Liver biomarkers
Liquid biopsy diagnoses non-alcoholic liver disease
Anna Devyataykina, PCR.news
Diagnosis of non-alcoholic steatohepatitis (NASH) and liver fibrosis currently requires invasive biopsy. Biomarkers exist, but they have low sensitivity and specificity (62-66%, 78-82%). An international team of scientists has found new biomarkers to diagnose these diseases and determine their stages with high accuracy.
The researchers selected RAB proteins that regulate the transport and secretion of collagen-splitting enzymes in stellate cells and perilipin-2 (PLIN2) in circulating monocytes. Using proteomic analysis, it was found that the level of RAB14 changes most strongly in liver fibrosis among RAB proteins and is present in stellate cells and monocytes. And with the help of flow cytometry, the authors revealed a high correlation of PLIN2 expression in monocytes and hepatocytes.
Then, using a neural network, the scientists analyzed the selected blood parameters in 250 patients, some of whom had histologically confirmed NASH and liver fibrosis. PLIN2 turned out to be a good indicator for the diagnosis of NASH. Its sensitivity, specificity and accuracy were 88-95%, 90-100% and 92-93%, respectively, in two cohorts.
RAB14 protein was used to diagnose liver fibrosis using a model that takes into account parameters such as waist circumference, age, plasma glucose level, cholesterol associated with high-density lipoproteins (HDL), and ALT. Accuracy, sensitivity and specificity were 99.2%, 100% and 95.8%, respectively. Moreover, RAB14 turned out to be comparable with ultrasound two-dimensional elastography in the effectiveness of assessing the severity of fibrosis.
A feature of these biomarkers is also the possibility of diagnosing diseases even with concomitant pathologies. For example, the accuracy of RAB14 in detecting liver fibrosis was 95.8% in a subgroup of obese patients, 100% in a subgroup of diabetic patients and 100% in a subgroup of diabetic and obese patients. The accuracy in determining the stages of fibrosis was 62%, 68.5% and 68.2%, respectively.
Thus, RAB14 and PLIN2 markers allow to quickly, accurately and noninvasively detect NASH and fibrosis, as well as to determine the stage of the disease. According to the authors, this will increase opportunities for screening studies and clinical trials of drugs.
Article by Angelini et al. Accurate liquid biopsy for the diagnosis of non-alcoholic steatohepatitis and liver fibrosis is published in the Gut journal.
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