Published online Dec 7, 2019. doi: 10.3748/wjg.v25.i45.6579
Peer-review started: November 1, 2019
First decision: November 22, 2019
Revised: November 25, 2019
Accepted: November 29, 2019
Article in press: November 29, 2019
Published online: December 7, 2019
Core tip: The next generation of management of autoimmune hepatitis will depend on clarification of the pathogenic sequence from susceptibility to triggering events to disease maintenance or escalation. Studies that move the pathogenesis of autoimmune hepatitis closer to its cause have the potential to replace blanket immunosuppressive regimens and even suggest strategies for prevention. Investigations that expand concepts of acquired epigenetic change in gene expression, pathogenic molecular mimicries, epitope spread, bystander activation, and intestinal dysbiosis may narrow the knowledge gap between environmental factors and disease occurrence and behavior. Protective as well as site-specific corrective interventions may emerge.