Related Experiment Video
Updated: Feb 8, 2026

Author Spotlight: Advancing Hepatic Fibrosis Diagnosis Using Magnetic Resonance Elastography and AI
Published on: July 21, 2023
Connective tissue growth factor in serum as a new candidate test for assessment of hepatic fibrosis
Axel M Gressner1, Eray Yagmur, Birgit Lahme
1Institute of Clinical Chemistry and Pathobiochemistry, Central Laboratory, Institute of Medical Statistics, RWTH University Hospital, Aachen, Germany. gressner@twth-aachen.de
Background:
No reliable, cost-effective serum test is available for assessment of liver fibrogenesis, the most serious complication of chronic inflammatory liver diseases (CLD). In sera of patients with CLD, we determined the concentration of connective tissue growth factor (CTGF), a secreted downstream mediator of the potent fibrogenic cytokine transforming growth factor beta (TGF-beta).
Patients And Methods:
We studied 83 patients with CLD (17 with chronic hepatitis, 16 with histologically proven fibrosis, and 50 with cirrhosis) and 74 healthy individuals. Serum CTGF was measured by use of a sandwich immunoassay.
Results:
The mean concentration of CTGF was highest in the fibrosis group (5.2-fold) and in the chronic viral hepatitis group (4.3-fold) but lower in those patients with fully developed cirrhosis. The area under the ROC curve (AUC) of CTGF for fibrosis vs control was 0.955 (95% confidence interval, 0.890-0.987). The CTGF/platelet ratio increased the detection limit for cirrhosis from 84% to 92% and the specificity from 85% to 87.5% (cutoff for CTGF was 364 microg/L, ratio 2.05).
Conclusion:
CTGF in serum is a candidate marker of ongoing fibrogenesis in chronic liver diseases.
Related Concept Videos
Introduction to Connective Tissues
Classification of Connective Tissues
Connective Tissue Proper
Connective tissue proper is the most abundant class of connective tissues. As its name implies, it predominantly connects different tissues in the body. Depending on the cell types, ground substance, viscosity, and fiber types in the ECM, connective tissue proper is further categorized into loose and dense....
Embryonic Connective Tissues
The mesenchyme is the first connective tissue that emerges in the developing embryo. It consists of loosely arranged multipotent mesenchymal cells and reticular fibers in the extracellular matrix. This loose arrangement allows easy migration of cells, which is essential for germ layer positioning, patterning, and organ morphogenesis during embryonic development.
Dense Connective Tissue
Dense Regular Connective Tissue
In dense regular connective tissue, fibers are arranged parallel to each other, enhancing its tensile strength and resistance to stretching in the direction of the fiber orientations. Ligaments and tendons are made of dense regular...
Functions of Connective Tissues
Hard connective tissues, such as bones and cartilage, provide structure and support to the body.
Loose Connective Tissue
Adipose Tissue
Adipose tissue consists primarily of fat storage cells called adipocytes and little extracellular matrix. A large number of capillaries present within adipose tissue allow rapid mobilization of lipid molecules. White adipose tissue is...

