School of Medicine, The 2nd Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China.
Liver Disease Department of Integrative Medicine, Ningbo No. 2 Hospital, Ningbo, China.
Expert Rev Mol Diagn. 2024 Nov;24(11):1009-1022. doi: 10.1080/14737159.2024.2413941. Epub 2024 Oct 10.
Nonalcoholic fatty liver disease (NAFLD) is a common metabolism-related disease worldwide. Although studies have shown that some medications may be effective for treating NAFLD, they do not satisfy the medical requirements, and lifestyle changes are the most basic strategy. Thus, early detection of NAFLD and timely lifestyle interventions are highly important.
The traditional diagnostic methods for NAFLD are limited by accuracy, cost, and security issues. Cytokeratin 18 (CK18), which is a marker of apoptosis and overall cell death, is an excellent biomarker for NAFLD. Liver fat accumulation in NAFLD triggers the activation of caspases, which increases the CK18 cleavage and its release into the blood. CK18 can help diagnose different stages of NAFLD, especially the nonalcoholic steatohepatitis (NASH) stage. In evaluating the efficacy of the NAFLD treatment and predicting the risk of NAFLD-related diseases, CK18 plays a significant role.
CK18 can non-invasively monitor the pathological conditions of NAFLD patients and provide new hope for the early diagnosis of NAFLD. Adding CK18 to the NAFLD diagnostic criteria that are widely used in clinical settings may be efficient for the detection of NAFLD and early effective intervention.
非酒精性脂肪性肝病（NAFLD）是一种常见的与代谢相关的全球性疾病。虽然研究表明，某些药物可能对治疗 NAFLD 有效，但它们并不能满足医疗需求，而生活方式的改变则是最基本的策略。因此，早期发现 NAFLD 并及时进行生活方式干预非常重要。
NAFLD 的传统诊断方法受到准确性、成本和安全性问题的限制。细胞角蛋白 18（CK18）是细胞凋亡和整体细胞死亡的标志物，是 NAFLD 的一个极好的生物标志物。NAFLD 中的肝脂肪堆积会触发半胱天冬酶的激活，从而增加 CK18 的裂解并将其释放到血液中。CK18 有助于诊断 NAFLD 的不同阶段，特别是非酒精性脂肪性肝炎（NASH）阶段。在评估 NAFLD 治疗的疗效和预测与 NAFLD 相关疾病的风险方面，CK18 发挥着重要作用。
CK18 可以无创监测 NAFLD 患者的病理状况，为 NAFLD 的早期诊断提供新的希望。将 CK18 添加到广泛应用于临床的 NAFLD 诊断标准中，可能有助于检测 NAFLD 并进行早期有效干预。
