The pathogenesis of autoimmune hepatitis is still poorly understood and therefore, the therapy administered to treat this condition is broadly targeted immunosuppression. However, the aim of therapy in the future should be more specific; it should be a therapy that interrupts the pathogenetic cascade at defined checkpoints. Even though these checkpoints are not yet defined, possible targets of immunotherapy are emerging. These are specifically enhancing the regulatory T-cell activity, anti-cytokine interventions, in particular targeting the tumor necrosis factor, and hopefully in the foreseeable future, defining the key T-cell receptors used and developing new therapies directed against these.

1.
Cook GC, Mulligan R, Sherlock S: Controlled prospective trial of corticosteroid therapy in active chronic hepatitis. Q J Med 1971;40:159-185.
2.
Kirk AP, Jain S, Pocock S, Thomas HC, Sherlock S: Late results of the royal free hospital prospective controlled trial of prednisolone therapy in hepatitis B surface antigen negative chronic active hepatitis. Gut 1980;21:78-83.
3.
Mackay IR: Chronic hepatitis: effect of prolonged suppressive treatment and comparison of azathioprine with prednisolone. Q J Med 1968;37:379-392.
4.
European Association for the Study of the Liver: EASL clinical practice guidelines: autoimmune hepatitis. J Hepatol 2015;63:971-1004.
5.
Czaja AJ: Difficult treatment decisions in autoimmune hepatitis. World J Gastroenterol 2010;16:934-947.
6.
van Gerven NM, Verwer BJ, Witte BI, et al: Relapse is almost universal after withdrawal of immunosuppressive medication in patients with autoimmune hepatitis in remission. J Hepatol 2013;58:141-147.
7.
Sockalingam S, Blank D, Abdelhamid N, Abbey SE, Hirschfield GM: Identifying opportunities to improve management of autoimmune hepatitis: evaluation of drug adherence and psychosocial Factors. J Hepatol 2012;57:1299-1304.
8.
Osterberg L, Blaschke T: Adherence to medication. N Engl J Med 2005;353:487-497.
9.
Alvarez F, Ciocca M, Canero-Velasco C, et al: Short-term cyclosporine induces a remission of autoimmune hepatitis in children. J Hepatol 1999;30:222-227.
10.
Larsen FS, Vainer B, Eefsen M, Bjerring PN, Adel Hansen B: Low-dose tacrolimus ameliorates liver inflammation and fibrosis in steroid refractory autoimmune hepatitis. World J Gastroenterol 2007;13:3232-3236.
11.
Kanzler S, Gerken G, Dienes HP, Meyer zum Buschenfelde KH, Lohse AW: Cyclophosphamide as alternative immunosuppressive therapy for autoimmune hepatitis - report of three cases. Z Gastroenterol 1997;35:571-578.
12.
Weiler-Normann C, Lohse AW: Autoimmune hepatitis: a life-long disease. J Hepatol 2013;58:5-7.
13.
van Gerven NM, de Boer YS, Zwiers A, et al: HLA-DRB1*03:01 and HLA-DRB1*04:01 modify the presentation and outcome in autoimmune hepatitis type-1. Genes Immun 2015;16:247-252.
14.
Yoshizawa K, Ota M, Katsuyama Y, et al: Genetic analysis of the HLA region of Japanese patients with type 1 autoimmune hepatitis. J Hepatol 2005;42:578-584.
15.
Ridgway WM, Fasso M, Fathman CG: A new look at MHC and autoimmune disease. Science 1999;284:749, 751.
16.
Peiseler M, Sebode M, Franke B, et al: FOXP3+ regulatory T cells in autoimmune hepatitis are fully functional and not reduced in frequency. J Hepatol 2012;57:125-132.
17.
Longhi MS, Ma Y, Bogdanos DP, Cheeseman P, Mieli-Vergani G, Vergani D: Impairment of CD4(+)CD25(+) regulatory T-cells in autoimmune liver disease. J Hepatol 2004;41:31-37.
18.
Weiler-Normann C, Schramm C: Drug induced liver injury and its relationship to autoimmune hepatitis. J Hepatol 2011;55:747-749.
19.
Lohr HF, Schlaak JF, Gerken G, Fleischer B, Dienes HP, Meyer zum Buschenfelde KH: Phenotypical analysis and cytokine release of liver-infiltrating and peripheral blood T lymphocytes from patients with chronic hepatitis of different etiology. Liver 1994;14:161-166.
20.
Weiler-Normann C, Schramm C, Quaas A, et al: Infliximab as a rescue treatment in difficult-to-treat autoimmune hepatitis. J Hepatol 2013;58:529-534.
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