Colosimo S, Tomlinson JW. Bile acids as drivers and biomarkers of hepatocellular carcinoma. World J Hepatol 2022; 14(9): 1730-1738 [PMID: 36185719 DOI: 10.4254/wjh.v14.i9.1730]
Corresponding Author of This Article
Jeremy W Tomlinson, FRCP, PhD, Professor, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, NIHR Oxford Biomedical Research Centre, Churchill Hospital, Oxford OX3 7LE, United Kingdom. jeremy.tomlinson@ocdem.ox.ac.uk
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
World J Hepatol. Sep 27, 2022; 14(9): 1730-1738 Published online Sep 27, 2022. doi: 10.4254/wjh.v14.i9.1730
Bile acids as drivers and biomarkers of hepatocellular carcinoma
Santo Colosimo, Jeremy W Tomlinson
Santo Colosimo, Jeremy W Tomlinson, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford OX3 7LE, United Kingdom
Santo Colosimo, School of Nutrition Science, University of Milan, Milan 20133, Italy
Author contributions: All authors have read and approve the final manuscript.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jeremy W Tomlinson, FRCP, PhD, Professor, Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, NIHR Oxford Biomedical Research Centre, Churchill Hospital, Oxford OX3 7LE, United Kingdom. jeremy.tomlinson@ocdem.ox.ac.uk
Received: May 30, 2022 Peer-review started: May 30, 2022 First decision: July 13, 2022 Revised: July 18, 2022 Accepted: August 16, 2022 Article in press: August 16, 2022 Published online: September 27, 2022
Abstract
The prevalence of hepatocellular carcinoma (HCC) is rapidly increasing, driven not least in part by the escalating prevalence of non-alcoholic fatty liver disease. Bile acid (BA) profiles are altered in patients with HCC and there is a developing body of evidence from in vitro human cellular models as well as rodent data suggesting that BA are able to modulate fundamental processes that impact on cellular phenotype predisposing to the development of HCC including senescence, proliferation and epithelial-mesenchymal transition. Changes in BA profiles associated with HCC have the potential to be exploited clinically. Whilst excellent diagnostic and imaging tools are available, their use to screen populations with advanced liver disease at risk of HCC is limited by high cost and low availability. The mainstay for HCC screening among subjects with cirrhosis remains frequent interval ultrasound scanning. Importantly, currently available serum biomarkers add little to diagnostic accuracy. Here, we review the current literature on the use of BA measurements as predictors of HCC incidence in addition to their use as a potential screening method for the early detection of HCC. Whilst these approaches do show early promise, there are limitations including the relatively small cohort sizes, the lack of a standardized approach to BA measurement, and the use of inappropriate control comparator samples.
Core Tip: The rapidly increasing prevalence of hepatocellular carcinoma (HCC) highlights the unmet clinical need to develop and enhance early diagnostic strategies. Evidence from rodent and in vitro models suggests that bile acids may have a crucial role in the pathogenesis of HCC. Changes in circulating bile acid profiles are observed in patients with HCC. Serum and urine bile acid profiles may predict HCC risk and may have potential as a non-invasive screening tool.
