Table 2.
Summary of recent biomarkers of ALD [76].
| Biomarkers | Summary | Methods of analysing | Uses |
|---|---|---|---|
| Biomarkers of Liver Cell Death and Regeneration | |||
| Cytokeratin 18 | Intracellular intermediate filament Protein released during hepatocyte damage | ELISA for M65 and M30 (circulating fragments of cytokeratin-18) | Predicts diagnosis, severity and prognosis of alcoholic hepatitis |
| Augmenter of Liver Regeneration (ALR) | Protein that promotes liver regeneration, decreased in advanced liver disease | ELISA for serum levels of ALR | Human studies pending; could be used to predict staging of the severity in ALD |
| Biomarkers of Immune Response | |||
| CD 163 | Macrophage receptor protein on Kupffer cells, which are increased in AH | ELISA for plasma concentrations of soluble CD163 | Potential to predict severity and prognosis of alcoholic hepatitis |
| ST2 Receptor | Protein receptors in inflammatory cascade found in hepatocyte inflammation and fibrosis | ELISA for plasma soluble ST2 receptors | Possible therapeutic target; predicts ongoing liver inflammation, staging of ALD severity |
| TNF- related Apoptosis inducing ligand (TRAIL) | Inflammatory cytokine released by the Kupffer cells activation, seen in hepatocyte injury | Western blot for serum levels of TRAIL | Potential to predict severity of alcoholic hepatitis; ongoing research a possible therapeutic target |
| Immunoglobulins (IgM, IgG, IgA) | Increased in AH | Quantitative serum immunoglobulin tests | Can be used to predict severity of alcoholic hepatitis; |
| MicroRNAs (MiR-155, MiR-223) | Noncoding RNAs that regulate expression of their respective target messenger RNA; miR-155 deficiency attenuates chronic alcohol-induced liver injury; MiR-223 is found in neutrophils and increased in AUD | Quantitative PCR for miRNA levels | Can be used to predict severity and prognosis of alcoholic hepatitis; ongoing research as possible therapeutic target |
| Biomarkers of Metabolic Changes | |||
| Stearoyl-CoA desaturase 1 (SCD1) | Rate-limiting enzyme that catalyzes the formation of monounsaturated fatty acids and reduced lipid synthesis, influences hepatic inflammation | SCD1 activity can be measured indirectly by the palmitoleic acid to palmitic acid ratio via serum lipid measurements | Ongoing research as possible therapeutic target for early ALD |
| Magnesium | Electrolyte, which is decreased in alcohol use and liver disease | Serum levels | Could predict onset and staging of ALD |
| Uric acid | Breakdown product of purine metabolism, which is elevated in alcohol use and liver disease | Serum levels | Pro-inflammatory pathological could be used to predict severity in ALD |
| Biomarkers of Chemical Causes | |||
| Acrolein | Toxic metabolite of alcohol metabolism, which accumulates in ALD | Urine tandem mass spectrometry detects the catabolic product of acrolein, 3 hydroxypropyl mercapturic acid (3HMP) | Can be used to predict severity of alcoholic hepatitis |
| Resolvins | Lipid mediators that counter-regulate proinflammatory responses, decreased in ALD | ELISA for serum levels of resolvins | Could predict inflammation and severity of alcoholic hepatitis; ongoing research as possible therapeutic target |