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Review
. 2017 Oct 5;4(1):FSO250.
doi: 10.4155/fsoa-2017-0083. eCollection 2018 Jan.

Liver fibrosis: a compilation on the biomarkers status and their significance during disease progression

Krishna Sumanth Nallagangula  1   1 , Shashidhar Kurpad Nagaraj  1   1 , Lakshmaiah Venkataswamy  2   2 , Muninarayana Chandrappa  3   3
Affiliations
Review

Liver fibrosis: a compilation on the biomarkers status and their significance during disease progression

Krishna Sumanth Nallagangula et al. Future Sci OA. .

Abstract

Liver fibrosis occurs in response to different etiologies of chronic liver injury. Diagnosing degree of liver fibrosis is a crucial step in evaluation of severity of the disease. An invasive liver biopsy is the gold standard method associated with pain and complications. Biomarkers to detect liver fibrosis include direct markers of extracellular matrix turnover and indirect markers as a reflection of liver dysfunction. Although a single marker may not be useful for successful management, a mathematical equation combining tests might be effective. The main purpose of this review is to understand the diagnostic accuracy of biomarkers and scoring systems for liver fibrosis. Advances in -omics approach have generated clinically significant biomarker candidates for liver fibrosis that need further evaluation.

Keywords: -omics; biomarker; biomarker discovery; genetic markers; hepatic regeneration; liver fibrosis; sensitivity and specificity; validation strategies.

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Conflict of interest statement

Financial & competing interests disclosure The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. No writing assistance was utilized in the production of this manuscript.

Figures

<b>Figure 1.</b>
Figure 1.. Pathophysiology of liver fibrosis.
After chronic liver injury, necrotic or apoptotic cells will be replaced by regenerated parenchymal cells. Inflammation-connected activation of hepatic stellate cells takes place and transdifferentiation into myofibroblast-like cells which attains contractile, proinflammatory and fibrogenic property. ASH: Alcoholic steatohepatitis; EMT: Epithelial mesenchymal transition; ET-1: Endothelin-1; HSC: Hepatic stellate cell; NAFLD: Nonalcoholic fatty liver disease; ROS: Reactive oxygen species. Reproduced with permission from [5].
<b>Figure 2.</b>
Figure 2.. Algorithm of liver fibrosis markers.
γGT: Gamma glutamyl transferase; ALP: Alkaline phosphatase; ALT: Alanine aminotransferase; APRI: AST to platelet ratio index; AST: Aspartate aminotransferase; ELF: Enhanced liver fibrosis; FIB-4: Fibrosis-4; MMP: Matrix metalloproteinase; PICP: Procollagen I carboxy peptide; PIIICP: Procollagen III amino peptide; TIMP: Tissue inhibitor of metalloproteinase.
<b>Figure 3.</b>
Figure 3.. Histological scoring system for liver fibrosis.
Reproduced with permission from [10].
See this image and copyright information in PMC

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