Circulating markers of liver fibrosis progression.
BACKGROUND
Fibrogenesis is a typical reaction of the liver to injury. In the case of overstimulation of fibrogenesis clinically significant fibrosis and, eventually, cirrhosis occur. Treatment of liver cirrhosis is limited, therefore it is important to screen and monitor patients at risk of cirrhosis. Noninvasive parameters are ideal for this purpose due to their risk profile and repeatability.


METHODS
Systematic review of literature.


RESULTS
Among large number of proposed biomarkers, there is a distinct difference between two groups or classes. Class I biomarkers are associated with the process of fibrogenesis, their presence in the serum is the result of the increased turnover of extracellular matrix. Class II biomarkers and their combinations are mostly markers of liver function or structural damage. We have identified 27 Class I and 13 Class II biomarkers that have been proposed in the literature. We have evaluated in detail those which reached limited clinical application.


CONCLUSIONS
General clinical acceptance of these biomarkers is low because of various drawbacks. Simple and readily available biomarkers have low accuracy in predicting liver fibrosis and more advanced markers have low cost-benefit ratio. Therefore liver biopsy remains the "gold standard" for diagnosis of fibrosis. However potential noninvasive alternatives exist and their implementation could be valuable.
Jarcuska
Peter
P
1st Department of Internal Medicine, P.J. Safárik University, Kosice, Slovakia. petjarc@yahoo.com
Janicko
Martin
M
Veselíny
Eduard
E
Jarcuska
Pavol
P
Skladaný
Lubomír
L
D015415:Biomarkers / Q000097:blood; D018450:Disease Progression; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis* / Q000473:pathology
D015415:Biomarkers