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Factoring the intestinal microbiome into the pathogenesis of autoimmune hepatitis

The intestinal microbiome is a reservoir of microbial antigens and activated immune cells. The aims of this review were to describe the role of the intestinal microbiome in generating innate and adaptive immune responses, indicate how these responses contribute to the development of systemic immune-...

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Autor principal: Czaja, Albert J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5107691/
https://www.ncbi.nlm.nih.gov/pubmed/27895415
http://dx.doi.org/10.3748/wjg.v22.i42.9257
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author Czaja, Albert J
author_facet Czaja, Albert J
author_sort Czaja, Albert J
collection PubMed
description The intestinal microbiome is a reservoir of microbial antigens and activated immune cells. The aims of this review were to describe the role of the intestinal microbiome in generating innate and adaptive immune responses, indicate how these responses contribute to the development of systemic immune-mediated diseases, and encourage investigations that improve the understanding and management of autoimmune hepatitis. Alterations in the composition of the intestinal microflora (dysbiosis) can disrupt intestinal and systemic immune tolerances for commensal bacteria. Toll-like receptors within the intestine can recognize microbe-associated molecular patterns and shape subsets of T helper lymphocytes that may cross-react with host antigens (molecular mimicry). Activated gut-derived lymphocytes can migrate to lymph nodes, and gut-derived microbial antigens can translocate to extra-intestinal sites. Inflammasomes can form within hepatocytes and hepatic stellate cells, and they can drive the pro-inflammatory, immune-mediated, and fibrotic responses. Diet, designer probiotics, vitamin supplements, re-colonization methods, antibiotics, drugs that decrease intestinal permeability, and molecular interventions that block signaling pathways may emerge as adjunctive regimens that complement conventional immunosuppressive management. In conclusion, investigations of the intestinal microbiome are warranted in autoimmune hepatitis and promise to clarify pathogenic mechanisms and suggest alternative management strategies.
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spelling pubmed-51076912016-11-28 Factoring the intestinal microbiome into the pathogenesis of autoimmune hepatitis Czaja, Albert J World J Gastroenterol Frontier The intestinal microbiome is a reservoir of microbial antigens and activated immune cells. The aims of this review were to describe the role of the intestinal microbiome in generating innate and adaptive immune responses, indicate how these responses contribute to the development of systemic immune-mediated diseases, and encourage investigations that improve the understanding and management of autoimmune hepatitis. Alterations in the composition of the intestinal microflora (dysbiosis) can disrupt intestinal and systemic immune tolerances for commensal bacteria. Toll-like receptors within the intestine can recognize microbe-associated molecular patterns and shape subsets of T helper lymphocytes that may cross-react with host antigens (molecular mimicry). Activated gut-derived lymphocytes can migrate to lymph nodes, and gut-derived microbial antigens can translocate to extra-intestinal sites. Inflammasomes can form within hepatocytes and hepatic stellate cells, and they can drive the pro-inflammatory, immune-mediated, and fibrotic responses. Diet, designer probiotics, vitamin supplements, re-colonization methods, antibiotics, drugs that decrease intestinal permeability, and molecular interventions that block signaling pathways may emerge as adjunctive regimens that complement conventional immunosuppressive management. In conclusion, investigations of the intestinal microbiome are warranted in autoimmune hepatitis and promise to clarify pathogenic mechanisms and suggest alternative management strategies. Baishideng Publishing Group Inc 2016-11-14 2016-11-14 /pmc/articles/PMC5107691/ /pubmed/27895415 http://dx.doi.org/10.3748/wjg.v22.i42.9257 Text en ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ 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.
spellingShingle Frontier
Czaja, Albert J
Factoring the intestinal microbiome into the pathogenesis of autoimmune hepatitis
title Factoring the intestinal microbiome into the pathogenesis of autoimmune hepatitis
title_full Factoring the intestinal microbiome into the pathogenesis of autoimmune hepatitis
title_fullStr Factoring the intestinal microbiome into the pathogenesis of autoimmune hepatitis
title_full_unstemmed Factoring the intestinal microbiome into the pathogenesis of autoimmune hepatitis
title_short Factoring the intestinal microbiome into the pathogenesis of autoimmune hepatitis
title_sort factoring the intestinal microbiome into the pathogenesis of autoimmune hepatitis
topic Frontier
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5107691/
https://www.ncbi.nlm.nih.gov/pubmed/27895415
http://dx.doi.org/10.3748/wjg.v22.i42.9257
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