Published in:
01-12-2017 | Fatty Liver Disease (S Harrison and J George, Section Editors)
Wet Biomarker-Based Assessment of Steatosis, Inflammation, and Fibrosis in NAFLD
Published in: Current Hepatology Reports | Issue 4/2017
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Purpose of Review
Non-alcoholic fatty liver disease (NAFLD) is a disease on the rise; the severe form with steatohepatitis (NASH) may progress to liver cirrhosis with increased morbidity and mortality. Non-invasive biomarkers for the diagnosis of NASH with fibrosis are an area of intensive research. We review the current literature and new research on wet biomarkers for the diagnosis of NASH and fibrosis.
Recent Findings
A number of single parameters as well as composite scores show acceptable efficacy for the prediction of NASH and fibrosis. Composite scores generally use parameters that are usually easily accessible or commercially available. Other markers include the apoptosis marker CK-18, the macrophage activation marker soluble (s)CD163, and others.
Summary
From a clinical point of view, the FIB-4 and NAFLD fibrosis score perform well and are easily accessible compared to some of the commercially available tests. CK-18 and sCD163 are promising for both NASH diagnosis and resolution but need further validation and assay standardisation. The combination of these biomarkers with imaging techniques, e.g. fibroscan, may work synergistically to improve NASH diagnosis and follow-up in the future.