January 15, 2008

Drexel University College of Medicine scientists, in partnership with the Hepatitis B Foundation, may have discovered a reliable alternative to liver biopsy for the early detection of liver fibrosis and cirrhosis, diseases affecting more than five million Americans. People with hepatitis B and C infections, as well as fatty liver diseases, are at greatest risk for progressing to cirrhosis that can lead to liver cancer.

Successful treatment depends on the early detection of fibrosis and cirrhosis. Currently, detection involves a surgical liver biopsy, which is an unpleasant, expensive procedure and carries some risk. Patients and doctors would prefer tests that are "not invasive" such as a blood test to detect and monitor liver disease.

Lead investigators are Timothy Block, PhD, professor in the Department of Microbiology and Immunology and director of the Drexel Institute for Biotechnology & Virology Research and Anand Mehta, DPhil, associate professor in the Department of Microbiology and Immunology and associate director of the Institute. Their discovery that the blood of most, if not all, people they tested with a diagnosis of liver cirrhosis, contains high levels of a special antibody that recognizes a carbohydrate sugar commonly found on bacteria. Detection of this antibody in the blood of an affected person correlates very well with a diagnosis of increasing fibrosis and cirrhosis in the new study. The study will be published in the February edition of the Journal of Virology.

Working with the National Cancer Institute (NCI) Early Detection Research Network, the researchers have been able to test this approach in 300 blood samples from people with liver disease, and can conduct the new test in thousands. Although the test is still experimental and more is needed before it can be used to monitor disease, the discovery is promising.

"If this work is validated, it may offer a new, non-invasive way to test for liver disease, allowing people to either avoid biopsy or to know when they really need one. It also implies that bacteria may have a much bigger role in initiating liver disease than realized, and even lead to new therapies," said Block.

Complications from bacteria in people with cirrhosis are well understood; however, bacteria are not usually seen early in the disease. The significance of this new discovery may suggest earlier treatments with antibiotics could benefit patients with chronic liver disease.