Rasmussen said that, at present, liver patients regularly have invasive core-needle biopsies to check their transplanted liver. Strong antiviral drugs are available to try to offset hepatitis C liver damage, she explained, but these are not always effective and usually have harsh side effects. Surgeons have been hoping for a test that could indicate if a patient was likely to do well with less aggressive treatment. This knowledge might spare the patient from unnecessary repeat biopsies and the most potent antiviral regimens, which impose severe, flu-like discomfort, chronic fatigue, depression and anemia.
She added that the discovery of the protein and molecular markers of hepatitis-induced liver injuries was an important first step, but not yet a solution. More research would have to be conducted for evidence of the markers' usefulness in clinical decision making before a practical lab test for patient could be designed.
The two research teams led by Rasmussen and Diamond took different, highly sophisticated approaches to find prognostic markers. The Diamond group performed global protein analyses of liver biopsies taken at 6 months and a year after transplantation. State-of-the art mass spectrometry methods and computational modeling directed them to 250 proteins, out of 4,324 originally uncovered, whose regulation was markedly different in patients with rapidly progressing fibrosis. These patients showed an enrichment of regulatory proteins associated with various immune, liver-protective, and fibrosis-generating processes. The researchers also observed an increase in proinflammatory activity and impairment in antioxidant defenses.
This particular protein-abundance and protein-activity profile occurred in patients who developed severe liver injury. The findings, Diamond and her team noted in their paper, might prove useful in prognosis if they lead to applications for pre
|Contact: Leila Gray|
University of Washington