title: Serum markers of liver fibrosis: combining the BIPED classification and the neo-epitope approach in the development of new biomarkers.
abstract: BACKGROUND
  Fibrosis is a central histological feature of chronic liver diseases and is characterized by the accumulation and reorganization of the extracellular matrix. The gold standard for assessment of fibrosis is histological evaluation of a percutaneous liver biopsy. Albeit a considerable effort have been invested in finding alternative non-invasive approaches, these have not been sufficiently successful to replace biopsy assessment.
  
  
  OBJECTIVE
  To identify the extracellular matrix proteins of interest, that as protein degradation fragments produced during extracellular matrix metabolism neo-epitopes, may be targeted for novel biochemical marker development in fibrosis. We used the recently proposed BIPED system (Burden of disease, Investigative, Prognostic, Efficacy and Diagnostic) to characterise present serological markers.
  
  
  METHODS
  Pubmed was search for keywords; Liver fibrosis, neo-epitopes, biomarkers, clinical trail, extra cellular matrix, protease, degradation, fragment.
  
  
  CONCLUSIONS
  Implementation of BIPED categorization in the development and validation of fibrosis biomarkers to simplify and standardize the use of existing and future biomarkers seems advantageous. In addition, a systematic use of the neo-epitope approach, i.e. the quantification of peptide epitopes generated from enzymatic cleavage of proteins during extracellular remodeling, may prove productive in the quest to find new markers of liver fibrosis.
authors.affiliation: Department of Pharmacology, Nordic Bioscience, Herlev, Denmark. ssv@nordicbioscience.com
authors.forename: Sanne Skovgård
authors.initials: SS
authors.lastname: Veidal
authors.forename: Anne-Christine
authors.initials: AC
authors.lastname: Bay-Jensen
authors.forename: Gervais
authors.initials: G
authors.lastname: Tougas
authors.forename: Morten Asser
authors.initials: MA
authors.lastname: Karsdal
authors.forename: Ben
authors.initials: B
authors.lastname: Vainer
mesh_terms: D015415:Biomarkers / Q000097:blood; D000939:Epitopes / Q000097:blood* / Q000276:immunology; D016326:Extracellular Matrix Proteins / Q000145:classification* / Q000276:immunology / Q000378:metabolism*; D006801:Humans; D008099:Liver / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis / Q000276:immunology*; D010446:Peptide Fragments / Q000097:blood / Q000276:immunology
chemical_list: D015415:Biomarkers; D000939:Epitopes; D016326:Extracellular Matrix Proteins; D010446:Peptide Fragments