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Measurement of Liver Stiffness Using Atomic Force Microscopy Coupled with Polarization Microscopy
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Current status of fibrosis markers
Keyur Patel1, Nicholas A Shackel
1aDuke Clinical Research Institute, Duke University, Durham, North Carolina, USA bLiver Cell Biology, Centenary Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
Current Opinion in Gastroenterology
|March 28, 2014
Summary
Noninvasive tests for liver fibrosis show promise, especially for advanced stages in chronic hepatitis C (CHC) and nonalcoholic fatty liver disease (NAFLD). Further research is needed for reliable biomarkers for steatosis and fibrosis progression.
Area of Science:
- Hepatology
- Biomarker Discovery
- Medical Imaging
Background:
- Fibrosis pathophysiology understanding and technological advancements drive noninvasive diagnostic tools.
- Serum biomarkers and imaging modalities are emerging as alternatives to liver biopsy.
- Development has primarily focused on chronic hepatitis C (CHC) and nonalcoholic fatty liver disease (NAFLD).
Purpose of the Study:
- To review recent advances in noninvasive fibrosis assessment.
- To highlight the potential clinical applications of these emerging modalities.
- To discuss their utility in diagnosing and staging liver disease.
Main Methods:
- Review of current literature on serum biomarkers and imaging techniques.
- Analysis of noninvasive approaches developed for CHC and their adaptation for NAFLD.
- Evaluation of diagnostic and prognostic utility for advanced liver disease.
Main Results:
- Noninvasive methods, refined from CHC studies, are being applied to NAFLD.
- Combinations of serum markers and imaging tools aid in diagnosing cirrhosis and assessing advanced disease.
- Promising tools for NAFLD include cytokeratin-18 fragments, CAP, elastography, and MRI, requiring further validation.
Conclusions:
- Current noninvasive fibrosis tests offer significant diagnostic and prognostic value for advanced liver disease, integrated into CHC clinical practice.
- There is an ongoing need for reliable biomarkers for steatosis, nonalcoholic steatohepatitis, and fibrosis progression in chronic liver conditions.
- Future advancements in bioimaging and functional genomics are crucial for quantitative fibrosis assessment and novel biomarker development.
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