Evaluation of Liver Fibrosis: A Concise Review

Afdhal, Nezam H.; Nunes, David

doi:10.1111/j.1572-0241.2004.30110.x

Cited by 546 publications

(424 citation statements)

References 149 publications

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“…Liver biopsy remains the golden standard for fibrosis evaluation, 25 but variability in the distribution of fibrosis within the liver limits the accuracy of assessment of fibrosis with liver biopsy. 26 Thus, less well-characterized cases and controls may partially account for the inconsistent results in previous genetic association studies.…”

Section: Discussionmentioning

confidence: 99%

A novel nonsynonymous variant of matrix metalloproteinase-7 confers risk of liver cirrhosis

Hung

Chang

et al. 2009

Hepatology

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Liver cirrhosis is characterized by progressive accumulation of extracellular matrix following chronic liver injuries. In the extracellular space, the constant turnover of liver matrix is regulated by the matrix metalloproteinase (MMP) class of enzyme. To assess whether genetic variations in MMP would result in diversity of liver cirrhosis, a case-control study of 320 patients with hepatocellular carcinoma, with or without cirrhosis, was conducted. Ten single-nucleotide polymorphism markers from four potential fibrosis-associated genes were selected for genotyping. Among these genes, a nonsynonymous single-nucleotide polymorphism which generates the variation of Gly-137 and Asp-137 in the MMP-7 gene was found to be strongly associated with the development of liver cirrhosis. In contrast to MMP-7(Gly-137) that predominantly secretes out into the cell culture medium, the cirrhosis-associated MMP-7(Asp-137) variant is preferentially localized on the extracellular membranes where it exerts its proteolytic activity on pericellular substrates. Functional analysis demonstrated an increased ability of the MMP-7(Asp-137) variant to associate with the cell surface CD151 molecule. In wound-healing and Boyden chamber assays, cell motility was specifically enhanced with the expression of MMP-7(Asp-137) as compared to the cells expressing MMP-7(Gly-137). These results demonstrate that the MMP-7(Asp-137) variant confers a gain-of-function phenotype for MMP-7. Conclusion: We have identified a novel genetic association of MMP-7(Asp-137) variant with liver cirrhosis in patients with hepatocellular carcinoma. Whether the MMP-7 variant can be a new marker for liver cirrhosis will be further studied.

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Section: Discussionmentioning

confidence: 99%

A novel nonsynonymous variant of matrix metalloproteinase-7 confers risk of liver cirrhosis

Hung

Chang

et al. 2009

Hepatology

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“…To our knowledge, there are no studies using positron emission tomography CT in hepatosplenic schistosomiasis. Non-invasive markers have also been used to predict the presence and degree of LF in hepatic diseases such as hepatitis C, cirrhosis and schistosomiasis (Stone 2000, Guangjin et al 2002, Afdhal & Nunes 2004, Grigorescu 2006. It is worth mentioning that MR reproduces the pathological findings of Symmers' fibrosis more clearly than US does and is naturally less invasive and timeconsuming than histology.…”

Section: Discussionmentioning

confidence: 99%

Imaging techniques and histology in the evaluation of liver fibrosis in hepatosplenic schistosomiasis mansoni in Brazil: a comparative study

Voieta

Queiroz

Andrade

et al. 2010

Mem. Inst. Oswaldo Cruz

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Few publications have compared ultrasound (US) to histology in diagnosing schistosomiasis-induced liver fibrosis (LF); none has used magnetic resonance (MR). The aim of this study was to evaluate schistosomal LF using these three methods. Fourteen patients with hepatosplenic schistosomiasis admitted to hospital for surgical treatment of variceal bleeding were investigated. They were submitted to upper digestive endoscopy, US, MR and wedge liver biopsy. The World Health Organization protocol for US in schistosomiasis was used. Hepatic fibrosis was classified as absent, slight, moderate or intense. Histology and MR confirmed Symmers' fibrosis in all cases. US failed to detect it in one patient. Moderate agreement was found comparing US to MR; poor agreement was found when US or MR were compared to histology. Re-classifying LF as only slight or intense created moderate agreement between imaging techniques and histology. Histomorphometry did not separate slight from intense LF. Two patients with advanced hepatosplenic schistosomiasis presented slight LF. Our data suggest that the presence of the characteristic periportal fibrosis, diagnosed by US, MR or histology, associated with a sign of portal hypertension, defines the severity of the disease. We conclude that imaging techniques are reliable to define the presence of LF but fail in grading its intensity

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“…33 Features that would apply to an ideal biomarker have been described and are shown in Table 1. 34,35 Broadly speaking, serum markers of hepatic fibrosis can be considered in 1 of 2 categories: either indirect or direct. Indirect markers reflect alterations in hepatic function but do not directly reflect hepatic ECM metabolism, for example, platelet count, coagulation studies, and hepatic aminotransferases.…”

Section: Serum Markers Of Fibrosismentioning

confidence: 99%