Skip to main content
main-content
Erschienen in: Gastro-News 5/2022

20.10.2022 | Fettleber | Zertifizierte Fortbildung

Hepatologie

Leberfibrose - Diagnostik und innovative Therapieansätze

verfasst von: Dr. Dr. med. Natascha Röhlen, Prof. Dr. med. Robert Thimme, Prof. Dr. med. Tobias Böttler

Erschienen in: Gastro-News | Ausgabe 5/2022

zum CME-Kurs Einloggen, um Zugang zu erhalten

Auszug

Die Leberfibrose ist die prognostisch entscheidende Komplikation fast aller chronischen Lebererkrankungen. Sie beeinflusst maßgeblich den klinischen Verlauf. Daher sollten Patienten mit chronischer Lebererkrankung zwingend auf eine Fibrose untersucht werden. Nicht invasive Methoden zur Erfassung des Fibrosegrades erlauben anhand anthropometrischer Daten, physikalischer Parameter und laborchemischer Parameter der Leberfunktion eine Abschätzung des Fibroserisikos sowie des Risikos Fibrose-assoziierter Komplikationen bei chronischen Lebererkrankungen unterschiedlicher Ätiologie.
Literatur
1.
Zurück zum Zitat Marcellin P, Kutala BK. Liver diseases: A major, neglected global public health problem requiring urgent actions and large-scale screening. Liver Int. 2018;38:Suppl 1:2-6. Marcellin P, Kutala BK. Liver diseases: A major, neglected global public health problem requiring urgent actions and large-scale screening. Liver Int. 2018;38:Suppl 1:2-6.
2.
Zurück zum Zitat Kim D et al. Changing Trends in Etiology-Based Annual Mortality From Chronic Liver Disease, From 2007 Through 2016. Gastroenterology. 2018;155(4):1154-63.e3. Kim D et al. Changing Trends in Etiology-Based Annual Mortality From Chronic Liver Disease, From 2007 Through 2016. Gastroenterology. 2018;155(4):1154-63.e3.
3.
Zurück zum Zitat Urban S et al. Hepatitis D virus in 2021: virology, immunology and new treatment approaches for a difficult-to-treat disease. Gut. 2021;70(9):1782-94. Urban S et al. Hepatitis D virus in 2021: virology, immunology and new treatment approaches for a difficult-to-treat disease. Gut. 2021;70(9):1782-94.
4.
Zurück zum Zitat Bataller R et al. Liver fibrosis. J Clin Invest. 2005;115(2):209-18. Bataller R et al. Liver fibrosis. J Clin Invest. 2005;115(2):209-18.
5.
Zurück zum Zitat Rockey DCet al. Fibrosis--a common pathway to organ injury and failure. N Engl J Med. 2015;372(12):1138-49. Rockey DCet al. Fibrosis--a common pathway to organ injury and failure. N Engl J Med. 2015;372(12):1138-49.
6.
Zurück zum Zitat Roehlen N et al. Liver Fibrosis: Mechanistic Concepts and Therapeutic Perspectives. Cells. 2020;9(4):875. Roehlen N et al. Liver Fibrosis: Mechanistic Concepts and Therapeutic Perspectives. Cells. 2020;9(4):875.
7.
Zurück zum Zitat Bataller R et al. Hepatitis C virus core and nonstructural proteins induce fibrogenic effects in hepatic stellate cells. Gastroenterology. 2004;126(2):529-40. Bataller R et al. Hepatitis C virus core and nonstructural proteins induce fibrogenic effects in hepatic stellate cells. Gastroenterology. 2004;126(2):529-40.
8.
Zurück zum Zitat Saile Bet al. Fibrogenese-Zirrhose. Gastroenterologe.2007;4:228-37. Saile Bet al. Fibrogenese-Zirrhose. Gastroenterologe.2007;4:228-37.
9.
Zurück zum Zitat EASL Clinical Practice Guideline Panel. EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis - 2021 update. J Hepatol. 2021;75(3):659-89. EASL Clinical Practice Guideline Panel. EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis - 2021 update. J Hepatol. 2021;75(3):659-89.
10.
Zurück zum Zitat Boyum JH et al. Incidence and Risk Factors for Adverse Events Related to Image-Guided Liver Biopsy. Mayo Clin Proc. 2016;91(3):329-35. Boyum JH et al. Incidence and Risk Factors for Adverse Events Related to Image-Guided Liver Biopsy. Mayo Clin Proc. 2016;91(3):329-35.
11.
Zurück zum Zitat Schwarzer R, Ferlitsch A. Liver Biopsy-Transjugular. Clin Liver Dis (Hoboken). 2014;4(5):113-5. Schwarzer R, Ferlitsch A. Liver Biopsy-Transjugular. Clin Liver Dis (Hoboken). 2014;4(5):113-5.
12.
Zurück zum Zitat Roeb AE et al. Leitlinie der aktualisierten S2k-Leitlinie nicht-alkoholische Fettlebererkrankung der Deutschen Gesellschaft für Gastroenterologie, Verdauungs-und Stoffwechselkrankheiten (DGVS). April 2022 - AWMF-Registernummer: 021-025 Roeb AE et al. Leitlinie der aktualisierten S2k-Leitlinie nicht-alkoholische Fettlebererkrankung der Deutschen Gesellschaft für Gastroenterologie, Verdauungs-und Stoffwechselkrankheiten (DGVS). April 2022 - AWMF-Registernummer: 021-025
13.
Zurück zum Zitat Goodman ZD. Grading and staging systems for inflammation and fibrosis in chronic liver diseases. J Hepatol. 2007;47(4):598-607. Goodman ZD. Grading and staging systems for inflammation and fibrosis in chronic liver diseases. J Hepatol. 2007;47(4):598-607.
14.
Zurück zum Zitat Shah AG et al. Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2009;7(10):1104-12. Shah AG et al. Comparison of noninvasive markers of fibrosis in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol. 2009;7(10):1104-12.
15.
Zurück zum Zitat Peleg N et al. AST to Platelet Ratio Index and fibrosis 4 calculator scores for non-invasive assessment of hepatic fibrosis in patients with non-alcoholic fatty liver disease. Dig Liver Dis. 2017;49(10):1133-8. Peleg N et al. AST to Platelet Ratio Index and fibrosis 4 calculator scores for non-invasive assessment of hepatic fibrosis in patients with non-alcoholic fatty liver disease. Dig Liver Dis. 2017;49(10):1133-8.
16.
Zurück zum Zitat Boursier J et al. Diagnostic accuracy and prognostic significance of blood fibrosis tests and liver stiffness measurement by FibroScan in non-alcoholic fatty liver disease. J Hepatol. 2016;65(3):570-8. Boursier J et al. Diagnostic accuracy and prognostic significance of blood fibrosis tests and liver stiffness measurement by FibroScan in non-alcoholic fatty liver disease. J Hepatol. 2016;65(3):570-8.
17.
Zurück zum Zitat Catanzaro R et al. FIB-4 and APRI scores for predicting severe liver fibrosis in chronic hepatitis HCV patients: a monocentric retrospective study. Clin Exp Hepatol. 2021;7(1):111-6. Catanzaro R et al. FIB-4 and APRI scores for predicting severe liver fibrosis in chronic hepatitis HCV patients: a monocentric retrospective study. Clin Exp Hepatol. 2021;7(1):111-6.
18.
Zurück zum Zitat Leroy V et al. Prospective evaluation of FibroTest®, FibroMeter®, and HepaScore® for staging liver fibrosis in chronic hepatitis B: comparison with hepatitis C. J Hepatol. 2014;61(1):28-34. Leroy V et al. Prospective evaluation of FibroTest®, FibroMeter®, and HepaScore® for staging liver fibrosis in chronic hepatitis B: comparison with hepatitis C. J Hepatol. 2014;61(1):28-34.
19.
Zurück zum Zitat Angulo P et al. The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology. 2007;45(4):846-54. Angulo P et al. The NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology. 2007;45(4):846-54.
20.
Zurück zum Zitat Ruffillo G et al. Comparison of NAFLD fibrosis score and BARD score in predicting fibrosis in nonalcoholic fatty liver disease. J Hepatol. 2011 Jan;54(1):160-3. Ruffillo G et al. Comparison of NAFLD fibrosis score and BARD score in predicting fibrosis in nonalcoholic fatty liver disease. J Hepatol. 2011 Jan;54(1):160-3.
21.
Zurück zum Zitat Shaheen AAM et al. FibroTest and FibroScan for the prediction of hepatitis C-related fibrosis: a systematic review of diagnostic test accuracy. Am J Gastroenterol. 2007;102(11):2589-600. Shaheen AAM et al. FibroTest and FibroScan for the prediction of hepatitis C-related fibrosis: a systematic review of diagnostic test accuracy. Am J Gastroenterol. 2007;102(11):2589-600.
22.
Zurück zum Zitat Chen J, Liu C, Chen H, Liu Q, Yang B, Ou Q. Study on noninvasive laboratory tests for fibrosis in chronic HBV infection and their evaluation. J Clin Lab Anal. 2013 Jan;27(1):5-11. Chen J, Liu C, Chen H, Liu Q, Yang B, Ou Q. Study on noninvasive laboratory tests for fibrosis in chronic HBV infection and their evaluation. J Clin Lab Anal. 2013 Jan;27(1):5-11.
23.
Zurück zum Zitat Moreno C et al. Non-invasive diagnosis and biomarkers in alcohol-related liver disease. J Hepatol. 2019;70(2):273-83. Moreno C et al. Non-invasive diagnosis and biomarkers in alcohol-related liver disease. J Hepatol. 2019;70(2):273-83.
24.
Zurück zum Zitat Calès P et al. A novel panel of blood markers to assess the degree of liver fibrosis. Hepatology. 2005;42(6):1373-81. Calès P et al. A novel panel of blood markers to assess the degree of liver fibrosis. Hepatology. 2005;42(6):1373-81.
25.
Zurück zum Zitat Halfon P et al. Comparison of test performance profile for blood tests of liver fibrosis in chronic hepatitis C. J Hepatol. 2007;46(3):395-402. Halfon P et al. Comparison of test performance profile for blood tests of liver fibrosis in chronic hepatitis C. J Hepatol. 2007;46(3):395-402.
26.
Zurück zum Zitat Calès P et al. Comparison of blood tests for liver fibrosis specific or not to NAFLD. J Hepatol. 2009;50(1):165-73. Calès P et al. Comparison of blood tests for liver fibrosis specific or not to NAFLD. J Hepatol. 2009;50(1):165-73.
27.
Zurück zum Zitat Guha IN et al. Noninvasive markers of fibrosis in nonalcoholic fatty liver disease: Validating the European Liver Fibrosis Panel and exploring simple markers. Hepatology. 2008;47(2):455-60 Guha IN et al. Noninvasive markers of fibrosis in nonalcoholic fatty liver disease: Validating the European Liver Fibrosis Panel and exploring simple markers. Hepatology. 2008;47(2):455-60
28.
Zurück zum Zitat Rosenberg WMC et al. Serum markers detect the presence of liver fibrosis: a cohort study. Gastroenterology. 2004;127(6):1704-13. Rosenberg WMC et al. Serum markers detect the presence of liver fibrosis: a cohort study. Gastroenterology. 2004;127(6):1704-13.
29.
Zurück zum Zitat Zhang YNet al. Liver fibrosis imaging: A clinical review of ultrasound and magnetic resonance elastography. J Magn Reson Imaging. 2020;51(1):25-42. Zhang YNet al. Liver fibrosis imaging: A clinical review of ultrasound and magnetic resonance elastography. J Magn Reson Imaging. 2020;51(1):25-42.
30.
Zurück zum Zitat Fallatah HI. Noninvasive Biomarkers of Liver Fibrosis: An Overview. Advances in Hepatology. 2014 Apr 15;2014:1-15. Fallatah HI. Noninvasive Biomarkers of Liver Fibrosis: An Overview. Advances in Hepatology. 2014 Apr 15;2014:1-15.
31.
Zurück zum Zitat Castéra L et al. Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology. 2005;128(2):343-50. Castéra L et al. Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology. 2005;128(2):343-50.
32.
Zurück zum Zitat Vergara S et al. The use of transient elastometry for assessing liver fibrosis in patients with HIV and hepatitis C virus coinfection. Clin Infect Dis. 2007 Oct 15;45(8):969-74. Vergara S et al. The use of transient elastometry for assessing liver fibrosis in patients with HIV and hepatitis C virus coinfection. Clin Infect Dis. 2007 Oct 15;45(8):969-74.
33.
Zurück zum Zitat Marcellin P et al. Non-invasive assessment of liver fibrosis by stiffness measurement in patients with chronic hepatitis B. Liver Int. 2009 Feb;29(2):242-7. Marcellin P et al. Non-invasive assessment of liver fibrosis by stiffness measurement in patients with chronic hepatitis B. Liver Int. 2009 Feb;29(2):242-7.
34.
Zurück zum Zitat Corpechot C et al. Assessment of biliary fibrosis by transient elastography in patients with PBC and PSC. Hepatology. 2006;43(5):1118-24. Corpechot C et al. Assessment of biliary fibrosis by transient elastography in patients with PBC and PSC. Hepatology. 2006;43(5):1118-24.
35.
Zurück zum Zitat Yoneda M et al. Transient elastography in patients with non-alcoholic fatty liver disease (NAFLD). Gut. 2007;56(9):1330-1. Yoneda M et al. Transient elastography in patients with non-alcoholic fatty liver disease (NAFLD). Gut. 2007;56(9):1330-1.
36.
Zurück zum Zitat Nahon P et al. Assessment of liver fibrosis using transient elastography in patients with alcoholic liver disease. J Hepatol. 2008;49(6):1062-8. Nahon P et al. Assessment of liver fibrosis using transient elastography in patients with alcoholic liver disease. J Hepatol. 2008;49(6):1062-8.
37.
Zurück zum Zitat Herrmann E et al. Assessment of biopsy-proven liver fibrosis by two-dimensional shear wave elastography: An individual patient data-based meta-analysis. Hepatology. 2018;67(1):260-72. Herrmann E et al. Assessment of biopsy-proven liver fibrosis by two-dimensional shear wave elastography: An individual patient data-based meta-analysis. Hepatology. 2018;67(1):260-72.
38.
Zurück zum Zitat Lassailly G et al. Bariatric Surgery Provides Long-term Resolution of Nonalcoholic Steatohepatitis and Regression of Fibrosis. Gastroenterology. 2020;159(4):1290-1301.e5. Lassailly G et al. Bariatric Surgery Provides Long-term Resolution of Nonalcoholic Steatohepatitis and Regression of Fibrosis. Gastroenterology. 2020;159(4):1290-1301.e5.
39.
Zurück zum Zitat Marcellin P et al. Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study. Lancet. 2013;381(9865):468-75. Marcellin P et al. Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study. Lancet. 2013;381(9865):468-75.
40.
Zurück zum Zitat D'Ambrosio R et al. A morphometric and immunohistochemical study to assess the benefit of a sustained virological response in hepatitis C virus patients with cirrhosis. Hepatology. 2012;56(2):532-43. D'Ambrosio R et al. A morphometric and immunohistochemical study to assess the benefit of a sustained virological response in hepatitis C virus patients with cirrhosis. Hepatology. 2012;56(2):532-43.
41.
Zurück zum Zitat Younossi ZM et al. Obeticholic acid for the treatment of non-alcoholic steatohepatitis: interim analysis from a multicentre, randomised, placebo-controlled phase 3 trial. Lancet. 2019;394(10215):2184-96. Younossi ZM et al. Obeticholic acid for the treatment of non-alcoholic steatohepatitis: interim analysis from a multicentre, randomised, placebo-controlled phase 3 trial. Lancet. 2019;394(10215):2184-96.
42.
Zurück zum Zitat Manatsathit W et al. Accuracy of liver stiffness, spleen stiffness, and LS-spleen diameter to platelet ratio score in detection of esophageal varices: Systemic review and meta-analysis. J Gastroenterol Hepatol. 2018;33(10):1696-706. Manatsathit W et al. Accuracy of liver stiffness, spleen stiffness, and LS-spleen diameter to platelet ratio score in detection of esophageal varices: Systemic review and meta-analysis. J Gastroenterol Hepatol. 2018;33(10):1696-706.
43.
Zurück zum Zitat de Franchis R et al. Baveno VII - Renewing consensus in portal hypertension. J Hepatol. 2022 Apr;76(4):959-74. de Franchis R et al. Baveno VII - Renewing consensus in portal hypertension. J Hepatol. 2022 Apr;76(4):959-74.
44.
Zurück zum Zitat Marasco G et al. Spleen stiffness measurement for assessing the response to β-blockers therapy for high-risk esophageal varices patients. Hepatol Int. 2020 Sep;14(5):850-7. Marasco G et al. Spleen stiffness measurement for assessing the response to β-blockers therapy for high-risk esophageal varices patients. Hepatol Int. 2020 Sep;14(5):850-7.
45.
Zurück zum Zitat Wang J et al. Liver stiffness measurement predicted liver-related events and all-cause mortality: A systematic review and nonlinear dose-response meta-analysis. Hepatol Commun. 2018;2(4):467-76. Wang J et al. Liver stiffness measurement predicted liver-related events and all-cause mortality: A systematic review and nonlinear dose-response meta-analysis. Hepatol Commun. 2018;2(4):467-76.
46.
Zurück zum Zitat Singh S et al. Liver stiffness is associated with risk of decompensation, liver cancer, and death in patients with chronic liver diseases: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2013;11(12):1573-84.e1-2; quiz e88-9. Singh S et al. Liver stiffness is associated with risk of decompensation, liver cancer, and death in patients with chronic liver diseases: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2013;11(12):1573-84.e1-2; quiz e88-9.
47.
Zurück zum Zitat Bitzer M et al. S3-Leitlinie - Diagnostik und Therapie des Hepatozellulären Karzinoms.Langversion 2.0 - Juni 2021 AWMF-Registernummer: 032 - 053OL Bitzer M et al. S3-Leitlinie - Diagnostik und Therapie des Hepatozellulären Karzinoms.Langversion 2.0 - Juni 2021 AWMF-Registernummer: 032 - 053OL
48.
Zurück zum Zitat Harrison SA et al. Selonsertib for patients with bridging fibrosis or compensated cirrhosis due to NASH: Results from randomized phase III STELLAR trials. J Hepatol. 2020;73(1):26-39. Harrison SA et al. Selonsertib for patients with bridging fibrosis or compensated cirrhosis due to NASH: Results from randomized phase III STELLAR trials. J Hepatol. 2020;73(1):26-39.
49.
Zurück zum Zitat Guirguis E et al. Emerging therapies for the treatment of nonalcoholic steatohepatitis: A systematic review. Pharmacotherapy. 2021;41(3):315-28. Guirguis E et al. Emerging therapies for the treatment of nonalcoholic steatohepatitis: A systematic review. Pharmacotherapy. 2021;41(3):315-28.
50.
Zurück zum Zitat Harrison SA et al. Effects of Resmetirom on Noninvasive Endpoints in a 36-Week Phase 2 Active Treatment Extension Study in Patients With NASH. Hepatol Commun. 2021;5(4):573-88. Harrison SA et al. Effects of Resmetirom on Noninvasive Endpoints in a 36-Week Phase 2 Active Treatment Extension Study in Patients With NASH. Hepatol Commun. 2021;5(4):573-88.
51.
Zurück zum Zitat Ratziu V et al. Aramchol in patients with nonalcoholic steatohepatitis: a randomized, double-blind, placebo-controlled phase 2b trial. Nat Med. 2021;27(10):1825-35. Ratziu V et al. Aramchol in patients with nonalcoholic steatohepatitis: a randomized, double-blind, placebo-controlled phase 2b trial. Nat Med. 2021;27(10):1825-35.
Metadaten
Titel
Hepatologie
Leberfibrose - Diagnostik und innovative Therapieansätze
verfasst von
Dr. Dr. med. Natascha Röhlen
Prof. Dr. med. Robert Thimme
Prof. Dr. med. Tobias Böttler
Publikationsdatum
20.10.2022
Verlag
Springer Medizin
Erschienen in
Gastro-News / Ausgabe 5/2022
Print ISSN: 1869-1005
Elektronische ISSN: 2520-8667
DOI
https://doi.org/10.1007/s15036-022-3108-8

Weitere Artikel der Ausgabe 5/2022

Gastro-News 5/2022 Zur Ausgabe

Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Innere Medizin und bleiben Sie gut informiert – ganz bequem per eMail.