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Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Nov 27, 2021; 13(11): 1494-1511
Published online Nov 27, 2021. doi: 10.4254/wjh.v13.i11.1494
Promising diagnostic biomarkers of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis: From clinical proteomics to microbiome
Carolina Castillo-Castro, Alexandro José Martagón-Rosado, Rocio Ortiz-Lopez, Luis Felipe Garrido-Treviño, Melissa Villegas-Albo, Francisco Javier Bosques-Padilla
Carolina Castillo-Castro, Alexandro José Martagón-Rosado, Rocio Ortiz-Lopez, Luis Felipe Garrido-Treviño, Melissa Villegas-Albo, Francisco Javier Bosques-Padilla, Tecnológico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey 64710, Mexico
Alexandro José Martagón-Rosado, Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición, Ciudad de México 14080, Mexico
Francisco Javier Bosques-Padilla, Centro Regional para el Estudio de las Enfermedades Digestivas, Servicio de Gastroenterología, Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico
Author contributions: Castillo-Castro C and Martagón-Rosado AJ wrote the paper; Garrido-Treviño LF and Villegas-Albo M made the illustrations; Ortiz-López R and Bosques-Padilla FJ reviewed and composed the final document.
Conflict-of-interest statement: The authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Francisco Javier Bosques-Padilla, PhD, Full Professor, Centro Regional para el Estudio de las Enfermedades Digestivas, Servicio de Gastroenterología, Facultad de Medicina y Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Ave. Madero y Gonzalitos S/N, Col. Mitras, Monterrey 64460, Mexico. fbosques58@hotmail.com
Received: February 24, 2021
Peer-review started: February 24, 2021
First decision: May 3, 2021
Revised: June 6, 2021
Accepted: October 14, 2021
Article in press: October 14, 2021
Published online: November 27, 2021
Processing time: 272 Days and 21.4 Hours
Abstract

Fatty liver has been present in the lives of patients and physicians for almost two centuries. Vast knowledge has been generated regarding its etiology and consequences, although a long path seeking novel and innovative diagnostic biomarkers for nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) is still envisioned. On the one hand, proteomics and lipidomics have emerged as potential noninvasive resources for NAFLD diagnosis. In contrast, metabolomics has been able to distinguish between NAFLD and NASH, even detecting degrees of fibrosis. On the other hand, genetic and epigenetic markers have been useful in monitoring disease progression, eventually functioning as target therapies. Other markers involved in immune dysregulation, oxidative stress, and inflammation are involved in the instauration and evolution of the disease. Finally, the fascinating gut microbiome is significantly involved in NAFLD and NASH. This review presents state-of-the-art biomarkers related to NAFLD and NASH and new promises that could eventually be positioned as diagnostic resources for this disease. As is evident, despite great advances in studying these biomarkers, there is still a long path before they translate into clinical benefits.

Keywords: Fatty liver; Biomarkers; Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis

Core Tip: Nonalcoholic fatty liver disease is increasing in prevalence worldwide. Liver biopsy is considered the gold standard for diagnosis, but it has several limitations. Given the burden on the healthcare system caused by liver fibrosis in a population with metabolic syndrome, there is a priority for noninvasive and accurate diagnostic biomarkers that differentiate patients with steatosis from those with nonalcoholic steatohepatitis, stage fibrosis, predict progression, and monitor treatment response. These biomarkers could assist clinicians in early interventions, avoiding complications and improving prognosis. Here, we summarize the current evidence and future directions.