Noninvasive Assessment of Liver Fibrosis: Current and Future Clinical and Molecular Perspectives

Abstract

Liver fibrosis is one of the risk factors for hepatocellular carcinoma (HCC) development. The staging of liver fibrosis can be evaluated only via a liver biopsy, which is an invasive procedure. Noninvasive methods for the diagnosis of liver fibrosis can be divided into morphological tests such as elastography and serum biochemical tests. Transient elastography is reported to have excellent performance in the diagnosis of liver fibrosis and has been accepted as a useful tool for the prediction of HCC development and other clinical outcomes. Two-dimensional shear wave elastography is a new technique and provides a real-time stiffness image. Serum fibrosis markers have been studied based on the mechanism of fibrogenesis and fibrolysis. In the healthy liver, homeostasis of the extracellular matrix is maintained directly by enzymes called matrix metalloproteinases (MMPs) and their specific inhibitors, tissue inhibitors of metalloproteinases (TIMPs). MMPs and TIMPs could be useful serum biomarkers for liver fibrosis and promising candidates for the treatment of liver fibrosis. Further studies are required to establish liver fibrosis-specific markers based on further clinical and molecular research. In this review, we summarize noninvasive fibrosis tests and molecular mechanism of liver fibrosis in current daily clinical practice.

A Mixture of Pure, Isolated Polyphenols Worsens the Insulin Resistance and Induces Kidney and Liver Fibrosis Markers in Diet-Induced Obese Mice

“…Our results showed an upregulation of kidney injury molecule-1 (Kim-1) [ 42 ], and an upregulation in the mRNA levels of the transcription factor carbohydrate-responsive element-binding protein b (Chrebpb) , the increase of which has been related to the progression of diabetic kidneys ( Figure 5 a) [ 43 ]. In addition, an upward trend in the expression of fibronectin (Fn-1) , a protein related to fibrotic processes [ 44 , 45 ] was also detected.…”

“…The fibrotic process involves a complex network of signal transduction pathways where the transforming growth factor-beta (TGFb) has a central role [ 45 ]. Fibrosis is determined among others by an increase in the expression of collagens, proteoglycans, glycoproteins, and fibronectins [ 44 ]. Fibronectin is one of the main players by affecting the TFGb release and as responsible protein for the accumulation of collagen and hence the development of fibrosis [ 66 , 67 ].…”

Identification of potential plasma markers for hepatitis B virus‐related chronic hepatitis and liver fibrosis/cirrhosis

“…19 As the prevalence of HBVassociated liver disease has risen rapidly in recent years, the accuracy of diagnostic testing is becoming increasingly important, which may direct the proper timing of treatment. 4,20 Although liver biopsy remains the gold standard for the assessment of LF or LC, it has some limitations such as its invasive nature, sampling errors, potential complications, and inappropriate application for routine dynamic surveillance and follow-up tests. 21 At present, various candidate biomarkers or discriminative models had been proposed, and most of them were concentrated at end-stage liver diseases, especially on HCC.…”

National, clinical cohort study of late effects among survivors of acute lymphoblastic leukaemia: the ALL-STAR study protocol

“…Ultrasound 2D shear wave elastography is performed on the right liver lobe for evaluation of parenchymal stiffness and fibrosis. 49 …”

“…Portal vein flow is measured using Doppler ultrasound. Ultrasound 2D shear wave elastography is performed on the right liver lobe for evaluation of parenchymal stiffness and fibrosis 49. T2* and mapping is performed for visualisation of possible myocardial oedema and fibrosis, and to evaluate myocardial iron content 52.…”