Fatty liver disease: new blood test for disease status
Non-alcoholic fatty liver disease is one of the most common chronic liver diseases in the world. The disease can have serious consequences. It is therefore particularly important to identify the persons concerned at an early stage. Researchers are now reporting a new blood test to determine the current state of the disease.
A research team has identified the role of a specific subtype of macrophages (white blood cells) in progressive non-alcoholic fatty liver disease. As part of the immune system, these cells have a protective function against liver fibrosis and cirrhosis and at the same time are suitable as biomarkers of liver disease progression which can be measured by blood tests. The results were published in the Journal of Hepatology.
About 30% of the European population is affected
According to a recent report from the Medical University (MedUni) of Vienna, non-alcoholic fatty liver disease is one of the most common chronic liver diseases worldwide and is estimated to affect approximately 30% of the European population. .
Chronic fatty liver disease can lead to irreversible cirrhosis of the liver, the only treatment for which is liver transplantation, which is why early detection of patients with non-alcoholic fatty liver disease is particularly important.
The development of the disease (pathogenesis) of non-alcoholic fatty liver disease, in particular advanced steatohepatitis (NASH, also: fatty liver hepatitis), is accompanied by severe changes in the immune cells of the liver.
The increased accumulation of a subtype of trap cells (macrophages), on the surface of which the TREM2 receptor is present in large quantities, has only recently been described in fatty liver disease. However, the role of TREM2 positive macrophages in fatty liver disease was not known until now.
Some scavenger cells have a protective function in fibrosis
A MedUni Vienna research team led by Christoph Binder and Tim Hendrikx from the Clinical Institute for Laboratory Medicine has now been able to show in an animal model that these specific scavenger cells have a protective function in fibrosis – a precursor to cirrhosis of the liver.
According to the information, these cells are increasingly found in the inflammatory processes of non-alcoholic fatty liver disease in the affected areas of the liver, where they accumulate especially in areas of cell damage and fibrosis.
Researchers were also able to show in bone marrow transplant models that hematopoietic TREM2 deficiency prevents efficient fat storage and the breakdown of excess connective tissue (extracellular matrix), leading to increased fatty liver disease (steatohepatitis ), cell death and fibrosis.
TREM2-positive macrophages therefore perform an important protective function in non-alcoholic fatty liver disease, where they prevent fat accumulation, inflammatory processes and disease progression to liver fibrosis.
"By enhancing this protective function of TREM2-positive macrophages, new therapeutic approaches for the treatment of fatty liver could be developed", explains Florentina Porsch, co-first author of the study.
Significantly better than previously used biomarkers
TREM2 is present in the body both as a membrane receptor on cells, but there is also a soluble form (sTREM2) that can be detected in the blood. The role of this soluble form in the immune system has not yet been elucidated.
However, scientists have found on a patient basis that it is suitable for determining current disease status and can differentiate between different stages of fatty liver hepatitis much better than previously used biomarkers.
"TREM2 in soluble form is an excellent biomarker to identify and indicate the state of advanced liver disease, which, if left untreated, can progress from fatty liver to incurable cirrhosis of the liver," explains the first author Tim Hendrikx from the Department of Laboratory Medicine at MedUni Vienna. (ad)
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This text corresponds to the specifications of the specialized medical literature, medical guidelines and current studies and has been verified by health professionals.
Sources:Medical University of Vienna: New Blood Test Identified for Fatty Liver Status, (Accessed: Jun 25, 2022), Medical University of Vienna Tim Hendrikx, Florentina Porsch, Máté G. Kiss, Dragana Rajčić, Nikolina Papac-Milicevic, Laura Göderle, Anastasiya Hladik, Constanze Hoebinger, Lisa E. Shaw, Hauke Horstmann, Sylvia Knapp, Sophia Derdak, Martin Bilban, Lena Heintz, Marcin Krawczyk, Rafael Paternostro, Michael Trauner, Matthias Farlik, Dennis Wolf, Christoph J. Binder: Soluble Levels of TREM2 reflect the recruitment and expansion of TREM2+ macrophages that localize in fibrotic areas and limit NASH; in: Journal of Hepatology, (published: 2022-06-20), Journal of Hepatology
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