The management of autoimmune hepatitis (AIH) has remained largely unchanged for the past three decades. The optimal regimen for patients who do not respond to first-line treatment of corticosteroids with or without azathioprine remains unclear. There is growing interest in the use of immunotherapies targeting cluster of differentiation 4–positive (CD4+) forkhead box P3–positive (Foxp3)+ regulatory T cells (Tregs). Tregs are a T-lymphocyte subpopulation with immunosuppressive and cytoprotective capacity that plays a key role in restraining autoreactive conventional T lymphocytes and preventing autoimmunity. Due to their constitutive expression of CD25, the alpha-chain of the interleukin-2 (IL-2) receptor, Tregs are highly dependent on, and exquisitely sensitive to, IL-2.(1) The use of lowdose IL-2 (LDIL-2) as an immunomodulatory agent is being explored in various autoimmune disorders.(2) We report here the clinical and immunological effects of LDIL-2 in 2 patients with refractory AIH.
[1]
D. Vergani,et al.
In autoimmune hepatitis type 1 or the autoimmune hepatitis–sclerosing cholangitis variant defective regulatory T‐cell responsiveness to IL‐2 results in low IL‐10 production and impaired suppression
,
2015,
Hepatology.
[2]
F. Ginhoux,et al.
Liver inflammation abrogates immunological tolerance induced by Kupffer cells
,
2015,
Hepatology.
[3]
D. Klatzmann,et al.
Low-dose interleukin 2 in patients with type 1 diabetes: a phase 1/2 randomised, double-blind, placebo-controlled trial.
,
2013,
The lancet. Diabetes & endocrinology.
[4]
J. Ritz,et al.
Low-Dose Interleukin-2 Therapy Restores Regulatory T Cell Homeostasis in Patients with Chronic Graft-Versus-Host Disease
,
2013,
Science Translational Medicine.