Abstract

Background: In today’s context when liver diseases have spread across countries and people of all ages, it is of high importance to consider novel methods of non-toxic and long lived therapeutics. Among various therapies, immunotherapy for acute and chronic liver diseases is rapidly moving to the forefront among treatment options in hepatology medicine.

Objective: The present review covers the recent advances in immunotherapy of hepatocellular carcinoma (HCC), viral hepatitis, cirrhosis, obesity induced inflammation, non alcoholic fatty liver diseases (NAFLD), and drug induced liver injury (DILI) and disease pertaining to autoimmunity in liver.

Methods: A Literature search pertaining to liver immune tolerance and various immunotherapies using the major scientific databases on preclinical studies as well as clinical trials and meta-analysis were analyzed to know about the tolerance and immunotherapy of liver diseases.

Results: Immunotherapy in liver might be problematic owing to the immune tolerance property of liver. The key to therapeutic approach by utilizing this immune biology of liver is based on harnessing the immunomodulatory techniques to achieve immune activity or inhibition. Therefore, it is a necessity to overcome this immune tolerance for effective immunotherapeutic strategies. Immunotherapy may also help to boost and enhance the immunity of patients against liver diseases in combination with conventional treatment methods, or more than one method in immunotherapy may produce synergistic effect and prove to be better than when applied alone.

Conclusion: Liver has a unique immuno- biological advantage which is utilized to maintain a balance between immunity and tolerance. This intricate balance of hepatic immune cells can be modulated to effect treatments in various liver diseases. However it is important to maintain a balance between the immunity of the liver and its modulation to provide protection against hepatic disease. The key to successful curing of these conditions lies along this fine line of manipulating liver immune cells for our own benefit.

Keywords: Alcoholic liver disease, DILI, HCC, immunotherapy, liver diseases, NAFLD.

Graphical Abstract