Hepatic (liver) fibrosis is a devastating disease, which requires a not very pleasant procedure of biopsy to be detected. However, Russian medics developed a technique, which allows skipping this painful diagnostic method and estimating the level of liver fibrosis on the basis of biochemical measurements.s.

Liver cells or hepatocytes are clustered in lobules (segments), each surrounded by connective tissue. Fibrosis makes this connective tissue grow enormously, and the number of hepatocytes significantly drops. Fibrosis slowly progresses and can develop into cirrhosis, which is an irreversible change of a liver’s structure. Biopsy is a common procedure for estimating how developed hepatic fibrosis is by measuring a ratio of connective tissue and hepatocytes. It is a painful and rather dangerous technique, and that is why medics try to prescribe it to children with chronic liver diseases very rarely. However, abolishment of biopsy leads to inadequate estimations of fibrosis stage and medication efficiency. Thus, medics from all over the world are looking for noninvasive diagnostics techniques of live fibrosis.

 

 

Growth of liver’s connective tissue is accompanied by biochemical changes, which are not a mystery for doctors. These changes include rapid increase in concentration of a protein, known as transforming growth factor-β1 (TGF-β1), collagen of type IV and hyaluronic acid; moreover, measurements show decreasing activity of enzymes, known as metalloproteinases MMP-2 and MMP-9. Before this study, medics had no idea whether they could use concentration of mentioned substances in blood serum for estimating what damage had been done to liver (in other words, to determine a stage of liver fibrosis).

In order to clarify this situation, Russian scientists from the Science Centre of Child Health (Russian academy of medical sciences) have examined 95 patients, aged between 1 year and 17 years, who suffered from various chronic liver diseases, as well as 15 almost healthy children. All experiment participants had to give their blood for measuring concentrations of hyaluronic acid, collagen of type IV, TGF-β1 and both metalloproteinases, as well proteins of lectin family, which are suspected to promote fibrosis development. In addition, all children with liver disorders had to undergo liver biopsy.

Researchers have compared results of biopsy with measured biochemical parameters and concluded that changed in blood serum concentration of a MMP-2 metalloproteinase and TGF-β1 allow diagnosing slightest changes in liver structure. As for other test substances, changes in concentration of hyaluronic acid and collagen of type IV are a less sensitive marker of changes in liver structure – they are able to indicate only massive fibrosis or liver cirrhosis. Mentioned parameters can be used for estimating the level of liver degradation and for monitoring dynamics of this disease in children with chronic liver pathologies. These techniques can be applied to adult patients as well.

Source: Science & Technologies

Kizilova Anna