4. Immune System Dysfunction: Unraveling the Inner Turmoil
In the heart of AIH lies the immune system, a complex network designed to protect, which in this case, paradoxically turns against the body. Unpacking the intricacies of immune system dysfunction reveals an array of cellular actors gone rogue – T-cells, B-cells, and cytokines – that normally guard against pathogens now orchestrating an attack on the liver’s architecture. The AIH narrative is one of a civil war, with immune regulators and effectors caught in a detrimental loop of miscommunication and overreaction.
Central to this dysfunction is the T-cell, the immune system’s strategist, which in AIH patients is often found in a state of overdrive. T-cells are misled into recognizing liver cells as threats, marshaling an army of antibodies and inflammatory cells to the site. The liver, besieged by this friendly fire, becomes inflamed and damaged. This autoimmune assault is not a fleeting skirmish but a sustained campaign that can progressively scar the liver, leading to cirrhosis or even liver failure if left unchecked.
B-cells, the body’s antibody factories, also play their part in this internal conflict. In AIH, they produce an arsenal of autoantibodies, some of which serve as markers for diagnosis and disease monitoring. The presence of these autoantibodies is a testament to the immune system’s confusion, as it churns out weapons against its own proteins.
Compounding this cellular turmoil is the role of cytokines – the chemical messengers that can incite or calm inflammation. In AIH, the balance of these cytokines is tipped towards inflammation, perpetuating liver damage. It’s a delicate ecosystem that has lost its equilibrium, with the very elements designed to resolve inflammation and repair tissue contributing to ongoing damage.
Dissecting the role of immune system dysfunction in AIH is more than a scientific exercise; it’s a quest to pinpoint therapeutic targets. Treatments aim to dampen this autoimmune activity, restoring peace among the cellular populace. Immunosuppressive therapies, the cornerstone of AIH treatment, are a testament to the importance of reining in the immune system’s overzealousness. It’s a balancing act of maintaining enough immune activity to protect the body while quelling the insurrection within. (4)
