The Enhanced Liver Fibrosis (ELF) score: Normal values, influence factors and proposed cut-off values

A Placebo-Controlled Trial of Obeticholic Acid in Primary Biliary Cholangitis

“…Secondary efficacy end points included levels of alkaline phosphatase, GGT, alanine aminotransferase, aspartate aminotransferase, total and conjugated bilirubin, and albumin; prothrombin time; international normalized ratio; plasma bile acid levels; level of fibroblast growth factor , an enterokine released after FXR activation; inflammation, as assessed by highsensitivity C-reactive protein (CRP) and tumor necrosis factor α (TNF-α) levels; interleukin-6 level; transforming growth factor β (TGF-β) level; liver apoptosis, as assessed by the cleaved cytokeratin 18 level; serum autotaxin level; and noninvasive measures of fibrosis, such as transient elastography 18 and the enhanced liver fibrosis score 19 (including the components of levels of hyaluronic acid, procollagen type III N-terminal peptide [P3NP], and tissue inhibitor of metalloproteinase 1 [TIMP-1]). Other secondary end points included results of categorical analyses of alkaline phosphatase levels and biochemical-response criteria; symptoms, as assessed by the primary biliary cirrhosis-40 (PBC-40) questionnaire (a diseasespecific quality-of-life questionnaire) 20 ; and a patient-research questionnaire.…”

Non-invasive Diagnostics of Liver Fibrosis

“…Since 1997, a group of European scientists led by Rosenberg, and funded by Bayer Health care, have been seeking serum markers of liver fi brosis [6,8,28,29,30]. The program lasts for more than a decade and comes to identifying the ELF panel and is currently marketed in Europe.…”

“…It is of great importance that this test can detect patients with mild or moderate fi brosis, which is usually asymptomatic. Each of the three biomarkers included in the ELF has its informative value [16,17,18,28,29,31,32]. The advantage of this test is that it is automated and offered by different companies on the market.…”

Evaluation of Kallistatin as a Biomarker in Chronic Hepatitis C Patients

“…However, identifying the hepatic fibrosis at an early stage remains an open challenge, due to the poor diagnostic accuracy of many circulating biomarkers and algorithms in the early and mild stages of liver fibrosis when compared to advanced fibrosis. [19,20] Hepatic fibrosis is a silent disease affecting people all over the world as well as Egyptian population. The slow and asymptomatic progression of the disease in the majority of cases is considered as one of the major obstacles to adopt specific biomarkers for early detection of fibrosis.…”