Unmet needs in autoimmune liver diseases

Mirjam Kolev; Andreas E Kremer; Christiane Sokollik; Merill Eric Gershwin; Benedetta Terziroli Beretta-Piccoli; speakers of 4th Swiss Autoimmune Liver Disease Meeting

doi:10.1016/j.coi.2025.102565

Unmet needs in autoimmune liver diseases

Curr Opin Immunol. 2025 May 24:95:102565. doi: 10.1016/j.coi.2025.102565. Online ahead of print.

Authors

Mirjam Kolev¹, Andreas E Kremer², Christiane Sokollik³, Merill Eric Gershwin⁴, Benedetta Terziroli Beretta-Piccoli⁵; speakers of 4th Swiss Autoimmune Liver Disease Meeting

Collaborators

speakers of 4th Swiss Autoimmune Liver Disease Meeting:
Raul J Andrade⁶, Carina Bobzin⁷, Ynto de Boer⁸, Eleonora de Martin⁹, Annamaria Deganello¹⁰, Michael Heneghan¹¹, Gideon Hirschfield¹², Pietro Invernizzi¹³, Tom H Karlsen¹⁴, Antonio Lanzavecchia¹⁵, Ansgar W Lohse¹⁶, Maria S Longhi¹⁷, Maria I Lucena¹⁸, Michael Manns¹⁹, Robert Mitchell-Thain²⁰, Christian Münz²¹, Mike Recher²², Marianne Samyn²³, Davide Salvioni²⁴, Ingo Van Thiel²⁵, Michael Trauner²⁶, Patrick van Rheenen²⁷, Yoh Zen²⁸

Affiliations

¹ Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Switzerland.
² Department of Gastroenterology and Hepatology, University Hospital Zürich, University of Zürich, Zürich, Switzerland.
³ Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Hospital, Inselspital, University of Bern, 3010 Bern, Switzerland.
⁴ Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, Davis, California, USA.
⁵ Epatocentro Ticino, Lugano, Switzerland; Faculty of Medical Biosciences, Università della Svizzera Italiana, Switzerland; MowatLabs, Faculty of Life Sciences & Medicine, King's College London, King's College Hospital, London, UK; Servizio di Gastroenterologia ed Epatologia, Ente Ospedaliero Cantonale, Ospedale Civico, Lugano, Switzerland. Electronic address: benedetta.terziroli@usi.ch.
⁶ Servicio Aparato Digestivo Instituto de Investigación Biomédica de Málaga-IBIMA_Plataforma Bionand, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.
⁷ SwissHePa, Founder and President, Zurich, Switzerland.
⁸ Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, VU University Medical Center, Amsterdam, the Netherlands.
⁹ APHP, Hôpital Paul Brousse, Centre Hépato-Biliaire, INSERM Unit 1193, FHU Hepatinov, Villejuif, France.
¹⁰ Department of Radiology, King's College London, King's College Hospital, London, UK.
¹¹ Institute of Liver Studies, King's College Hospital, London, UK.
¹² Toronto Centre for Liver Disease, Division of Gastroenterology and Hepatology, University of Toronto, Toronto, Canada.
¹³ Division of Gastroenterology and Center for Autoimmune Liver Division of Gastroenterology, Center for Autoimmune Liver Diseases, European Reference Network on Hepatological Diseases (ERN RARE-LIVER), IRCCS Fondazione San Gerardo dei Tintori, Monza, Italy; Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
¹⁴ Norwegian PSC Research Center, Department of Transplantation Medicine, Division of Surgery, Inflammatory Medicine and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Norway; Research Institute of Internal Medicine, Division of Surgery, Inflammatory Medicine and Transplantation, Oslo University Hospital Rikshospitalet, Oslo, Norway.
¹⁵ Institute for Research in Biomedicine, Università della Svizzera italiana, Bellinzona 6500, Switzerland; Institute of Microbiology, ETH Zurich, Zurich 8093, Switzerland.
¹⁶ Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
¹⁷ Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, USA.
¹⁸ Servicio de Farmacología Clínica, IBIMA Plataforma Bionand, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain.
¹⁹ Hannover Medical School, Centre of ERN RARE-LIVER, Hannover, Germany.
²⁰ PBC Foundation, Edinburgh, UK.
²¹ Viral Immunobiology, Institute of Experimental Immunology, University of Zürich, Zürich, Switzerland.
²² Immunodeficiency Clinic, Medical Outpatient Unit and Immunodeficiency Lab, Department Biomedicine, University Hospital, Petersgraben 4, 4031 Basel, Switzerland.
²³ Paediatric Liver, GI and Nutrition Centre, King's College Hospital, London, United Kingdom.
²⁴ Associazione Malattie Autoimmuni del Fegato, President, Muggiò, Italy.
²⁵ Deutsche Leberhilfe, Köln, Germany.
²⁶ Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University, Vienna, Austria.
²⁷ Department of Paediatric Gastroenterology, University of Groningen, University Medical Centre Groningen, Beatrix Children's Hospital, Groningen, the Netherlands.
²⁸ Institute of Liver Studies, King's College Hospital, London SE5 9RS, UK.

PMID: 40414140
DOI: 10.1016/j.coi.2025.102565

Abstract

Autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis are well-defined autoimmune liver diseases, the pathophysiology of which remains enigmatic. While major therapeutic advances have been achieved for many other autoimmune diseases, precision therapy for these diseases has lagged. For example, limited data exist on the use of innovative drugs targeting the immune system, such as monoclonal antibodies that block immune checkpoint, mRNA vaccines, the influence of infections, the microbiome, and drugs on loss of tolerance in liver autoimmunity. The knowledge on recent radiological techniques, on the expanding role of artificial intelligence in medicine, and on the relationship between the pediatric and adult phenotypes also urgently needs to be advanced in liver autoimmunity. Increased patient involvement focusing on individual symptom burden is also crucial for improving long-term quality of treatment. The fourth Swiss Autoimmune Liver Disease Meeting provided a unique interdisciplinary platform for experts and patients to discuss critical gaps. This opinion paper highlights the discussions on unmet needs and potential solutions in autoimmune liver diseases.

Publication types

Review