Liver Function Test

Liver Biomarker

New Biomarker for Predicting Liver Cancer Spread and Survival

New studies let hope that a unique pattern of microRNAs, small RNA molecules which regulate gene activity, might predict whether liver cancer will spread and whether liver cancer patients will have shorter or longer survival.

Liver Biomarkers for development of new therapeutics

Liver biomarkers are of increasing importance in the development of new therapeutics for treatment and prevention of a broad range of diseases to avoid hepatotoxicity. Just recently vitamin D-binding protein (Gc globulin) and liver fatty acid binding protein (L-FABP), have been identified as biomarkers of liver toxicity and injury. In the past limitations of existing biomarkers to detect liver injury in experimental animals highlight the need for new liver biomarkers to predict human liver toxicity.

Liver Biomarkers as noninvasive Tests for Liver Fibrosis

Non-invasive biomarkers of liver fibrosis are not only interesting inliver transplant patients were you would like to avoid liver biopsy or for haemophilia patients but for HCV-infected haemophilia patients a study has shown that a liver biomarker could correctly identified clinically advanced or minimal liver disease. Liver biopsy, due to its risks and limitations, is an imperfect gold standard for assessing the severity of the most frequent chronic liver diseases chronic hepatitis C (HCV), chronic hepatitis B (HBV) non alcoholic (NAFLD) fatty liver diseases and alcoholic (ALD) fatty liver diseases.

The data from studies suggests that biomarkers might be used in some cases as an alternative to liver biopsy for the assessment of fibrosis stage in the four most common chronic liver diseases, namely chronic hepatitis C (HCV), chronic hepatitis B (HBV) non alcoholic (NAFLD) fatty liver diseases and alcoholic (ALD) fatty liver diseases. However neither biomarkers nor biopsy alone is sufficient for definitive liver diagnostic allone; all the biological and clinical data must be taken into account.

Hyaluronic Acid Measurement can assist in Diagnosis and Monitoring of Liver Fibrosis and Cirrhosis

Fibrotic injury distorts the normal liver architecture and can result in organ dysfunction and hypertension. Liver Fibrosis can progress silently and lead to cirrhosis and also hepatocellular carcinoma (HCC). Stage diagnosis is essential for optimal treatment decisions and serum Hyaluronic Acid (HA) measurement can assist in diagnosis and monitoring of liver fibrosis and cirrhosis. Serum levels of HA are typically low in healthy individuals as circulating HA is rapidly removed from the blood by sinusoidal endothelial cells (SECs) in the liver. Serum HA correlates with liver pathology, particularly in cirrhosis, where there is a reduction in HA receptors resulting in an increase in circulating HA.

Alpha 2 Macroglobulin to assess Liver Fibrosis

Alpha 2 Macroglobulin is a glycoprotein used as a marker of membrane permeability and is a plasma proteinase inhibitor.Increases in alpha 2 macroglobulin may be observed in various pathological conditions.Decreased levels may be found during inflammatory processes.Alpha 2 Macroglobulin is one of the parameters included in the hepascore algorithm to assess liver fibrosis.

Measure Bile Acids in Serum or EDTA Plasma.

Bile acids are produced in the liver by cytochrome P450-mediated oxidation of cholesterol which are conjugate to form bile salts and stored in the gallbladder.Upon eating a meal the gall bladder secretes bile into the intestine where is serves to emulsify dietary fats.The bile acids form miscelles with lipids and fat-soluble vitamins that can be absorbed via the villi of the small intestine.Bile acid production is a key route of cholesterol elimination, stimulates the flow of bile which eliminates catabolites from the liver and reduces the bacteria flora found in the small intestine and biliary tract. Bile Acids ready-to-use liquid reagents can be used to measure Bile Acids in serum or EDTA plasma.This colorimetric, kinetic assay is based on enzymatic recycling and has a measuring range of 1-180µmol/L. 3-alpha-hydroxysteroid dehydrogenase (3-alpha-HSD) oxidizes bile acids to 3-keto steroids, whereby Thio-NAD is reduced to Thio-NADH.The reaction is reversible, and the same enzyme can convert 3-keto steroids and NADH to bile acids and NAD (recycling of bile acids).The rate of formation for Thio-NADH is determined by measuring the change of absorbance at 405nm.

Some Proteins which might be used as Liver Biomarkers

  • Lectin-reactive alpha fetoprotein (AFP-L3)
  • Des-gamma-carboxy-prothrombin (DCP)
  • ER6Q
  • Vimentin
  • actin alpha 1 skeletal muscle protein
  • hMFAP 4
  • tropomyosin
  • PTGES 2
  • amyloid P component
  • transgelin
  • calponin 1
  • homo sapiens p20 protein
  • 17 kDa myosin light chain
  • H chain H Igg B12
  • prolyl 4-hydroxylase
  • beta subunit methylenetetrahydrofolate dehydrogenase 1
  • PRO2619
  • aldehyde dehydrogenase 1
  • fibrinogen alpha chain preproprotein
  • fructose-bisphosphate aldolase B
  • argininosuccinate synthetase
  • Eefla2
  • AT P 5 Al
  • alpha-2 actin
  • regucalcin
  • serum albumin
  • mitochondrial malate dehydrogenase
  • mitochondrial acetoacetyl-CoA thiolase

Some non-patented Liver Biomarkers

  • Hyaluronic Acid (HA)
  • Hepascore
  • Prothrombin
  • Gamma Glutamyl Transpeptidase
  • Apolipoprotein A1 (PGA) index
  • Age platelet (AP) index
  • Bonacini index
  • Pohl score
  • Forns index
  • Aspartate aminotransferase/Platelets Ratio index (APRI)
  • MP3 (MMP1, PIINP) index
  • FIB4
  • FibroIndex

Contact us regarding "Liver Biomarker"
or call Tilo Stolzke at +49 451 400 83 01 directly.

Studies and publications

  • Automation of the Hepascore and validation as a biochemical index of liver fibrosis in patients with chronic hepatitis C from the ANRS HC EP 23 Fibrostar cohort.Clin Chim Acta. 2010 Jan;411(1-2):86-91. Epub 2009 Oct 19.Guéchot J, Lasnier E, Sturm N, Paris A, Zarski JP
  • Identification of Metastasis-related MicroRNAs in Hepatocellular Carcinoma Budhu A, Jia H, Forgues M, Liu C, Goldstein D, Lam A, Zanetti KA, Ye Q, Qin L, Croce CM, Tang ZY, Wang, XW. HEP-07-1296. Hepatology. Online January 7, 2008. Vol. 47 No. 1.Assessment of liver fibrosis: Noninvasive means Poynard T, Morra R, Ingiliz P, Imbert-Bismut F, Thabut D, Messous D, Munteanu M, Massard J, Benhamou Y, Ratziu V.Saudi J Gastroenterol 2008;14:163-73
  • Stiffness and Impedance: The New Liver Biomarkers EditorialRaza Malik, Nezam Afdhal, Clinical Gastroenterology and HepatologyVolume 5, Issue 10, Pages 1144-1146 (October 2007)
  • Non-invasive biomarkers of liver fibrosis in haemophilia patients with hepatitis C: can you avoid liver biopsy? MAOR, Y.; BASHARI, D.; KENET, G.; LUBETSKY, A.; LUBOSHITZ, J.; SCHAPIRO, J. M.; PÉNARANDA, G.; BAR-MEIR, S.; MARTINOWITZ, U.; HALFON, P. Haemophilia, Volume 12, Number 4, July 2006 , pp. 372-379(8)

Ultrasound in Hepatology