Unmet needs in autoimmune liver diseases.

Journal: Current opinion in immunology
Published Date: May 24, 2025

Abstract

Autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis are well-defined autoimmune liver diseases, the pathophysiology of which remains enigmatic. While major therapeutic advances have been achieved for many other autoimmune diseases, precision therapy for these diseases has lagged. For example, limited data exist on the use of innovative drugs targeting the immune system, such as monoclonal antibodies that block immune checkpoint, mRNA vaccines, the influence of infections, the microbiome, and drugs on loss of tolerance in liver autoimmunity. The knowledge on recent radiological techniques, on the expanding role of artificial intelligence in medicine, and on the relationship between the pediatric and adult phenotypes also urgently needs to be advanced in liver autoimmunity. Increased patient involvement focusing on individual symptom burden is also crucial for improving long-term quality of treatment. The fourth Swiss Autoimmune Liver Disease Meeting provided a unique interdisciplinary platform for experts and patients to discuss critical gaps. This opinion paper highlights the discussions on unmet needs and potential solutions in autoimmune liver diseases.

Authors

  • Mirjam Kolev
    Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland.
  • Andreas E Kremer
    Department of Gastroenterology and Hepatology, University Hospital Zürich, University of Zürich, Zürich, Switzerland.
  • Christiane Sokollik
    Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital, Inselspital, University of Bern, 3010 Bern, Switzerland.
  • Merill Eric Gershwin
    Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, Davis, California, USA.
  • Benedetta Terziroli Beretta-Piccoli
    Epatocentro Ticino, Lugano, Switzerland; Faculty of Medical Biosciences, Università della Svizzera Italiana, Switzerland; MowatLabs, Faculty of Life Sciences & Medicine, King's College London, King's College Hospital, London, UK; Servizio di Gastroenterologia ed Epatologia, Ente Ospedaliero Cantonale, Ospedale Civico, Lugano, Switzerland. Electronic address: benedetta.terziroli@usi.ch.

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