Autoimmune hepatitis : a review of molecular mechanisms and research gaps in African populations

Abstract

Autoimmune hepatitis (AIH) is an inflammatory liver disease characterised by immune-mediated hepatic injury, often leading to liver failure. The underlying molecular mechanisms of AIH remain poorly elucidated, hindering diagnostic and therapeutic advances. This review overviews the current understanding of AIH pathogenesis, which arises from a complex interplay of genetic predisposition, environmental triggers, and immune mechanisms (loss of tolerance, regulatory T cell dysfunction). Furthermore, current technologies and models which are being used to deconvolve the molecular profiles and pathophysiology of AIH are also discussed. Although AIH has a low reported global burden, AIH research is critically skewed towards European ancestry populations. This leaves a significant knowledge gap in diverse ancestry groups, such as those of African ancestry, where emerging research suggests that these patients may experience a more aggressive disease. Collectively, this highlights the need for research in underrepresented global populations to develop tailored diagnostics and effective targeted treatments.