Chronic liver disease: life-threatening and progressive
Millions of people worldwide suffer from chronic liver disease. The major causes are infection by one of the hepatitis viruses and excessive use of alcohol. The liver is a very complex organ, where more than 500 metabolic functions take place, including clearing toxic substances from our body and producing proteins that coagulate the blood following wounds. Liver problems have a high rate of incidence and - after cancer and cardiovascular disorders - they are the third cause of death among people between 40 and 65.
The most problematic aspect of chronic liver disease is liver fibrosis, in which connective tissue grows throughout the liver, disrupting the composition of this complex organ and, in time, its functioning as well. Depending on its cause and on the patient, liver fibrosis can evolve rapidly or slowly. There are several distinct stages. One of the final stages is cirrhosis of the liver. When a patient develops cirrhosis, the chance of liver cancer rises sharply (25 to 40 times higher than normal) and in a very advanced stage the liver is no longer able to function. The only possibility at that point is a liver transplant - an extremely complicated intervention.
Current treatment is problematic
In order to decide which treatment is appropriate for a particular patient with liver fibrosis, doctors need to know which stage the liver disease is in. As soon as cirrhosis has set in, they will want to start tracking the possible development of liver cancer, which can occur at any moment. Of course, early detection and appropriate treatment is vital. But this is precisely the problem. Today, the only way to detect cirrhosis is through a biopsy - where a tissue sample is taken by injecting a needle through the skin into the liver. Biopsy is not entirely risk-free and is very expensive (about 1500 euro per patient).
Ghent discovery enables quick, inexpensive test
VIB researcher Nico Callewaert and his colleagues in the team of Roland Contreras (Dept. for Molecular Biomedical Research, Ghent University) have developed a new method that only requires a little blood in order to detect the cirrhosis stage reliably. In a test group of patients, the researchers succeeded in detecting 70 - 80% of the early liver cirrhoses. Not a single patient was diagnosed incorrectly. The new test detects changes in the quantities of the various sugars that are produced by the liver, which occur in the transition from fibrosis to cirrhosis. The researchers have been able to measure the sugar changes quite accurately with advanced instrumentation that is already being used in clinical laboratories, but for genetic tests.
A hopeful future
The test is now being perfected. Through future collaborations with industry, the researchers hope to arrive at a test that is easy to use and that shows 100% specificity for cirrhosis of the liver. The test could then be used to follow people with chronic hepatitis C viral infection. Often, 10 years can pass between the first diagnosis and the development of cirrhosis of the liver. An annual test could quickly detect a change and be able to predict an early stage of cirrhosis. Nico Callewaert comments: 'We hope to be able to alert patients when the chance of liver cancer increases sharply. At that moment, the doctor can test frequently for the presence of cancer cells and detect the cancer early enough so that the patient can quite possibly be helped.'
Note to the Editor:
VIB, the Flanders Interuniversity Institute for Biotechnology, is a research institute where 800 scientists conduct gene technological research in a number of life-science domains, such as human health care and plant systems biology. Through a joint venture with four Flemish universities (Ghent University, the Catholic University of Leuven, the University of Antwerp, and the Free University of Brussels) and a solid funding program for strategic basic research, VIB unites the forces of nine university science departments in a single institute. VIB also manages an extensive patent portfolio and distributes scientifically substantiated information about all aspects of biotechnology to a broad public.