Molecular Characterization of Autoimmune Hepatitis: A Lipidomic Approach
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- This is an observational study: the protocol does not assign a study treatment.
- Who it may be relevant to
- Registry conditions: Autoimmune Hepatitis, Non-Alcoholic Fatty Liver Disease. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Italy
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
Molecular Characterization of Autoimmune Hepatitis Through Lipidomic Analysis and Extracellular Vesicle Profiling: A Controlled Pilot Clinical Study
Overview
This is a two-arm, prospective, controlled observational pilot clinical study aimed at characterizing the lipidomic profile and extracellular vesicles (EVs) of patients with autoimmune hepatitis (AIH) compared to patients with non-alcoholic fatty liver disease (NAFLD). A total of 24 adult outpatients will be enrolled at the Hepatology Outpatient Unit of IRCCS "S. de Bellis". Blood samples will be collected by venipuncture to perform lipidomic analyses on red blood cell membranes and serum, and to isolate and characterize EVs. No intervention beyond standard clinical practice will be applied
Detailed description
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.
Primary outcome measures
- Lipidomic profile [Time frame: At enrollment (single time point - baseline blood draw)]
Secondary outcome measures (3)
- Number and size distribution of serum-derived extracellular vesicles assessed by nanoparticle tracking analysis (NTA) [Time frame: At enrollment (single time point - baseline blood draw)]
- Concentration of serum lipidomic and biochemical biomarkers for AIH diagnosis assessed by integrated lipidomic and biochemical analysis [Time frame: At enrollment (single time point - baseline blood draw)]
- Expression profile of EV-associated proteins and miRNAs involved in AIH pathogenesis assessed by proteomic and transcriptomic analysis [Time frame: At enrollment (single time point - baseline blood draw)]
Eligibility criteria
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
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Case-control
Study locations
Italy · 1 center
- IRCCS "S. de Bellis" - Nutritional Biochemistry Lab — Castellana Grotte
Publications
- Muratori L, Lohse AW, Lenzi M. Diagnosis and management of autoimmune hepatitis. BMJ. 2023 Feb 6;380:e070201. doi: 10.1136/bmj-2022-070201. PMID 36746473
- 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. PMID 40648888
- 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. PMID 40663808
Identifiers
NCT: NCT07644936 · PR-23-26-NOTARNICOLA