Autoimmune Hepatitis with Elevated Serum IgG4 Levels Have a High Prevalence of Cirrhosis at Diagnosis

Figure 3

Possible liver fibrosis or cirrhosis pathogenesis of AIH with elevated serum IgG4It has reported IgG4 can target the PD-1 receptor on the surface of T cells to block the PD-1 pathway-mediated inhibition of T cell proliferation and cytokine production [25]. In our study, we speculate AIH with elevated serum IgG4 possibly have relatively elevated estrogen levels that lead to increased IgG4 antibody production by B cells and then IgG4 bind to the surface of TH17 cells to block the PD-1 pathway-mediated inhibition of TH17 cell proliferation and cytokine production. Thus, the proliferation of TH17 cells and the production of related cytokines can be increased to act on hepatic stellate cells which result in a high prevalence of cirrhosis.