Standard Liver Function Tests and Their Limitations: Selectivity and sensitivity of individual serum bile acid levels in hepatic dysfunction

Azer, Samy A.; McCaughan, Geoffrey W.; Stacey, Neill H.

doi:10.1007/978-3-662-12385-0_14

Cited by 3 publications

(3 citation statements)

References 117 publications

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“…Specificity refers to the percentage of people who test negative for a disease among a group of people. To calculate sensitivity and specificity, we used the following equations: [17] Sensitivity number of true positives = ½true positive þ number of false negatives Specificity ¼ number of true negatives = ½true negative þ number of false positives:…”

Section: Discussionmentioning

confidence: 99%

“…Other limitations of standard biochemical liver function tests have been discussed in the literature [examples]. [16,17,18] With this information in mind, clinicians and researchers are examining the clinical use of serum bile acid in the diagnosis of liver injury and diseases.…”

Section: Introductionmentioning

confidence: 99%

“…The reason for not including studies before 1990 is the presence of literature reviews on these years, and we do not want to repeat what we already know from the literature. [17] We also felt that expanding the scope of the review to cover pediatric and neonatal liver diseases will complicate the scope of this review.…”

Section: Introductionmentioning

confidence: 99%

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Use of bile acids as potential markers of liver dysfunction in humans

Azer

Hasanato

2021

Medicine

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Objective: This study aimed to determine the effectiveness of using total, individual serum, or urinary bile acids (BA) as potential markers of liver dysfunction.Methods: We searched the PubMed and Web of Science databases using the following keywords-"serum bile acids," "liver dysfunction," "liver injury," "liver disease," "traditional liver function tests," "Chronic liver disease," "acute liver injury". The search was complemented by manual screening of the list of references for relevant articles. We selected only English-language manuscripts for adult patients based on predetermined inclusion and exclusion criteria. Animal studies and studies on neonates and children were not included.Outcome measures: Changes in BA concentrations or ratios at or prior to changes in liver function tests.Results: A total of 547 studies were identified, of which 28 were included after reading the entire manuscript. These studies included 1630 patients and 836 controls published between 1990 and 2017. The methods used in BA assays varied significantly, and the studies did not agree. on specific individual BA or BA ratios as biomarkers of specific liver injury or dysfunction. Except for the prognostic value of BA in intrahepatic cholestasis of pregnancy (ICP), studies have failed to provide evidence for BA as a liver biomarker.Conclusions: Despite the research conducted on BA for over 27 years, there are inconsistencies in the reported results and a lack of solid evidence to support the use of individual BA or BA ratios as biomarkers of liver injury. Adequately conducted studies needed to resolve this limitation in the literature.Abbreviations: BA = bile acids, CA = cholic acid, CDCA = chenodeoxycholic acid, DCA = deoxycholic acid, ICP = intrahepatic cholestasis of pregnancy, LCA = lithocholic acid, LC-MS = liquid chromatography-mass spectrometry, NAFLD = non-alcoholic fatty liver disease, UDCA = ursodeoxycholic acid.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Use of bile acids as potential markers of liver dysfunction in humans

Azer

Hasanato

2021

Medicine

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Hepatotoxicity induced by nickel nano and microparticles in male rat: a comparative study

Singh

Verma

Rana

2021

Toxicol. Environ. Health Sci.

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Investigation into Hepatoprotective Activity ofCitrus limon.

Bhavsar

Joshi

Shah

et al. 2007

Pharmaceutical Biology

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The current study was designed to investigate the effect of Citrus limon (L.) Burm. (Rutaceae) fruits, commonly known as lemon, in experimental liver damage. The ethanol extract of Citrus limon fruits was evaluated for its effects on experimental liver damage induced by carbon tetrachloride, and the ethyl acetate soluble fraction of the extract was evaluated on HepG2 cell line. The ethanol extract normalized the levels of aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), alkaline phosphatase (ALP), and total and direct bilirubin, which were altered due to carbon tetrachloride intoxication in rats. In the liver tissue, treatment significantly reduced the levels of malondialdehyde (MDA), hence the lipid peroxidation, and raised the levels of antioxidant enzymes superoxide dismutase (SOD) and catalase. It improved the reduced glutathione (GSH) levels in treated rats in comparison with CCl 4 -intoxicated rats. In the histopathologic studies, treated animals exhibited restoration of the liver architecture toward normal. Three doses of ethanol extract (i.e., 150, 300, and 500 mg=kg) were evaluated. The effect seen was dose dependent, and the effect of the highest dose was almost equal to the standard silymarin. In the investigation carried out on human liver-derived HepG2 cell line, significant reduction in cell viability was observed in cells exposed to CCl 4 . A dose-dependent increase in the cell viability was observed when CCl 4 -exposed HepG2 cells were treated with different concentrations of ethyl acetate soluble fraction of the ethanol extract. The highest percentage viability of HepG2 cells was observed at a concentration of 100 mg=mL. The extract merits further investigation to identify the active principles responsible for the hepatoprotective effect. The results from the current investigation also indicate good correlation between the in vivo and in vitro studies.

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Standard Liver Function Tests and Their Limitations: Selectivity and sensitivity of individual serum bile acid levels in hepatic dysfunction

Cited by 3 publications

References 117 publications

Use of bile acids as potential markers of liver dysfunction in humans

Use of bile acids as potential markers of liver dysfunction in humans

Hepatotoxicity induced by nickel nano and microparticles in male rat: a comparative study

Investigation into Hepatoprotective Activity ofCitrus limon.

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