Bibliographic record
Abstract
Potential conflict of interest: Nothing to report. Author names in bold designate shared co‐first authorship. Anti‐CD20 has been successfully administered to autoimmune hepatitis (AIH) patients showing an incomplete response or frequent relapses when under treatment with standard immunosuppression, including prednisone either alone or in association with azathioprine, mycophenolate mofetil, cyclosporine, or tacrolimus.1 Therefore, in these patients, it cannot be excluded that B‐cell depletion could have been induced while the immune system was still affected by previous therapy. However, if and how their immunological status differed from that of naïve patients (or our treatment‐naïve AIH model) are unknown. Pilot studies using anti‐CD20 antibodies as initial treatment for AIH are needed to address this issue. B‐cell depletion can exacerbate colitis in an animal model of cholangitis based on transforming growth factor beta (TGF‐β) receptor II‐dominant negative mice.2 However, in patients with primary biliary cirrhosis showing an incomplete response to ursodeoxycholic acid, anti‐CD20 antibody treatment did not induce colitis.3 These patients showed an increased frequency of regulatory T cells and expression of TGF‐β and decreased expression of tumor necrosis factor alpha (TNF‐α)3; an interesting observation given that current treatments for inflammatory bowel diseases aim at reducing TNF‐α levels. Type 1 regulatory T cells cells, through their capacity to produce high amounts of interleukin‐10, are efficient in suppressing innate immune response.5 However, in the case of an AIH, the adaptive immune system is the main pathway in cause, giving to FoxP3 T‐regulatory cells a central role in the suppression of liver inflammation.4 Altogether, our preclinical data on B‐cell depletion4 and published data in AIH patients1 suggest that prospective studies using anti‐CD20 as initial therapy to induce remission in patients with AIH are indicated. These studies will be able to provide safety profile and design tailored protocols for different subtypes of AIH patients, including those with other comorbidities. Initial therapy should allow a rapid, complete remission of liver inflammation with minimal or no side effects to avoid or diminish the evolution to cirrhosis or recover from liver failure; such is not the case with currently administered immunosuppressive drugs.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.032 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.003 |
| Research integrity | 0.009 | 0.011 |
| Insufficient payload (model declined to judge) | 0.148 | 0.076 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".