ABSTRACT

Introduction

Hepatic fibrosis is the excessive synthesis and deposition of extracellular matrix including collagen in the tissue. Chronic liver insult leads to progressive parenchymal damage, portal hypertension, and cirrhosis. Determination of hepatic collagen by invasive liver biopsy is the gold standard to estimate severity and stage of fibrosis. However, this procedure is associated with pain, carries the risk of infection and bleeding, and is afflicted with a high degree of sampling error. Therefore, there is urgent need for serological collagen-derived markers to assess collagen synthesis/turnover.

Areas covered

Biochemical properties of collagens, cellular sources of hepatic collagen synthesis, and regulatory aspects in collagen expression. Markers are discussed suitable to estimate hepatic collagen synthesis and/or turnover. Discussed studies were identified through a PubMed search done in May 2020 and the authors’ topic knowledge.

Expert opinion

Hepatic fibrosis is mainly characterized by accumulation of collagen-rich scar tissue. Although traditionally performed liver biopsy is still standard in estimating hepatic fibrosis, there is evidence that noninvasive diagnostic scores and collagen-derived neo-epitopes provide clinical useful information. These noninvasive tests are less expensive than liver biopsy, better tolerated, safer, and more acceptable to patients. Therefore, these tests will lead to dramatic changes in diagnosis.

中文翻译：

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胶原蛋白作为肝纤维化生物标志物的临床应用进展。

摘要

介绍

肝纤维化是组织中包括胶原蛋白在内的细胞外基质的过度合成和沉积。慢性肝损伤导致进行性实质损伤、门脉高压和肝硬化。通过侵入性肝活检确定肝胶原蛋白是估计纤维化严重程度和阶段的金标准。然而，该过程与疼痛有关，存在感染和出血的风险，并且受到高度采样误差的困扰。因此，迫切需要血清胶原蛋白衍生标志物来评估胶原蛋白合成/周转。

覆盖区域

胶原蛋白的生化特性、肝胶原蛋白合成的细胞来源以及胶原蛋白表达的调节方面。讨论了适合估计肝胶原合成和/或周转的标记物。讨论的研究是通过 2020 年 5 月进行的 PubMed 搜索和作者的主题知识确定的。

专家意见

肝纤维化的主要特征是富含胶原蛋白的瘢痕组织的堆积。尽管传统上进行的肝活检仍然是估计肝纤维化的标准方法，但有证据表明无创诊断评分和胶原蛋白衍生的新表位提供了临床有用的信息。这些无创检查比肝活检便宜，耐受性更好，更安全，更容易被患者接受。因此，这些测试将导致诊断的巨大变化。