Limited applicability of cathepsin D for the diagnosis and monitoring of non‐alcoholic steatohepatitis

Abstract

Background and Aim To date, there are limited data on the applicability of cathepsin D for the diagnosis and monitoring of non‐alcoholic steatohepatitis (NASH). Methods This study included patients with biopsy‐proven non‐alcoholic fatty liver disease (NAFLD) diagnosed between November 2012 and October 2015. Serum cathepsin D levels were measured using the CatD enzyme‐linked immunosorbent assay (USCN Life Science, Wuhan, China) using stored samples collected on the same day of the liver biopsy procedure. The performance of cathepsin D in the diagnosis and monitoring of NASH was evaluated using receiver operating characteristic analysis. Results Data for 216 liver biopsies and 34 healthy controls were analyzed. The mean cathepsin D level was not significantly different between NAFLD patients and controls; between NASH and non‐NASH patients; and across the different steatosis, lobular inflammation, and hepatocyte ballooning grades. The area under receiver operating characteristic curve (AUROC) of cathepsin D for the diagnosis of NAFLD and NASH was 0.62 and 0.52, respectively. The AUROC of cathepsin D for the diagnosis of the different steatosis, lobular inflammation, and hepatocyte ballooning grades ranged from 0.51 to 0.58. Of the 216 liver biopsies, 152 were paired liver biopsies from 76 patients who had a repeat liver biopsy after 48 weeks. There was no significant change in the cathepsin D level at follow‐up compared to baseline in patients who had histological improvement or worsening for steatosis, lobular inflammation, and hepatocyte ballooning grades. Cathepsin D was poor for predicting improvement or worsening of steatosis and hepatocyte ballooning, with AUROC ranging from 0.47 to 0.54. It was fair for predicting worsening (AUROC 0.73) but poor for predicting improvement (AUROC 0.54) of lobular inflammation. Conclusion Cathepsin D was a poor biomarker for the diagnosis and monitoring of NASH in our cohort of Asian patients, somewhat inconsistent with previous observations in Caucasian patients. Further studies in different cohorts are needed to verify our observation.

A Comparison of Various Chips Used for the Manufacture of Biosensors Applied in Non-Fluidic Array SPRi, Based on the Example of Determination of Cathepsin D

“…In the comparison of the results obtained with various immunosensors, only those for healthy persons were taken into account, because different diseases can significantly affect the level of Cath D in the serum (see Table 1 ). Reported results for Cath D in blood serum varied from 0.144–0.46 [ 26 ] to 126.6 ng mL −1 [ 31 ] with a median of 4.22 ng mL −1 [ 26 , 27 ], that is, they ranged over more than three orders of magnitude. Therefore, the results of the present study, which give an average value of 2.88 ± 0.6 ng mL −1 , are in good agreement with the median of the results reported in the literature (4.22 ± 3.01; 4.20 ± 1.65 ng mL −1 ).…”

Liver Fat Scores for Noninvasive Diagnosis and Monitoring of Nonalcoholic Fatty Liver Disease in Epidemiological and Clinical Studies

“… 123 In contrast, CatD had only weak effectiveness in indicating changes in NAFLD and NASH in an Asian population, again underscoring ethnic differences in the parameters of NAFLD. 124 Again, quantification of cathepsin D is expensive and possibly not cost-effective for NAFLD screening.…”