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Noninvasive Biomarkers for Liver Fibrosis

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Liver Diseases

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Abstract

Fibrosis is a serious problem of chronic liver diseases. Liver fibrosis occurs as a response to different causes of chronic liver diseases. The diagnosing of the degree of liver fibrosis is an essential step in the assessment of the severity of the liver disease and is important for better patient care. The reference method for diagnosis and staging of liver fibrosis is liver biopsy, but it is invasive with many complications and limitations. Up to date, many non-invasive direct or indirect serum markers representing the activity of fibrogenesis have been developed. The direct biomarkers are a mirror of extracellular matrix turnover and indirect markers reflect the hepatocellular dysfunction. These markers may be used single or, in conjugation with each other. The major objective of this review is to understand the diagnostic accuracy, advantages and disadvantages of non-invasive biomarkers and scoring systems currently being used for studying liver fibrosis.

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Author information

Authors and Affiliations

  1. Department of Internal Medicine and Hepatology, Mansoura University, Mansoura, Egypt

    Gamal Shiha

  2. Egyptian Liver Research Institute and Hospital (ELRIH), Sherbin, El-Mansoura, Mansoura, Egypt

    Gamal Shiha

  3. Departments of Tropical Medicine, Mansoura University, Mansoura, Egypt

    Nasser Mousa

Authors
  1. Gamal Shiha
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  2. Nasser Mousa
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Editor information

Editors and Affiliations

  1. Faculty of Medicine, “Titu Maiorescu” University, Central Military Emergency University Hospital “Dr. Carol Davila”, Bucharest, Romania

    Florentina Radu-Ionita

  2. New Jersey Medical School, Rutgers University New Jersey Medical School, Newark, NJ, USA

    Nikolaos T. Pyrsopoulos

  3. Carol Davila University of Medicine and Pharmacy, Central Military Emergency University Hospital “Dr. Carol Davila”, Bucharest, Romania

    Mariana Jinga

  4. Faculty of Medicine, “Titu Maiorescu” University, Central Military Emergency University Hospital “Dr. Carol Davila”, Bucharest, Romania

    Ion C. Tintoiu

  5. Medical Radiation Sciences, Curtin University, Perth, WA, Australia

    Zhonghua Sun

  6. “Prof. C.C. Iliescu” Emergency Institute for Cardiovascular Diseases, Bucharest, Romania

    Ecaterina Bontas

Self Study

Self Study

1.1 Questions

  1. 1.

    Which statement is true?

    1. (a)

      Hepatic stellate cells are the key cell of liver fibrosis

    2. (b)

      Hepatic stellate cells resident in portal tract

    3. (c)

      Hepatic stellate cells transdifferentiate into Kupffer cells

    4. (d)

      Hepatic stellate cells synthetized albumin

  2. 2.

    Which statement/statements is/are true?

    1. (a)

      After chronic liver injury, necrotic cells will be replaced by regenerated parenchymal cells

    2. (b)

      In chronic hepatitis, hepatocytes synthesize laminin

    3. (c)

      Activated hepatic stellate cells transdifferentiate into myofibroblast-like cells

    4. (d)

      Liver fibrosis is not linked with changes in composition of ECM

  3. 3.

    Which statement/statements is/are true as regard biomarkers of liver fibrosis?

    1. (a)

      Associated with morbidity or mortality

    2. (b)

      Biomarkers are more expensive

    3. (c)

      Direct markers are not organ specific, influenced by unrelated sites of inflammation

    4. (d)

      Not sensitive enough to discriminate intermediate stages of fibrosis

    5. (e)

      All of these markers are routinely available in all laboratories

  4. 4.

    Which statement/statements is/are true?

    1. (a)

      ECM homeostasis based on, the well equilibrium between matrix metalloproteinases and inhibitors tissue inhibitors of matrix metalloproteinases

    2. (b)

      The constituents of the ECM are similar in both normal and fibrotic liver

    3. (c)

      Normal liver includes collagens (I, III and IV)

    4. (d)

      The progressive fibrosis are correlated with the marked decrease of tissue inhibitors of matrix metalloproteinases (TIMP1 and 2)

1.2 Answers

  1. 1.

    Which statement is true?

    • a

  2. 2.

    Which statement/statements is/are true?

    • a and c

  3. 3.

    Which statement/statements is/are true as regard biomarkers of liver fibrosis?

    • c and d

  4. 4.

    Which statement/statements is/are true?

    • a

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Shiha, G., Mousa, N. (2020). Noninvasive Biomarkers for Liver Fibrosis. In: Radu-Ionita, F., Pyrsopoulos, N., Jinga, M., Tintoiu, I., Sun, Z., Bontas, E. (eds) Liver Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-24432-3_36

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  • Online ISBN: 978-3-030-24432-3

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