Clinical Benefits of Biochemical Markers of Fibrosis in Egyptian Children With Chronic Liver Diseases
The need for repetition of liver biopsy, especially in assessing the degree of fibrosis and follow-up of treatment protocols, justifies an intensive search for non-invasive alternatives. We attempted to investigate the clinical usefulness of serum fibrogenesis markers in pediatric chronic liver dise...
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Published in | Gastroenterology research Vol. 3; no. 6; pp. 262 - 271 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
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Elmer Press
01.12.2010
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Abstract | The need for repetition of liver biopsy, especially in assessing the degree of fibrosis and follow-up of treatment protocols, justifies an intensive search for non-invasive alternatives. We attempted to investigate the clinical usefulness of serum fibrogenesis markers in pediatric chronic liver diseases.
We measured serum levels of TGF-β1, collagen IV, laminin, MMP-2 and EGF-R, in 50 children with chronic liver disease (HBV, HCV and Bilharziasis) and 30 healthy controls, and determined their relationship to frequently used liver function tests and liver biopsy findings in patients.
TGF-β1, collagen IV, laminin and MMP-2, but not EGF-R, were significantly higher in patients than in controls (P < 0.01). None of these markers correlated with the histological fibrosis stage, whereas laminin correlated with necroinflammatory activity (P < 0.01). TGF-β1, collagen IV, laminin and MMP-2 had the ability to discriminate patients with significant fibrosis, while only collagen IV and laminin were able to discriminate those with cirrhosis. Among these markers, collagen IV had the best predictive accuracy for significant fibrosis (AUROC 0.94; PPV 91.5%) and cirrhosis (AUROC 0.85; PPV 80%).
In conclusion, these markers may be useful in reducing but not replacing the need for liver biopsy in the monitoring of disease progression and treatment effectiveness and might be an inseparable part of assessment of chronic hepatopathies. |
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AbstractList | The need for repetition of liver biopsy, especially in assessing the degree of fibrosis and follow-up of treatment protocols, justifies an intensive search for non-invasive alternatives. We attempted to investigate the clinical usefulness of serum fibrogenesis markers in pediatric chronic liver diseases.
We measured serum levels of TGF-β1, collagen IV, laminin, MMP-2 and EGF-R, in 50 children with chronic liver disease (HBV, HCV and Bilharziasis) and 30 healthy controls, and determined their relationship to frequently used liver function tests and liver biopsy findings in patients.
TGF-β1, collagen IV, laminin and MMP-2, but not EGF-R, were significantly higher in patients than in controls (P < 0.01). None of these markers correlated with the histological fibrosis stage, whereas laminin correlated with necroinflammatory activity (P < 0.01). TGF-β1, collagen IV, laminin and MMP-2 had the ability to discriminate patients with significant fibrosis, while only collagen IV and laminin were able to discriminate those with cirrhosis. Among these markers, collagen IV had the best predictive accuracy for significant fibrosis (AUROC 0.94; PPV 91.5%) and cirrhosis (AUROC 0.85; PPV 80%).
In conclusion, these markers may be useful in reducing but not replacing the need for liver biopsy in the monitoring of disease progression and treatment effectiveness and might be an inseparable part of assessment of chronic hepatopathies. BACKGROUNDThe need for repetition of liver biopsy, especially in assessing the degree of fibrosis and follow-up of treatment protocols, justifies an intensive search for non-invasive alternatives. We attempted to investigate the clinical usefulness of serum fibrogenesis markers in pediatric chronic liver diseases. METHODSWe measured serum levels of TGF-β1, collagen IV, laminin, MMP-2 and EGF-R, in 50 children with chronic liver disease (HBV, HCV and Bilharziasis) and 30 healthy controls, and determined their relationship to frequently used liver function tests and liver biopsy findings in patients. RESULTSTGF-β1, collagen IV, laminin and MMP-2, but not EGF-R, were significantly higher in patients than in controls (P < 0.01). None of these markers correlated with the histological fibrosis stage, whereas laminin correlated with necroinflammatory activity (P < 0.01). TGF-β1, collagen IV, laminin and MMP-2 had the ability to discriminate patients with significant fibrosis, while only collagen IV and laminin were able to discriminate those with cirrhosis. Among these markers, collagen IV had the best predictive accuracy for significant fibrosis (AUROC 0.94; PPV 91.5%) and cirrhosis (AUROC 0.85; PPV 80%). CONCLUSIONSIn conclusion, these markers may be useful in reducing but not replacing the need for liver biopsy in the monitoring of disease progression and treatment effectiveness and might be an inseparable part of assessment of chronic hepatopathies. |
Author | Behairy, Behairy E Sira, Mostafa M Hussein, Mohsen H El-Shaheed, Azza Abd Mahdy, Karam El-Batanony, Mohamed Abdel-Ghaffar, Tawhida Y |
AuthorAffiliation | a Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt d Medical Biochemistry Department, National Research Centre, El Bohouth Street, Dokki 12311, Cairo, Egypt b Department of Pediatric Hepatology, National Liver Institute, Menofiya University, 32511 Shebin El-koom, Menofiya, Egypt c Department of Child Health, National Research Centre, El Bohouth Street, Dokki 12311, Cairo, Egypt e Department of Pathology, National Liver Institute, Menofiya University, 32511 Shebin El-koom, Menofiya, Egypt |
AuthorAffiliation_xml | – name: c Department of Child Health, National Research Centre, El Bohouth Street, Dokki 12311, Cairo, Egypt – name: d Medical Biochemistry Department, National Research Centre, El Bohouth Street, Dokki 12311, Cairo, Egypt – name: b Department of Pediatric Hepatology, National Liver Institute, Menofiya University, 32511 Shebin El-koom, Menofiya, Egypt – name: a Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt – name: e Department of Pathology, National Liver Institute, Menofiya University, 32511 Shebin El-koom, Menofiya, Egypt |
Author_xml | – sequence: 1 givenname: Tawhida Y surname: Abdel-Ghaffar fullname: Abdel-Ghaffar, Tawhida Y organization: Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt – sequence: 2 givenname: Behairy E surname: Behairy fullname: Behairy, Behairy E organization: Department of Pediatric Hepatology, National Liver Institute, Menofiya University, 32511 Shebin El-koom, Menofiya, Egypt – sequence: 3 givenname: Azza Abd surname: El-Shaheed fullname: El-Shaheed, Azza Abd organization: Department of Child Health, National Research Centre, El Bohouth Street, Dokki 12311, Cairo, Egypt – sequence: 4 givenname: Karam surname: Mahdy fullname: Mahdy, Karam organization: Medical Biochemistry Department, National Research Centre, El Bohouth Street, Dokki 12311, Cairo, Egypt – sequence: 5 givenname: Mohamed surname: El-Batanony fullname: El-Batanony, Mohamed organization: Department of Pathology, National Liver Institute, Menofiya University, 32511 Shebin El-koom, Menofiya, Egypt – sequence: 6 givenname: Mohsen H surname: Hussein fullname: Hussein, Mohsen H organization: Department of Pediatric Hepatology, National Liver Institute, Menofiya University, 32511 Shebin El-koom, Menofiya, Egypt – sequence: 7 givenname: Mostafa M surname: Sira fullname: Sira, Mostafa M organization: Department of Pediatric Hepatology, National Liver Institute, Menofiya University, 32511 Shebin El-koom, Menofiya, Egypt |
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Keywords | Bilharziasis Collagen IV Hepatitis B virus Liver fibrosis Egyptian children Hepatitis C virus |
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Title | Clinical Benefits of Biochemical Markers of Fibrosis in Egyptian Children With Chronic Liver Diseases |
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