Possible New Way To Detect, Monitor Liver Disease
Scientists working at the Hepatitis B Foundation, in partnership with Drexel University College of Medicine, think they may have discovered a reliable alternative to liver biopsy for the early detection of liver fibrosis and cirrhosis, which afflict more than 5 million Americans. People with hepatitis B and C infections, as well as fatty liver diseases, are at greatest risk for progressing to cirrhosis that can lead to liver cancer.
Successful treatment depends on the early detection of fibrosis and cirrhosis. Currently, detection involves a surgical liver biopsy, which is an unpleasant, expensive procedure and carries some risk. Patients and doctors would prefer tests that are "not invasive" such as a blood test to detect and monitor liver disease.
Lead investigators Drs. Anand Mehta and Timothy Block report in the upcoming Journal of Virology, which appears online next week and in print February 2008, their discovery that the blood of most, if not all, people they tested with a diagnosis of liver cirrhosis, contains high levels of a special antibody that recognizes a carbohydrate sugar commonly found on bacteria. Detection of this antibody in the blood of an affected person correlates very well with a diagnosis of increasing fibrosis and cirrhosis in the new study.
"This is a fascinating discovery and is important because, if confirmed, the test could help us replace liver biopsy as a method for staging liver disease. In addition, it may be teaching us something about how liver disease occurs," said David Thomas, M.D., Chief, Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD.
Working with the National Cancer Institute (NCI) Early Detection Research Network, the researchers have been able to test this approach in 300 blood samples from people with liver disease, and can conduct the new test in thousands. Although the test is still experimental and more is needed before it can be used to monitor disease, the discovery is promising.
"If this work is validated, it may offer a new, non-invasive way to test for liver disease, allowing people to either avoid biopsy or to know when they really need one. It also implies that bacteria may have a much bigger role in initiating liver disease than realized, and even lead to new therapies," said Block.