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Performance of Serum microRNAs -122, -192 and -21 as Biomarkers in Patients with Non-Alcoholic Steatohepatitis.

TLDR
Candidates for a combined model of miRNAs and CK18-Asp396 levels relevant as a promising expansion for diagnosis and in turn treatment of NASH are defined.
Abstract
Objectives Liver biopsies are the current gold standard in non-alcoholic steatohepatitis (NASH) diagnosis. Their invasive nature, however, still carries an increased risk for patients' health. The development of non-invasive diagnostic tools to differentiate between bland steatosis (NAFL) and NASH remains crucial. The aim of this study is the evaluation of investigated circulating microRNAs in combination with new targets in order to optimize the discrimination of NASH patients by non-invasive serum biomarkers. Methods Serum profiles of four microRNAs were evaluated in two cohorts consisting of 137 NAFLD patients and 61 healthy controls. In a binary logistic regression model microRNAs of relevance were detected. Correlation of microRNA appearance with known biomarkers like ALT and CK18-Asp396 was evaluated. A simplified scoring model was developed, combining the levels of microRNA in circulation and CK18-Asp396 fragments. Receiver operating characteristics were used to evaluate the potential of discriminating NASH. Results The new finding of our study is the different profile of circulating miR-21 in NASH patients (p<0.0001). Also, it validates recently published results of miR-122 and miR-192 to be differentially regulated in NAFL and NASH. Combined microRNA expression profiles with CK18-Asp396 fragment level scoring model had a higher potential of NASH prediction compared to other risk biomarkers (AUROC = 0.83, 95% CI = 0.754-0.908; p<0.001). Evaluation of score model for NAFL (Score = 0) and NASH (Score = 4) had shown high rates of sensitivity (91%) and specificity (83%). Conclusions Our study defines candidates for a combined model of miRNAs and CK18-Asp396 levels relevant as a promising expansion for diagnosis and in turn treatment of NASH.

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Noninvasive Assessment of Liver Disease in Patients With Nonalcoholic Fatty Liver Disease.

TL;DR: The current state of the noninvasive assessment of liver disease in NAFLD is summarized, and an expert synthesis of how these nonin invasive tools could be utilized in clinical practice is provided.
Journal ArticleDOI

Genetics and epigenetics of NAFLD and NASH: Clinical impact

TL;DR: The status of research into important genetic and epigenetic modifiers of NAFLD progression are discussed and the potential to translate the accumulating wealth of genetic data into the design of novel therapeutics and the clinical implementation of diagnostic/prognostic biomarkers will be explored.
Journal ArticleDOI

Noninvasive biomarkers in NAFLD and NASH - current progress and future promise.

TL;DR: Current and potential biomarkers for different features of NAFLD, namely, steatosis, necroinflammation and fibrosis are reviewed, and MRI-estimated proton density fat fraction is currently the most accurate test to quantify hepatic steatohepatitis and can be considered the gold standard.
Journal ArticleDOI

Exosomes derived from palmitic acid-treated hepatocytes induce fibrotic activation of hepatic stellate cells

TL;DR: PA treatment enhanced the production of exosomes in these hepatocytes and changed their exosomal miRNA profile, and exosome derived from PA-treated hepatocytes caused an increase in the expression levels of fibrotic genes in HSCs.
Journal ArticleDOI

Noninvasive evaluation of nonalcoholic fatty liver disease: Current evidence and practice.

TL;DR: Current noninvasive methods for assessing nonalcoholic fatty liver disease, including steatosis, NASH, and NAFLD-related fibrosis, are discussed and effective algorithms consisting of imaging and nonimaging biomarkers for diagnosing advanced fibrosis and reducing unnecessary biopsies in clinical practice are explored.
References
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Journal ArticleDOI

Long-term follow-up of patients with NAFLD and elevated liver enzymes.

TL;DR: It is concluded that nonalcoholic fatty liver disease with elevated liver enzymes is associated with a clinically significant risk of developing end‐stage liver disease and Survival is lower in patients with NASH, and most NAFLD patients will develop diabetes or impaired glucose tolerance in the long term.
Journal ArticleDOI

Independent predictors of liver fibrosis in patients with nonalcoholic steatohepatitis

TL;DR: Older age, obesity, and presence of diabetes mellitus help identify those NASH patients who might have severe liver fibrosis, and this is the subgroup of patients who would be expected to derive the most benefit from having a liver biopsy and considering investigational therapies.
Journal ArticleDOI

Circulating microRNAs, potential biomarkers for drug-induced liver injury

TL;DR: It is demonstrated that specific microRNA species, such as mir-122 and mir-192, both are enriched in the liver tissue and exhibit dose- and exposure duration-dependent changes in the plasma that parallel serum aminotransferase levels and the histopathology of liver degeneration, but their changes can be detected significantly earlier.
Journal ArticleDOI

A novel and universal method for microRNA RT-qPCR data normalization

TL;DR: It is demonstrated that the mean expression value outperforms the current normalization strategy in terms of better reduction of technical variation and more accurate appreciation of biological changes.
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