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Autoimmune processes in the liver can cause severe damage and destruction leading to cirrhosis and liver failure. The clinical spectrum of autoimmune liver disease is very wide, and diagnostic difficulties often stand at the beginning of the patient's medical career. While in autoimmune hepatitis immunosuppressive therapy has long been shown to be life-saving, therapeutic progress is small in primary biliary cirrhosis and questionable in primary sclerosing cholangitis. New approaches to treatment will be needed in the future, but require better understanding of the pathogenesis of the underlying disease process.
This book, the proceedings of Falk Symposium 142 on 'Autoimmune Liver Disease' held in Freiburg, Germany, on 12-13 October 2004 (Part I of the Gastroenterology Week Freiburg), describes possible mechanisms of pathogenesis, discusses diagnostic criteria and takes up controversies concerning treatment options. In view of the relatively frequent manifestation of autoimmune hepatitis in childhood in particular, paediatric aspects of autoimmune liver disease, and the role of liver transplantation, are given prominence.
List of contents
Table of Contents List of principal contributors Preface SECTION I: IMMUNE REGULATION I Chair: K-H Meyer zum Büschenfelde, H Wekerle 1 Transforming growth factor-ß in T cell tolerance MO Li, Y Laouar, Y Peng, L Gorelik, RA Flavell 2 Viruses as initiators, accelerators or terminators of autoimmunity? -- a question of time and location of infection U Christen, MG von Herrath 3 Antigen-chip technology for accessing global information concerning the state of the body IR Cohen, FJ Quintana, Y Merbl SECTION II: IMMUNE REGULATION II Chair: PA Berg, PR Galle 4 CD95-mediated apoptosis: immune mission to death PH Krammer 5 Regulation of autoimmunity -- lessons from liver and skin B Arnold SECTION III: PATHOGENESIS I Chair: IG McFarlane, FB Bianchi 6 Autoreactive T cells: any evidence in autoimmune liver disease? Y Ma, MS Longhi, DP Bogdanos, G Mieli-Vergani, D Vergani 7 Autoimmune hepatitis in transgenic mouse models: what lessons can be learnt? P Bertolino, DG Bowen, M Zen, GW McCaughan 8 Autoantibodies to SLA/LP: specificity and pathogenetic relevance? U Cheruti, C Wang, AW Lohse, J Herkel 9 Role of microsomal antigens in autoimmune hepatitis CP Strassgurg SECTION IV: PATHOGENESIS II Chair: IR Mackay, R Poupon 10 The induction and destruction phases of primary biliary cirrhosis TK Mao, ME Gershwin 11 Disease models in primary biliary cirrhosis DEJ Jones 12 Infectious aetiology of primary biliary cirrhosis MF Bassendine 13 Role of genetics in immunopathogenesis PT Donaldson SECTION V:DIAGNOSIS Chair: VJ Desmet, MP Manns 14 Liver histology in autoimmune hepatitis -- diagnostic implications HP Dienes 15 Autoimmune hepatitis: clinical and laboratory diagnosis AJ Czaja 16 Diagnosis of primary biliary liver diseases, overlap syndromes and changing diagnoses J Heathcote SECTION VI: TREATMENT AND PROGNOSIS I Chair: EL Krawitt, A Stiehl 17 Standard treatment of autoimmune hepatitis S Luth, E Bayer, C Schramm, AW Lohse 18 Novel approaches to the treatment of autoimmune hepatitis TO Lankisch, CP Strassburg, MP Manns 19 Standard treatment for primary sclerosing cholangitis and overlap autoimmune hepatitis/primary sclerosing cholangitis E Schrumpf, KM Boberg 20 Novel approaches to the treatment of primary sclerosing cholangitis RW Chapman SECTION VII: TREATMENT AND PROGNOSIS II Chair: J Heathcote, R Williams 21 Novel approaches to the treatment of primary biliary cirrhosis U Leuschner 22 Prognosis of autoimmune liver diseases KM Boberg, E Schrumpf 23 Transplantation for autoimmune liver diseases J Neuberger SECTION VIII: PAEDIATRIC ASPECTS OF AUTOIMMUNE LIVER DISEASE Chair: M Burdelski, X Rogiers 24 Autoimmune hepatitis in children: clinical and diagnostic aspects F Alvarez 25 Therapeutic aspects of autoimmune liver disease in children G Mieli-Vergani, K Bargiota, M Samyn, D Vergani 26 Indications and results of liver transplantation for autoimmune liver disease in children D Kelly 27 Cyclosporin indication in `autoimmune hepatitis' F Alvarez Index
