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是否即将出现诊断奇迹?非酒精性脂肪性肝病中的新兴生物标志物。

Is There a Diagnostic Miracle on the Horizon? Emerging Biomarkers in MASLD.

作者信息

Iwaszko-Sochal Klaudyna, Kasztelan-Szczerbińska Beata, Cichoż-Lach Halina

机构信息

Department of Gastroenterology and Hepatology with Endoscopy Unit, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland.

出版信息

J Clin Med. 2025 Aug 30;14(17):6148. doi: 10.3390/jcm14176148.

Abstract

The incidence and prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) are increasing, and, currently, the disease affects approximately 30% of the global population. Therefore, there is a growing need for widely available, patient-friendly, and reliable diagnostic tools. Our review is focused on the presentation and discussion of emerging biomarkers for evaluation and non-invasive detection of liver fibrosis in patients with MASLD, including glycation markers (AGEs/sRAGE), lipid mediators (eicosanoids), fetuin-A, collagen turnover markers (PRO-C3, ADAPT), and omic-based technologies. As reported recently, some of these parameters revealed high diagnostic accuracy in clinical trials, so they may be incorporated as key diagnostic tools in the future MASLD approach. Employment of such biomarkers may enable correct and quick identification of MASLD and/or MASH patients, as well as better monitoring of their treatment response. The development of precision medicine, driven by multiomics and individualized profiling, promises a rearrangement from the traditional "one size fits all" to tailoring targeted care, as environmental factors may have an even more relevant impact on MASLD pathogenesis in comparison with genetic predisposition. Nevertheless, to enable their widespread clinical use, novel biomarkers require further rigorous validation and standardized implementation in healthcare settings.

摘要

代谢功能障碍相关脂肪性肝病(MASLD)的发病率和患病率正在上升,目前,该疾病影响着全球约30%的人口。因此,对广泛可用、患者友好且可靠的诊断工具的需求日益增加。我们的综述重点介绍和讨论用于评估和无创检测MASLD患者肝纤维化的新兴生物标志物,包括糖基化标志物(晚期糖基化终末产物/可溶性晚期糖基化终末产物受体)、脂质介质(类花生酸)、胎球蛋白-A、胶原周转标志物(前胶原3、ADAPT)以及基于组学的技术。最近有报道称,其中一些参数在临床试验中显示出较高的诊断准确性,因此它们可能会被纳入未来MASLD诊疗方法的关键诊断工具中。使用此类生物标志物可以正确、快速地识别MASLD和/或非酒精性脂肪性肝炎患者,并更好地监测他们的治疗反应。由多组学和个体化分析驱动的精准医学发展有望从传统的“一刀切”模式转变为定制靶向治疗,因为与遗传易感性相比,环境因素可能对MASLD发病机制产生更重要的影响。然而,为了使其能够在临床上广泛应用,新型生物标志物需要在医疗环境中进一步进行严格验证和标准化实施。

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