportion in mice blood was detected by flow cytometry. Results: HLA-DRB5 overexpression exacerbated PLT reduction since the 5th day of the establishment of ITP mice model and enhanced MHC-II/CD80/CD86 expression upregulation as well as CD8+ T cell ratio elevation in the blood of ITP mice while its effects were reversed by IREM-1 mAb. Conclusion: HLA-DRB5 overexpression upregulates MHC-II-mediated antigen presentation to CD8+ T cells, thus lowering PLT count in the ITP mice model.

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HLA, gut microbiome and hepatic autoimmunity

2022

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Genetic susceptibility to autoimmune liver diseases is conferred mainly by polymorphisms of genes encoding for the human leukocyte antigens (HLA). The strongest predisposition to autoimmune hepatitis type 1 (AIH-1) is linked to the allele DRB1*03:01, possession of which is associated with earlier disease onset and more severe course. In populations where this allele is very rare, such as in Asia, and in DRB1*03-negative patients, risk of AIH-1 is conferred by DRB1*04, which is associated with later disease onset and milder phenotype. AIH type 2 (AIH-2) is associated with DRB1*07. The pediatric condition referred to as autoimmune sclerosing cholangitis (ASC), is associated with the DRB1*13 in populations of Northern European ancestry. DRB1*1501 is protective from AIH-1, AIH-2 and ASC in Northern European populations. Possession of the DRB1*08 allele is associated with an increased risk of primary biliary cholangitis (PBC) across different populations. DRB1*03:01 and B*08:01 confer susceptibility to primary sclerosing cholangitis (PSC), as well as DRB1*13 and DRB1*15 in Europe. The hepatic blood supply is largely derived from the splanchnic circulation, suggesting a pathophysiological role of the gut microbiome. AIH appears to be associated with dysbiosis, increased gut permeability, and translocation of intestinal microbial products into the circulation; molecular mimicry between microbial and host antigens may trigger an autoaggressive response in genetically-predisposed individuals. In PBC an altered enteric microbiome may affect intestinal motility, immunological function and bile secretion. Patients with PSC have a gut microbial profile different from health as well as from patients with inflammatory bowel disease without PSC.

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The association between juvenile autoimmune hepatitis and HLA-DRB1 alleles: Iraqi tertiary center experience

Cited by 3 publications

References 23 publications

Investigating Acute Hepatitis after SARS-CoV-2 Vaccination or Infection: A Genetic Case Series

Investigating Acute Hepatitis after SARS-CoV-2 Vaccination or Infection: A Genetic Case Series

HLA-DRB5 Overexpression Promotes Platelet Reduction in Immune Thrombocytopenia Mice Model by Facilitating MHC-II-Mediated Antigen Presentation

HLA, gut microbiome and hepatic autoimmunity

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