Potential role of noninvasive biomarkers during liver fibrosis

Abstract

Various types of liver disease exist, such as hepatitis and alcoholic liver disease. These liver diseases can result in scarring of liver tissue, cirrhosis, and finally liver failure. During liver fibrosis, there is an excess and disorganized accumulation of extracellular matrix (ECM) components which cause the loss of normal liver cell functions. For patients with chronic liver disease, fibrosis prediction is an essential part of the assessment and management. To diagnose liver fibrosis, several invasive and noninvasive markers have been proposed. However, the adoption of invasive markers remains limited due to their inherent characteristics and poor patient acceptance rate. In contrast, noninvasive markers can expedite the clinical decision through informed judgment about disease stage and prognosis. These noninvasive markers are classified into two types: Imaging techniques and serum biomarkers. However, the diagnostic values of biomarkers associated with liver fibrosis have also been analyzed. For example, the serum levels of ECM proteins can react to either matrix accumulation or degradation. During virus-host interactions, several regulatory steps take place to control gene expression, such as the change in cellular microRNA expression profiles. MicroRNAs are a class of non-coding RNAs (18-20 long nucleotides) that function by post-transcriptional regulation of gene expression. Although various noninvasive markers have been suggested in recent years, certain limitations have restricted their clinical applications. Understanding the potential of non-invasive biomarkers as a therapeutic option to treat liver fibrosis is still in progress.

Keywords: Liver fibrosis; Non-invasive biomarkers; Viral hepatitis; MicroRNA; Cirrhosis; Fibroscan

Core Tip: Liver disease is quite common these days. Hepatitis, alcoholic liver disease, and non-alcoholic fatty liver disease can lead to liver cirrhosis. Liver fibrosis assessment is a crucial step for diagnosis and treatment purposes. Various markers have been proposed, including both invasive and non-invasive markers. Liver biopsy is the gold standard method but due to its invasiveness, it is not preferred these days. Non-invasive methods include serum biomarkers and imaging techniques. Combinational panels along with microRNAs are also used for the identification of liver fibrosis. Besides their cost-effectiveness, these panels are more dependable when compared with an individual biomarker.