Non-alcoholic fatty liver disease (NAFLD), recently renamed metabolic dysfunction-associated fatty liver disease (MAFLD), is a spectrum of diseases ranging from non-alcoholic fatty liver (NAFL) to non-alcoholic steatohepatitis (NASH ).
Invasive liver biopsy continues to be the gold standard for the diagnosis of NASH through histopathological evaluation of hepatic steatosis, ballooning, and lobular inflammation. However, this method has its limitations, such as sampling bias, low patient acceptance, and potential complications. Clinical imaging techniques such as ultrasound and MRI can detect or quantify hepatic steatosis, but are unable to differentiate between NASH and NAFLD. Therefore, there is a need to identify non-invasive parameters associated with NASH that can serve as surrogate markers for these histological features.
in a study (https://doi.org/10.1016/j.livres.2023.11.002) was published in KeAi journal Liver Research, a group of Chinese researchers described sequential ultrasound molecular imaging (USMI), an emerging strategy to identify NASH by visualizing hepatic steatosis and inflammation. Specifically, discrete microbubbles (MBs) were used to target CD36 and ICAM-1 individually, instead of dual-targeting MBs. This approach allows differentiating the source of the signal (either steatosis or inflammation) and identifying the predominant pathological change.
As a non-invasive diagnostic tool, this strategy has the potential to aid clinical treatment decisions and contribute to drug development for NASH. In addition, among various USMI-based sequential diagnostic models, the serial test model showed high diagnostic performance in NASH detection, with 95% sensitivity, 97% specificity, 95% positive predictive values, 97% negative predictive values, and 96% accuracy.
Tinghui Yin, lead author of the study
CD36 is known to be associated with hepatic steatosis, while increased levels of ICAM-1 are observed in the progression of liver inflammation. Therefore, quantitative visualization of hepatic CD36 and ICAM-1 may provide valuable information to determine the extent of hepatic steatosis and inflammation. This achievement brings the researchers one step closer to the ultimate goal of creating a viable non-invasive approach to the detection of NASH.
Source:
Journal Reference:
Sha, T., et al. (2023). Sequential molecular ultrasound imaging for noninvasive identification and evaluation of nonalcoholic steatohepatitis in murine models. Liver Research. doi.org/10.1016/j.livres.2023.11.002.
