Revealing the pathogenesis of autoimmune hepatitis and research progress in drug discovery from hepatic immune cells and intercellular communication signaling mechanisms.

Autoimmune hepatitis (AIH) is an immune-mediated chronic liver disease with an increasing incidence. The complex pathogenesis of AIH poses significant challenges for clinical treatment. In recent years, with the introduction of cutting-edge concepts such as "immune-metabolic interplay" and "intercellular communication networks," along with novel detection methods and technologies, research on the pathogenesis of AIH has shifted from a single-molecular-mechanism perspective to a systematic regulatory network analysis. This shift has not only provided more research evidence for a deeper understanding of the molecular biological mechanisms underlying AIH but also offers a potential reference for the development of targeted therapeutic drugs for AIH based on novel targets. Therefore, this review starts with aberrant activation signals from key immune cells-including dendritic cells (DCs), macrophages (Mφ), and T/B cells-and integrates the intercellular signaling communication mechanisms between hepatocytes, cholangiocytes, and immune cells to systematically summarize the key molecular biological mechanisms and targets identified in recent years, providing a reference for future elucidation of the critical mechanisms of AIH. On this basis, the review further integrates the current application and research progress of clinically used AIH therapeutic drugs, as well as those at various stages of development, including potential therapeutic compounds. It discusses the limitations of current clinical drugs and evaluates the feasibility and future application potential of potential compounds for AIH treatment in preclinical and clinical studies, thereby offering comprehensive research evidence for the management of AIH.