Nordic Bioscience A/S, Herlev, Denmark.
Aliment Pharmacol Ther. 2014 Aug;40(3):233-49. doi: 10.1111/apt.12820. Epub 2014 Jun 9.
Nearly 45% of all deaths are associated with chronic fibroproliferative diseases, of which the primary characteristic is altered remodelling of the extracellular matrix. A major difficulty in developing anti-fibrotic therapies is the lack of accurate and established techniques to estimate dynamics of fibrosis, regression or progression, in response to therapy.
One of the most pressing needs in modern clinical chemistry for fibroproliferative disorders is the development of biomarkers for early diagnosis, prognosis, and early efficacy for the benefit of patients and to facilitate improved drug development. The aim of this article was to review the serological biomarkers that may assist in early diagnosis of patients, separate fast from slow- or nonprogressors, and possibly assist in drug development for fibroproliferative diseases, exemplified by liver fibrosis. The lack of success of biochemical markers and the possible reasons for this is discussed in the context of other fields with biomarker success.
This is a personal opinion review article.
Biochemical markers, originating from the fibrotic structure, may have increased specificity and sensitivity for disease. Assessment of the tissue turnover balance by measurement of tissue formation and tissue degradation separately by novel technologies may provide value.
Novel technologies focused on the protein fingerprint in addition to biomarker classification, may increase the quality of biomarker development and provide the much needed biomarkers to further the fibroproliferative field. This is in direct alignment with the Food and Drug Administration and European Medicinal Agencies initiatives of personal health care.
近 45%的死亡与慢性纤维增生性疾病有关，其主要特征是细胞外基质的重塑改变。开发抗纤维化疗法的主要困难是缺乏准确和既定的技术来评估纤维化、消退或进展的动力学，以响应治疗。
对于纤维增生性疾病，现代临床化学最迫切的需求之一是开发生物标志物，用于早期诊断、预后和早期疗效，使患者受益，并促进药物开发的改善。本文的目的是综述血清生物标志物，这些标志物可能有助于早期诊断患者，区分快速进展者、缓慢进展者或非进展者，并可能有助于纤维增生性疾病的药物开发，以肝纤维化为例。讨论了生化标志物缺乏成功的原因，并结合其他具有生物标志物成功的领域进行了讨论。
这是一篇个人观点综述文章。
源自纤维结构的生化标志物可能具有更高的疾病特异性和敏感性。通过新的技术分别测量组织形成和组织降解来评估组织转化平衡可能具有价值。
除了生物标志物分类之外，专注于蛋白质指纹的新技术可能会提高生物标志物开发的质量，并提供急需的生物标志物来推动纤维增生性领域的发展。这与食品和药物管理局以及欧洲药品管理局的个人医疗保健倡议直接一致。
