Biomedical
Clinical importance of laboratory biomarkers in liver fibrosis
Valdas Banys,
Goda Aleknavičiūtė-Valienė
Peer Reviewed
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.
Key Questions and Answers
1. What is hepatic cirrhosis and what are its causes?
Hepatic cirrhosis is a severe liver disease characterized by the progressive destruction of the liver's architecture. It results from chronic hepatic injury due to various etiologies like alcoholic disease, non-alcoholic fatty liver disease, viral hepatitis, and cholestatic liver disease.
2. Why is liver biopsy considered the gold standard for fibrosis staging?
Liver biopsy is the gold standard for fibrosis staging because it provides a direct and reliable histological assessment of liver fibrosis. However, it is invasive, expensive, and carries the risk of complications.
3. What are the advantages of non-invasive biomarkers for liver fibrosis diagnosis?
Non-invasive biomarkers, such as hyaluronic acid, laminin, and collagen peptides, provide a cost-effective and safe alternative for diagnosing and staging liver fibrosis, eliminating the risks and limitations of liver biopsy.
4. What is the potential benefit of direct biomarkers like hyaluronic acid?
Direct biomarkers like hyaluronic acid are crucial in assessing liver fibrosis progression and monitoring treatment effectiveness. Their serum concentration correlates with fibrosis stages, helping in early diagnosis and evaluating the response to therapies such as antiviral treatments in hepatitis B patients.
