Abstract: Objective The aim of this study was to observe the efficacy and peripheral blood regulatory B cell subset changes in patients with autoimmune hepatitis (AIH) undergoing magnesium isoglycyrrhizinate and standard immunosuppressive therapy. Methods 108 patients with AIH were encountered in our hospital between April 2017 and April 2022, and were randomly divided into control (n=54) and observation (n=54) group, receiving standard immunosuppression treatment or oral magnesium isoglycyrrhizinate at base of it for six month. Serum immunoglobulin levels were detected by immunoturbidimetry, and peripheral blood B cell and regulatory B cell subsets were detected by FCM. Results At the end of six-month treatment, the biochemical response rate in the observation group was 85.2%, much higher than 66.7%(P＜0.05) in the control; serum ALT, AST and ALP level were (51.2±7.6)U/L, (46.2±8.6)U/L and (67.4±2.4)U/L, all significantly lower than[(80.3±8.5)U/L, (75.7±6.4)U/L and (89.7±2.6)U/L, respectively, P<0.05] in the control; there were no significant differences as respect to serum IgG, IgM and globulin levels between the two groups (P>0.05); the percentages of peripheral blood CD19⁺B cell, CD19⁺IL-10⁺B cell, CD19⁺CD24^hiCD38^hi regulatory B cell and CD19⁺CD24^hiCD27⁺ regulatory B cell were (7.1±2.6)%, (0.6±0.2)%, (2.9±1.0)% and (5.7±1.3)%, all significantly higher than [(5.2±1.8)%, (0.4±0.1)%, (2.2±0.9)% and (4.3±1.2)%, respectively, P<0.05], while the percentages of blood CD19⁺CD27⁺CD38⁺⁺ plasma cell and CD19⁺CD27^-CD38^-/+ naïve B cell were (4.2±1.2)% and (56.2±7.9)%, both much lower than [(6.5±1.7)% and (70.5±7.4)%, P<0.05] in the control. Conclusion The administration of standardized immunosuppressant and magnesium isoglycyrrhizinate combination therapy in the treatment of patients with AIH is efficacious, with a promising biochemical response, which might be related to the roles on modulation of peripheral blood regulatory B cells.

Key words: Autoimmune hepatitis, Standardized immunosuppression therapy, Magnesium isoglycyrrhizinate, Regulatory B cell, Therapy