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Molecular Characterization of Autoimmune Hepatitis: A Lipidomic Approach (AIH-LIPID)
Molecular Characterization of Autoimmune Hepatitis Through Lipidomic Analysis and Extracellular Vesicle Profiling: A Controlled Pilot Clinical Study
Studie Overzicht
Toestand
Gedetailleerde beschrijving
Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease characterized by high serum levels of transaminases and IgG immunoglobulins, presence of organ-specific and non-organ-specific autoantibodies, and interface hepatitis at histopathology. Two distinct types are recognized: AIH type 1, associated with anti-smooth muscle antibodies (SMA) and/or antinuclear antibodies (ANA); and AIH type 2, associated with anti-liver-kidney microsome type 1 (anti-LKM-1) and/or anti-liver cytosol type 1 (anti-LC-1) antibodies.
AIH presents a heterogeneous clinical picture driven by immune dysregulation involving B and T lymphocytes and macrophages. The autoimmune response is initiated by T lymphocyte recognition of self-antigens presented by MHC molecules, leading to differentiation into Th1, Th2, or Th17 cells that mediate hepatic damage.
Extracellular vesicles (EVs) have recently been implicated in AIH pathogenesis, acting as mediators of intercellular communication. EVs can carry autoantigens, signaling molecules, lipids, and nucleic acids, modulating immune responses and potentially facilitating immune tolerance disruption. In AIH, EVs may vehicle hepatic autoantigens and modulate immune cell activity in the liver.
No specific biomarkers currently exist that reliably distinguish AIH from other hepatic conditions, including NAFLD/MASLD, with which it is frequently associated due to overlapping metabolic alterations. A lipidomic approach is therefore proposed to identify specific lipid profiles associated with AIH.
Lipidomic analysis will be performed on red blood cell membranes and serum of both study arms. Extracted fatty acids will be derivatized and analyzed by gas chromatography with flame ionization detection (GC-FID), compared against the FAME Mix-37 chromatogram. EVs isolated from serum will be further characterized for potential use as biocompatible nanovectors for immunosuppressive or immunomodulatory drug delivery.
Studietype
Inschrijving (Geschat)
Contacten en locaties
Studiecontact
- Naam: Maria Notarnicola, biologyst
- Telefoonnummer: +39 0804994623
- E-mail: maria.notarnicola@irccsdebellis.it
Studie Contact Back-up
- Naam: Valentina De Nunzio
- Telefoonnummer: +39 0804994623
- E-mail: valentina.denunzio@irccsdebellis.it
Studie Locaties
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Bari
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Castellana Grotte, Bari, Italië, 70013
- IRCCS "S. de Bellis" - Nutritional Biochemistry Lab
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Contact:
- Maria Notarnicola, Biologyst
- Telefoonnummer: 0804994623
- E-mail: maria.notarnicola@irccsdebellis.it
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Contact:
- Valentina De Nunzio
- Telefoonnummer: 0804994623
- E-mail: valentina.denunzio@irccsdebellis.it
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Hoofdonderzoeker:
- Maria Notarnicola
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Onderonderzoeker:
- Emanuela Aloisio Caruso
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Onderonderzoeker:
- Valentina De Nunzio
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Onderonderzoeker:
- Giuliano Pinto
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Onderonderzoeker:
- Angela Tafaro
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Onderonderzoeker:
- Maria Principia Scavo
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Onderonderzoeker:
- Raffaele Cozzolongo
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Onderonderzoeker:
- Endrit Shahini
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Onderonderzoeker:
- Pasqua Letizia Pesole
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Bemonsteringsmethode
Studie Bevolking
Beschrijving
Inclusion Criteria:
ARM A:
- Confirmed diagnosis of autoimmune hepatitis (AIH);
- Adult age (≥18 years);
- Ability to provide written informed consent; Attending the Hepatology Outpatient Unit of IRCCS "S. de Bellis"
ARM B:
Exclusion Criteria:
- Confirmed diagnosis of non-alcoholic fatty liver disease (NAFLD);
- Adult age (≥18 years);
- Ability to provide written informed consent; Attending the Hepatology Outpatient Unit of IRCCS "S. de Bellis"
Esclusion Criteria:
- Liver cirrhosis;
- Active oncological diseases;
- Viral hepatitis (HBV, HCV, HIV infection);
- Severe medical conditions that may compromise study participation
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
Cohorten en interventies
Groep / Cohort |
|---|
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Arm A - Autoimmune Hepatitis (AIH)
12 adult outpatients with a confirmed diagnosis of autoimmune hepatitis (AIH), attending the Hepatology Outpatient Unit (UOSD Epatopatie) of IRCCS "S. de Bellis".
|
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Arm B - Non-Alcoholic Fatty Liver Disease (NAFLD)
12 adult outpatients with a confirmed diagnosis of non-alcoholic fatty liver disease (NAFLD), attending the Hepatology Outpatient Unit (UOSD Epatopatie) of IRCCS "S. de Bellis".
|
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Lipidomic profile
Tijdsspanne: At enrollment (single time point - baseline blood draw)
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Identification of specific lipid profiles (fatty acid composition) on red blood cell membranes and serum associated with AIH compared to NAFLD, assessed by gas chromatography with flame ionization detection (GC-FID).
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At enrollment (single time point - baseline blood draw)
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Number and size distribution of serum-derived extracellular vesicles assessed by nanoparticle tracking analysis (NTA)
Tijdsspanne: At enrollment (single time point - baseline blood draw)
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Isolation and characterization of EVs from patient serum to evaluate their use as biocompatible nanovectors for immunosuppressive/immunomodulatory drug delivery
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At enrollment (single time point - baseline blood draw)
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Concentration of serum lipidomic and biochemical biomarkers for AIH diagnosis assessed by integrated lipidomic and biochemical analysis
Tijdsspanne: At enrollment (single time point - baseline blood draw)
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Identification of molecular biomarkers for early and accurate AIH diagnosis through integrated lipidomic and biochemical analysis
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At enrollment (single time point - baseline blood draw)
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Expression profile of EV-associated proteins and miRNAs involved in AIH pathogenesis assessed by proteomic and transcriptomic analysis
Tijdsspanne: At enrollment (single time point - baseline blood draw)
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Identification of molecular pathways involved in AIH pathogenesis through EV characterization
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At enrollment (single time point - baseline blood draw)
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Medewerkers en onderzoekers
Publicaties en nuttige links
Algemene publicaties
- Muratori L, Lohse AW, Lenzi M. Diagnosis and management of autoimmune hepatitis. BMJ. 2023 Feb 6;380:e070201. doi: 10.1136/bmj-2022-070201.
- Nishikawa H, Kim SK, Asai A. Autoimmune Hepatitis and Drug-Induced Liver Injury in Japan. J Clin Med. 2025 Jun 25;14(13):4514. doi: 10.3390/jcm14134514.
- Longhi MS, Zhang L, Mieli-Vergani G, Vergani D. Can we cure autoimmune hepatitis? Curr Opin Immunol. 2025 Oct;96:102609. doi: 10.1016/j.coi.2025.102609. Epub 2025 Jul 14.
Studie record data
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Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
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Updates van studierecords
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Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- PR-23-26-NOTARNICOLA
Plan Individuele Deelnemersgegevens (IPD)
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