Clinical importance of laboratory biomarkers in liver fibrosis

Abstract

Hepatic cirrhosis is a major health problem across the world, causing high morbidity and mortality. This disease has many etiologies, yet the result of chronic hepatic injury is hepatic fibrosis causing cirrhosis and hepatocellular carcinoma, as the liver’s architecture is progressively destroyed. While liver biopsy is currently the gold standard for fibrosis staging, it has significant disadvantages, leading to a growing interest in non-invasive markers. Direct biomarkers – hyaluronic acid, laminin, collagen type III N-peptide, type IV collagen and cholylglycine – are new and rarely applied in routine clinical practice. This is the case primarily because there is no general consensus regarding the clinical application and effectiveness of the individual biomarkers. The usage of these markers in routine clinical practice could be advantageous for patients with liver fibrosis, requiring a simple blood test instead of a biopsy. The former option would be especially attractive for patients who are contraindicated for the latter. This review summarizes recent findings on direct biomarkers of liver fibrosis and highlights their possible applications and potential benefit for liver fibrosis diagnostics and/or staging.

Correlation Analysis of IL-17, IL-21, IL-23 with Non-Alcoholic Liver Fibrosis and Cirrhosis

“… 13 The direct biomarker that can usually be used to diagnose hepatic fibrosis is the ECM secretory protein, the level of which can vary with the degree of hepatic fibrosis. 7 In this study, the serum concentrations of PIIINP, CIV, LN, and HA were significantly higher in the cirrhotic group compared to the hepatic fibrosis group, and the change in concentration can effectively distinguish between hepatic fibrosis and cirrhosis. These four indicators are used as direct serum markers for the assessment and diagnosis of liver fibrosis, and they respond to the dynamic onset and development of liver fibrosis, suggesting damage to the hepatocyte matrix for degradation and clearance.…”

“… 5 , 6 Collagen type III N-peptide (PIIINP), type IV collagen (CIV), Laminin (LN), and Hyaluronic acid (HA) have been used as direct serum markers for the diagnosis of liver fibrosis and cirrhosis. 7 Studies have analyzed the normal reference intervals of PIIIP N-P in Northern European children and adults. 8 …”

“…5,6 Collagen type III N-peptide (PIIINP), type IV collagen (CIV), Laminin (LN), and Hyaluronic acid (HA) have been used as direct serum markers for the diagnosis of liver fibrosis and cirrhosis. 7 Studies have analyzed the normal reference intervals of PIIIP N-P in Northern European children and adults. 8 Helper T cell 17 (Th17) is a newly discovered subpopulation of T cells capable of secreting interleukin 17 , secreting cytokines such as interleukin 17 (IL-17), interleukin 21 (IL-21), interleukin , and interleukin 23 (IL-23) and other cytokines.…”

Metabolic dysfunction-associated fatty liver disease: current therapeutic strategies

“…The Mediterranean diet is still proposed by international guidelines as the treatment of choice ( 85 , 86 ). To successfully alleviate MAFLD and associated comorbidities, new molecular markers should be identified and use as specific targets for the treatment of this pathology with high cardio-metabolic risk ( 87 , 88 ).…”

Performance Evaluation of a Novel Non-Invasive Test for the Detection of Advanced Liver Fibrosis in Metabolic Dysfunction-Associated Fatty Liver Disease

“…Although these biomarkers are not organ-specific for the liver, it has been confirmed that in patients with chronic liver diseases and fibrosis, increased production and impaired elimination of HA as well as architectural changes in the liver parenchyma leading to an increase in LN concentration are observed. Serum levels of HA and LN are correlated to the stage of hepatic fibrosis [ 38 ].…”