Ebrahim NAA, Soliman SMA, Farghaly TA, Arafat AMA. Letter to the Editor: Evaluating cytokeratin 18 fragment as a non-invasive marker of fibrosis and lipid alterations in steatotic liver disease. World J Hepatol 2026; 18(7): 115836 [DOI: 10.4254/wjh.115836]
Corresponding Author of This Article
Noura A A Ebrahim, Department of Oncologic Pathology, National Cancer Institute, Cairo University, 1st Kasr-Alainy Street, Cairo 11796, Al Qāhirah, Egypt. npathologist@gmail.com
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Biochemistry & Molecular Biology
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letter
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Ebrahim NAA, Soliman SMA, Farghaly TA, Arafat AMA. Letter to the Editor: Evaluating cytokeratin 18 fragment as a non-invasive marker of fibrosis and lipid alterations in steatotic liver disease. World J Hepatol 2026; 18(7): 115836 [DOI: 10.4254/wjh.115836]
World J Hepatol. Jul 27, 2026; 18(7): 115836 Published online Jul 27, 2026. doi: 10.4254/wjh.115836
Letter to the Editor: Evaluating cytokeratin 18 fragment as a non-invasive marker of fibrosis and lipid alterations in steatotic liver disease
Noura A A Ebrahim, Soliman M A Soliman, Thoraya A Farghaly, Aya Mohamed Adel Arafat
Noura A A Ebrahim, Department of Oncologic Pathology, National Cancer Institute, Cairo University, Cairo 11796, Al Qāhirah, Egypt
Soliman M A Soliman, Department of Chemistry, Faculty of Science, Cairo University, Cairo 12613, Al Qāhirah, Egypt
Thoraya A Farghaly, Department of Chemistry, UMM AL-Qura University, Makkah 21955, Saudi Arabia
Aya Mohamed Adel Arafat, Clinical and Chemical Pathology, Kasr Al-Aini Faculty of Medicine, Cairo University, Cairo 11562, Egypt
Co-first authors: Noura A A Ebrahim and Soliman M A Soliman.
Author contributions: Ebrahim NAA and Soliman SMA were primarily responsible for this work; Ebrahim NAA and Soliman SMA developed the concept of the Letter to the Editor, conducted the in-depth literature evaluation, critically analyzed and synthesized the published findings, and prepared the initial and revised versions of the manuscript; Farghaly TA and Arafat AMA provided supportive contributions through assistance with the literature review, critical appraisal of the content, and editorial refinement of the manuscript. All authors reviewed and approved the final manuscript and accept responsibility for the integrity and accuracy of the work. Ebrahim NAA and Soliman SMA contributed equally to this work as co-first authors.
Conflict-of-interest statement: The authors declare that they have no financial, professional, or personal conflicts of interest that could have influenced the study’s design, analysis, interpretation, or presentation.
Corresponding author: Noura A A Ebrahim, Department of Oncologic Pathology, National Cancer Institute, Cairo University, 1st Kasr-Alainy Street, Cairo 11796, Al Qāhirah, Egypt. npathologist@gmail.com
Received: October 27, 2025 Revised: November 14, 2025 Accepted: January 21, 2026 Published online: July 27, 2026 Processing time: 270 Days and 19.8 Hours
Core Tip
Core Tip: Ichikawa et al examined the diagnostic utility of serum cytokeratin 18 fragment (CK18F) in patients with steatotic liver disease (SLD). Their findings demonstrated that CK18F-a marker of hepatocyte apoptosis-shows a strong relationship with liver injury markers and lipid disturbances, particularly elevated triglycerides, but not with conventional fibrosis indices. Notably, CK18F correlated closely with non-invasive composite scores such as FibroScan-aspartate aminotransferase and Steatosis-Associated Fibrosis Estimator, emphasizing its ability to reflect active hepatic inflammation and metabolic stress rather than fibrotic burden. These results suggest that incorporating CK18F into existing non-invasive assessment tools could enhance early detection and clinical stratification of individuals at metabolic and hepatic risk within the spectrum of metabolic dysfunction-associated SLD.
