Biomarkers in Liver Disease: From Diagnosis to Prognosis

A study published in Afro-Egypt J Infect Endem Dis under the title of Serum MiRNA-122 as a Diagnostic Marker in HCV Related Liver Cirrhosis aimed to evaluate serum miRNA-122 expression as a potential biomarker for diagnosis and monitoring different stages of disease in chronic hepatitis C patients. The study revealed that miRNA-122 expression levels were significantly increased among liver disease patients than healthy controls. Furthermore, miRNA-122 expression levels were significantly higher in the compensated patients compared to the decompensated patients. Also, this study elucidated that serum miRNA-122 levels were decreased with the progression of liver disease (from Child-Pugh class A to C) but without reaching to a significant difference. According to an interesting study published in the current issue of the Afro-Egyptian Journal of Infectious and Endemic Disease Presepsin and Resistin as Diagnostic Markers for Bacterial Infection in Patients with Decompensated CirrhosisPresepsin and resistin were significantly higher among patients with infection and positively correlated with Model for End-stage Liver Disease score (MELD), Child-pough score (CPS), CRP and PCT. At 1205 pg/ml as cutoff, Presepsin could predict infection at sensitivity 83.8%, specificity 93% and accuracy 88.7%. While using 21ng/ml as cutoff, Resistin could predict infection at sensitivity 64.6%, specificity 68.4% and accuracy 66.7%. Adding CRP to PCT or presepsin increased sensitivity to 99%, specificity 73.7%, and accuracy 85.4%. Adding presepsin to PCT or resistin increased sensitivity to 94.9%. Yet combined presepsin and PCT had higher specificity than combined presepsin and resistin. Conclusion: Presepsin has comparable diagnostic performances to CRP and PCT for bacterial infection in decompensated cirrhosis while resistin has poor sensitivity and specificity. Adding presepsin to CRP yields the same diagnostic performance as combined CRP and PCT. So, combining any of them to CRP helps to early diagnose bacterial infection in those patients