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Non-invasive biomarkers for monitoring the fibrogenic process in liver:A short survey

World Journal of Gastroenterology 2009年第20期15卷 2433-2440页

作者： Axel M Gressner Chun-Fang Gao Olav A Gressner Institute of Clinical Chemistry and Pathobiochemistry Central Laboratory RWTH- University Hospital Aachen Pauwelsstr. 30 52074 Aachen Germany Department of Laboratory Medicine Eastern Hepatobiliary Hospital Second Military Medical University 225 Shanghai Road Shanghai 200438 China

The clinical course ofchronic liver diseases is significantly dependent on the progression rate and the extent offibrosis, i.e. the non-structured replacement of necrotic parenchyma by extracellular matrix. Fibrogenesis, i.e. the development offibrosis can be regarded as an unlimited wound healing process, which is based on matrix (connective tissue) synthesis in activated hepatic stellate cells, fibroblasts (fibrocytes), hepatocytes and biliary epithelial cells, which are converted to matrix-producing (myo-)fibroblasts by a process defined as epithelial-mesenchymal transition. Blood (noninvasive) biomarkers offibrogenesis and fibrosis can be divided into class and class analytes. Class biomarkers are those single tests, which are based on the pathophysiology offibrosis, whereas class biomarkers aremostly multiparametric algorithms, which have been statistically evaluated with regard to the detection and activity ofongoing fibrosis. Currently available markers fulfil the criteria ofideal clinical-chemical tests only partially, but increased understanding ofthe complex pathogenesis offibrosis offers additional ways for pathophysiologically well based serum (plasma) biomarkers. They include TGF-β-driven marker proteins, bone marrow-derived cells (fibrocytes), and cytokines, which govern proand anti-fibrotic activities. Proteomic and glycomic approaches ofserum are under investigation to set up specific protein or carbohydrate profiles in patients with liver fibrosis. These and other novel parameters will supplement or eventually replaceliver biopsy/histology, high resolution imaging analysis, and elastography for the detection and monitoring of patients at risk ofdeveloping liver fibrosis.

关键词： Biochemical markers Diagnostic validity Liver fibrosis Monitoring multiparametric algorithms Non-invasive diagnostic tools

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