Noninvasive biomarkers in pediatric nonalcoholic fatty liver disease

Jayasekera, Dulshan W.; Hartmann, Phillipp

doi:10.4254/wjh.v15.i5.609

Cited by 5 publications

(4 citation statements)

References 150 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, this study positively evaluated the usefulness of TE in the non-invasive diagnosis of NASH in children [ 16 ]. Other studies have also demonstrated the utility of TE in the assessment of liver fibrosis in NAFLD/MAFLD patients, but it is worth noting that the indicated cut-off points of significant and advanced fibrosis varied widely between studies, reaching values of 7.4-9 kPa [ 17 – 19 ]. Further studies on larger groups of pediatric patients are needed to evaluate the usefulness of TE in assessing the degree of liver fibrosis in pediatric MAFLD, as well as to test its utility in differentiating patients according to the etiology of fibrosis.…”

Section: Discussionmentioning

confidence: 99%

Thrombospondin-2 as a potential noninvasive biomarker of hepatocyte injury but not liver fibrosis in children with MAFLD: A preliminary study

Zdanowicz,

Flisiak-Jackiewicz,

Bobrus-Chociej

et al. 2023

ceh

View full text Add to dashboard Cite

Aim of the study Metabolic-associated fatty liver disease (MAFLD) requires close monitoring due to its increased incidence and progression to fibrosis, cirrhosis and even hepatocellular carcinoma. The search for non-invasive markers to diagnose liver fibrosis is ongoing. The aim of our study was to evaluate the serum levels of growth differentiation factor-15 (GDF-15), thrombospondin-2 (TSP2), pentraxin 3 (PTX3) and angiopoietin-like protein 8 (ANGPTL8) in children with MAFLD. Material and methods Fifty-six overweight/obese children with suspected liver disease were included in this prospective study. MAFLD was diagnosed according to the latest consensus. Vibration-controlled transient elastography (TE) was performed to detect clinically significant liver fibrosis. Serum concentrations of GDF-15, TSP2, PTX3 and ANGPTL8 were measured by enzyme-linked immunosorbent assay (ELISA). Results Liver steatosis was diagnosed in abdominal ultrasound in 31 (55.36%) overweight/obese patients who were classified as the MAFLD group. Aspartate aminotransferase (AST)/platelet ratio (APRI) and liver stiffness measurement (LSM) values and TSP2 concentrations showed significantly higher values in patients in MAFLD than in the non-MAFLD group. TSP2 was significantly positively correlated with alanine transaminase (ALT), AST, γ-glutamyltransferase (GGT) and APRI in the study group. The receiver operating characteristics (ROC) analysis showed that the area under the curve (AUC) of LSM, APRI and serum TSP2 was significant for predicting MAFLD in obese children. In the multivariable regression model, LSM was the only significant parameter associated with the diagnosis of MAFLD in children. Conclusions TSP2 may be a potential biomarker of hepatocyte injury in pediatric patients with MAFLD. None of the examined biomarkers were found to be effective non-invasive markers of liver fibrosis in children.

show abstract

Section: Discussionmentioning

confidence: 99%

Thrombospondin-2 as a potential noninvasive biomarker of hepatocyte injury but not liver fibrosis in children with MAFLD: A preliminary study

Zdanowicz,

Flisiak-Jackiewicz,

Bobrus-Chociej

et al. 2023

ceh

View full text Add to dashboard Cite

show abstract

“… 1 , 4 Better noninvasive biomarkers are required to more easily detect early and more advanced stages of liver disease. 5 , 6 One noninvasive biomarker is the intestinal microbiota. The gut microbiota plays a role in many liver diseases, as evidenced by studies with germfree and conventional mice.…”

Section: Introductionmentioning

confidence: 99%

Fungal signature differentiates alcohol-associated liver disease from nonalcoholic fatty liver disease

Viebahn,

Hartmann,

Lang

et al. 2024

Gut Microbes

Self Cite

View full text Add to dashboard Cite

The fungal microbiota plays an important role in the pathogenesis of alcohol-associated liver disease (ALD) and nonalcoholic fatty liver disease (NAFLD). In this study, we aimed to compare changes of the fecal fungal microbiota between patients with ALD and NAFLD and to elucidate patterns in different disease stages between the two conditions. We analyzed fungal internal transcribed spacer 2 (ITS2) sequencing using fecal samples from a cohort of 48 patients with ALD, 78 patients with NAFLD, and 34 controls. The fungal microbiota differed significantly between ALD and NAFLD. The genera Saccharomyces , Kluyveromyces , Scopulariopsis , and the species Candida albicans ( C. albicans ), Malassezia restricta ( M. restricta ), Scopulariopsis cordiae ( S. cordiae ) were significantly increased in patients with ALD, whereas the genera Kazachstania and Mucor were significantly increased in the NAFLD cohort. We identified the fungal signature consisting of Scopulariopsis , Kluyveromyces , M. restricta , and Mucor to have the highest discriminative ability to detect ALD vs NAFLD with an area under the curve (AUC) of 0.93. When stratifying the ALD and NAFLD cohorts by fibrosis severity, the fungal signature with the highest AUC of 0.92 to distinguish ALD F0-F1 vs NAFLD F0-F1 comprised Scopulariopsis , Kluyveromyces , Mucor , M. restricta , and Kazachstania . For more advanced fibrosis stages (F2-F4), the fungal signature composed of Scopulariopsis , Kluyveromyces , Mucor , and M. restricta achieved the highest AUC of 0.99 to differentiate ALD from NAFLD. This is the first study to identify a fungal signature to differentiate two metabolic fatty liver diseases from each other, specifically ALD from NAFLD. This might have clinical utility in unclear cases and might hence help shape treatment approaches. However, larger studies are required to validate this fungal signature in other populations of ALD and NAFLD.

show abstract

“…Within another study, longitudinal follow-up of 20 years in a pediatric cohort diagnosed with NAFLD showed that a significant number of patients progress towards end-stage liver disease and require liver transplantation ( Feldstein et al, 2009 ). Although the current gold standard diagnostic method in pediatric NAFLD is represented by liver biopsy, several non-invasive biomarkers are currently being proposed for its early recognition ( Vos et al, 2017 ; Jayasekera and Hartmann, 2023 ). However, their utility is questionable, as it is presumed that only their combined use with other laboratory tests or imaging investigations can accurately quantify degree of liver fibrosis and can monitor disease progression ( Mosca et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Neutrophils: tissue and circulating signatures of pediatric non-alcoholic fatty liver disease

Săsăran,

Muntean,

Lupu

et al. 2024

Front. Cell Dev. Biol.

View full text Add to dashboard Cite

The recent rise in non-alcoholic fatty liver disease (NAFLD) among children and adolescents led to a thorough investigation of the peculiarities of the cellular infiltrate which characterize the disease at young ages. This review aims to highlight the key involvement of neutrophils in the pathogenesis of pediatric NAFLD and the potential biomarker role of neutrophil-to-lymphocyte ratio (NLR) in the same pediatric disorder. Neutrophils, which are first responders to inflammation, constitute an abundant component of an infiltrate which is particularly disposed within the portal area of children with NAFLD. The involvement of neutrophils in triggering liver fibrosis has been related amongst others to reactive oxygen species (ROS) production, to the stimulation of hepatic stellate cells, and to their synthesis of neutrophil elastase. As immune imbalance characterizes NAFLD, potentially emerging non-invasive biomarkers such as NLR have been proposed for the detection and prognosis of NAFLD. In adults, several studies asserted the role of NLR in the prediction of advancing liver fibrosis and mortality in subjects with NAFLD. In children, data is scarce with contradicting findings, as some studies failed to identify significant shifting in NLR values in children with NAFLD when compared with obese controls without liver impairment. However, NLR seems to significantly increase in children with obesity and different degrees of NAFLD when compared to healthy counterparts and their changes seem to be reversible with weight loss. Still, paucity of pediatric studies calls for future research addressing the role of NLR in predicting NAFLD development and progression in children with obesity.

show abstract

Noninvasive biomarkers in pediatric nonalcoholic fatty liver disease

Cited by 5 publications

References 150 publications

Thrombospondin-2 as a potential noninvasive biomarker of hepatocyte injury but not liver fibrosis in children with MAFLD: A preliminary study

Thrombospondin-2 as a potential noninvasive biomarker of hepatocyte injury but not liver fibrosis in children with MAFLD: A preliminary study

Fungal signature differentiates alcohol-associated liver disease from nonalcoholic fatty liver disease

Neutrophils: tissue and circulating signatures of pediatric non-alcoholic fatty liver disease

Contact Info

Product

Resources

About