MARKERS BIOCHIMICI DI FIBROPLASIA: IMPIEGO NELLA PRATICA CLINICA

In recent years, several in vitro and in vivo studies have clarified the basic processes ruling over synthesis, stabilization and degradation of the main components of the extracellular matrix (E.M.), an event well-known as fibroplasia. In this article the possible diagnosis of liver fibrosis by means of non-invasive tests is discussed. Up to now the liver biopsy is the only possible approach allowing diagnosis and quantification of fibrosis; however, such an invasive technique precludes repeated sampling on the same patient. Theoretically, fibrosis could be monitored by measuring the serum levels of some connective tissue metabolic products and the activity of specific enzymes involved in their synthesis and/or degradation. Nevertheless, none of these indices is liver-specific, since the connective tissue is largely distributed. Recently, metabolic by-products of Precollagen Type III and, in particular, the aminoterminal peptide (PIIIP) showed to be the more suitable index. Moreover, Laminin (LAM-PI), Collagen IV, Collagen VI sub-units and Propyl-hydroxylase serum levels proved to be reliable parameters of liver fibrosis.