Enhanced Liver Fibrosis Score Can Be Used to Predict Liver-Related Events in Patients With Nonalcoholic Steatohepatitis and Compensated Cirrhosis

Are, Vijay S.; Vuppalanchi, Raj; Vilar-Gómez, Eduardo; Chalasani, Naga

doi:10.1016/j.cgh.2020.06.070

Cited by 25 publications

(25 citation statements)

References 8 publications

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“…[ 34 ] ELF score of ≥11.3 has been shown to be associated with a fivefold increased risk of developing a liver-related outcome in nonalcoholic steatohepatitis and compensated cirrhosis. [ 35 ] An ELF score of ≥7.3 indicates significant fibrosis in patients with chronic hepatitis type B requiring antiviral medications. [ 36 ] The ELF test of ≥9.1 is a promising noninvasive method to assess severe liver fibrosis in patients with chronic hepatitis C. [ 37 ] Differences in ELF score cut-off values in CLD remain unclear, but may be explained by fibrous expansion differences of portal areas among CLDs.…”

Section: Discussionmentioning

confidence: 99%

“…The 2016 United Kingdom's National Institute for Health and Care Excellence (NICE) guidelines have shown that ELF of ≥10.51 could successfully diagnose advanced fibrosis in nonalcoholic fatty liver disease [34] . ELF score of ≥11.3 has been shown to be associated with a fivefold increased risk of developing a liver-related outcome in nonalcoholic steatohepatitis and compensated cirrhosis [35] . An ELF score of ≥7.3 indicates significant fibrosis in patients with chronic hepatitis type B requiring antiviral medications [36] .…”

Section: Discussionmentioning

confidence: 99%

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Enhanced liver fibrosis score as a surrogate of liver-related complications and mortality in primary biliary cholangitis

et al. 2021

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The presence of bridging fibrosis predicts survival of primary biliary cholangitis (PBC). This study aimed to compare serum parameters for the estimation of liver fibrosis and prediction of clinical outcomes in PBC. Out of 392 patients with PBC, 102 who underwent liver biopsy and in whom fibrosis indices, platelet count, hyaluronic acid, type IV collagen 7 second domain, procollagen type III amino-terminal peptide, tissue inhibitor of metalloproteinases 1, Mac-2 binding protein glycosylation isomer, N-terminal type III collagen propeptide levels; fibrosis index based on 4 factors, aspartate aminotransferase-to-platelet ratio index, and enhanced liver fibrosis (ELF) score were determined, were included. The correlation of histological stages based on both Scheuer and Nakanuma classifications with fibrosis indices was investigated. The Nakanuma system comprises grading for liver fibrosis and bile duct loss. Diagnostic performances of 10 fibrosis indices were evaluated to identify patients with poor prognosis. Moreover, correlations of those with PBC clinical manifestation and survival were also investigated. Enhances liver fibrosis (ELF) score had the highest correlation coefficient for liver fibrosis evaluated according to either the Scheuer or Nakanuma classification among 10 serum fibrosis indices. It also had the highest diagnostic performance in estimating Scheuer stage III and Nakanuma fibrosis score 2, both of which represent portal-bridging fibrosis. Patients with an ELF score of ≥10.0 had shorter survival and presented more frequently clinical complications than those with an ELF score of <10.0. ELF score determines the severity of liver fibrosis and predicts the occurrence of complications and survival in patients with PBC.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Enhanced liver fibrosis score as a surrogate of liver-related complications and mortality in primary biliary cholangitis

et al. 2021

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“…It has to be underlined that IRE1a, as well as MLK3, ROCK1, JNK, and ASK1 constitute NASH-promoting kinases, which are considered as mediators for NASH progression [ 70 , 71 ]. Furthermore, TRAIL-contained EVs induce the activation of macrophages and the NF-κB pathway, while EVs that carry ceramide are similarly involved in macrophage chemotaxis [ 72 , 73 , 74 ].…”

Section: The Association Between Evs and Nashmentioning

confidence: 99%

The Emerging Role of Extracellular Vesicles and Autophagy Machinery in NASH—Future Horizons in NASH Management

Trifylli

Kriebardis

Koustas³

et al. 2022

IJMS

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Non-alcoholic fatty liver disease (NAFLD) is considered the most frequent chronic hepatic disease in the general population, while it is the first cause of liver transplantation in the US. NAFLD patients will subsequently develop non-alcoholic steatohepatitis (NASH), which is characterized by aberrant hepatocellular inflammation with or without the presence of fibrosis. The lack of specific biomarkers and therapeutic strategies makes non-alcoholic steatohepatitis (NASH) management a difficult task for clinicians. Extracellular vesicles (EVs) constitute a heterogenic population of vesicles produced by inward or outward plasma-membrane budding. There is an emerging connection between autophagy EVs production, via an unconventional non-degradative procedure. Alterations in the amount of the secreted EVs and the cargo they carry are also involved in the disease progression and development of NASH. Autophagy constitutes a multistep lysosomal degradative pathway that reassures cell homeostasis and survival under stressful conditions, such as oxygen and energy deprivation. It prevents cellular damage by eliminating defected proteins or nοn-functional intracellular organelles. At the same time, it reassures the optimal conditions for the cells via a different mechanism that includes the removal of cargo via the secretion of EVs. Similarly, autophagy machinery is also associated with the pathogenetic mechanism of NAFLD, while it has a significant implication for the progression of the disease and the development of NASH. In this review, we will shed light on the interplay between autophagy and EVs in NASH, the emerging connection of EVs production with the autophagy pathway, and their possible manipulation for developing future therapeutic strategies for NASH.

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“…Patients with ELF ≥11.3 were more likely to develop liver-related events with a cox proportional hazard ratio (HR) of 4.81 compared to patients with an ELF <9.8. The AUROC of baseline ELF was 0.67, and that after increasing ELF overtime was 0.68 for predicting liver-related outcomes [ 67 ]. Similarly, the AUROCs for the serum biomarkers of FibroTest, FIB4, APRI, and Forns index were 0.79, 0.65, 0.60, and 0.40, respectively, for predicting non-liver-related mortality and 0.69, 0.64, 0.57, and 0.43, respectively, for predicting overall mortality in patients with ALD [ 20 ].…”

Section: Prediction Of Mortality and Liver-related Outcomesmentioning

confidence: 99%

Noninvasive Tests (NITs) for Hepatic Fibrosis in Fatty Liver Syndrome

Han

2020

Life

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Fatty liver syndrome is an emerging health problem in the world, due to the high prevalence of obesity and alcohol use disorder. Given the nature of the disease’s advancement to cirrhosis and liver-related complications, it is important to assess the severity of the disease, which is typically done via a liver biopsy. Due to the limitations and risks of liver biopsy, the role of noninvasive tests is essential and evolving to stratify the stage of the liver disease, predict the outcomes, and/or monitor the treatment response. This review is focused on noninvasive tests, including the use of serum-based biomarkers, ultrasound-based shear wave elastography, transient elastography, and magnetic resonance elastography in both clinical and research settings.

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Enhanced Liver Fibrosis Score Can Be Used to Predict Liver-Related Events in Patients With Nonalcoholic Steatohepatitis and Compensated Cirrhosis

Cited by 25 publications

References 8 publications

Enhanced liver fibrosis score as a surrogate of liver-related complications and mortality in primary biliary cholangitis

Enhanced liver fibrosis score as a surrogate of liver-related complications and mortality in primary biliary cholangitis

The Emerging Role of Extracellular Vesicles and Autophagy Machinery in NASH—Future Horizons in NASH Management

Noninvasive Tests (NITs) for Hepatic Fibrosis in Fatty Liver Syndrome

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