Transcriptomic profiling of blood from autoimmune hepatitis patients reveals potential mechanisms with implications for management

PLoS One. 2022 Mar 21;17(3):e0264307. doi: 10.1371/journal.pone.0264307. eCollection 2022.

Abstract

Autoimmune hepatitis (AIH) is a poorly understood, chronic disease, for which corticosteroids are still the mainstay of therapy and most patients undergo liver biopsy to obtain a diagnosis. We aimed to determine if there was a transcriptomic signature of AIH in the peripheral blood and investigate underlying biologic pathways revealed by gene expression analysis. Whole blood RNA from 75 AIH patients and 25 healthy volunteers was extracted and sequenced. Differential gene expression analysis revealed 249 genes that were significantly differentially expressed in AIH patients compared to controls. Using a random forest algorithm, we determined that less than 10 genes were sufficient to differentiate the two groups in our cohort. Interferon signaling was more active in AIH samples compared to controls, regardless of treatment status. Pegivirus sequences were detected in five AIH samples and 1 healthy sample. The gene expression data and clinical metadata were used to determine 12 genes that were significantly associated with advanced fibrosis in AIH. AIH patients with a partial response to therapy demonstrated decreased evidence of a CD8+ T cell gene expression signal. These findings represent progress in understanding a disease in need of better tests, therapies, and biomarkers.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers
  • CD8-Positive T-Lymphocytes
  • Cohort Studies
  • Hepatitis, Autoimmune* / diagnosis
  • Hepatitis, Autoimmune* / drug therapy
  • Hepatitis, Autoimmune* / genetics
  • Humans
  • Transcriptome

Substances

  • Biomarkers

Grants and funding

EC and MT received the American Association for the Study of Liver Diseases (aasld.org) Autoimmune Liver Diseases Pilot Reseach Award to perform this work. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.