Serum Hyaluronic Acid and Laminin as Biomarkers in Liver Fibrosis

Abstract

Background and Aim: Non-invasive methods have been proposed as surrogate markers for liver biopsy. It was shown that serum hyaluronic acid (HA) and laminin (LN) levels increase with the development of liver fibrosis. The aim of this study was to determine serum HA and LN levels cut-off points for predicting liver fibrosis, highlighting their diagnostic value and their changes during treatment.

Methods: Serum HA and LN levels in chronic hepatitis patients (n=62) and controls (n=20) were assessed by ELISA and liver histopathological parameters were evaluated by the modified Knodell score.

Results: Mean serum HA (113.4±59.2 ng/ml) and LN (91.9±20.9 ng/ml) concentrations in patients were greater than in controls (46.6±10.5 and 46.1±10.1 ng/ml, p<0.001). A strong correlation between serum HA and LN concentrations with hepatic necroinflammatory lesions was found (p<0.001). A cut-off point of 59.5 ng/ml HA and 52.0 ng/ml LN for the discrimination of patients with liver fibrosis from healthy controls and 102.0 ng/ml HA and 92.5 ng/ml LN for the discrimination of patients with mild from severe fibrosis showed acceptable AUC, sensitivity and specificity. After six months of treatment, a gradual decrease in serum HA and LN levels was observed, however the levels were still higher than those of the controls (p<0.05).

Conclusions: Serum hyaluronic acid and laminin concentrations increase in liver fibrosis and could be used as a noninvasive biomarker to discriminate between patients with liver fibrosis and healthy individuals.