Noninvasive biomarkers in non-alcoholic fatty liver disease: Current status and a glimpse of the future
Noninvasive biomarkers in non-alcoholic fatty liver disease: Current status and a glimpse of the future
复制标题
DOI：
10.3748/wjg.v20.i31.10851
复制
发表时间：
2014-08-21
影响因子：
4.3
通讯作者：
Dhawan, Anil
中科院分区：
文献类型：
--
作者：
Fitzpatrick, Emer;Dhawan, Anil
非侵入性疾病生物标志物的开发已成为非酒精性脂肪性肝病（NAFLD）研究的主要焦点。该疾病的大患病率和调查的侵入性意味着肝活检筛查是不切实际的。除了筛查外，区分单纯性脂肪变性与脂肪性肝炎和纤维化在临床上也很重要，因为两者的预后不同。血清生物标志物可以是来自大数据集的简单标记物的组合，也可以是疾病活动性的直接标记物。除纤维化外，NAFLD患者的血清炎症、细胞凋亡和氧化应激标志物已被广泛研究。除了NAFLD外，其他技术如瞬态弹性成像、磁共振弹性成像和声辐射力成像也越来越多地成为检测各种慢性肝病纤维化的无创方法。新的高通量方法，如蛋白质组学和糖组学，允许非假设驱动的新标记的鉴定，也可能有助于我们对疾病发病机制的理解。本文综述了在寻找理想的生物标志物时需要考虑的一些方法学问题。血清生物标记物和瞬态弹性成像等技术的结合可能提供最佳的诊断区分，但这仍有待于大规模研究的证明。（三）2014年百世登出版集团股份有限公司版权所有。
The development of non invasive biomarkers of disease has become a major focus of interest in nonalcoholic fatty liver disease (NAFLD). The large prevalence of the disease and the invasive nature of the investigation means that screening with liver biopsy is impractical. In addition to screening, the differentiation of those with simple steatosis vs steatohepatitis and fibrosis is clinically important as the prognosis of each differs. Serum biomarkers may be a combination of simple markers derived from large data sets or direct markers of disease activity. Serum markers of inflammation, apoptosis and oxidative stress in addition to fibrosis have been extensively studied in patients with NAFLD. Other techniques such as transient elastography, magnetic resonance elastography and acoustic radiation force imaging are becoming more established as noninvasive methods of detecting fibrosis in a variety of chronic liver conditions in addition to NAFLD. Newer high throughput methods such as proteomics and glycomics allow the nonhypothesis-driven identification of novel markers and may also potentially contribute to our understanding of the pathogenesis of the condition. This review addresses some of the methodological issues which need to be considered in the search for the ideal biomarker. It is likely that a combination of serum biomarkers and techniques such as transient elastography may provide the optimal diagnostic discrimination however this remains to be proven in large studies. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.