Enhanced Liver Fibrosis (ELF) Test

ELF testing offers several advantages over traditional liver screening. It is simple, fast, and inexpensive, and avoids the discomfort and risk associated with invasive biopsy. Furthermore, ELF testing is a highly reliable indicator of liver fibrosis, even in earlier stages. The test comprehensively evaluates three distinct biomarkers implicated in liver fibrosis: 

Hyaluronic Acid (HA): 

HA is a building block for connective tissue within the liver. Hepatic stellate cells respond to localized injuries from fat accumulation with collagen synthesis. Chronic stellate cell hyperactivity, consistent with fibrosis, results in the release of HA. 

"Multiple studies have reported increased HA deposition in inflammatory diseases of the liver. Whereas the concentration of HA in the healthy liver is low, its concentration significantly increases in the inflamed liver, leading to increased levels of serum HA. As a result, the level of circulating HA has been proposed as a biomarker for cirrhotic liver disease, for monitoring liver function, for assessing liver fibrosis, and for diagnosing chronic viral hepatitis C"

Fibrotic states and oxidative stress go hand in hand. Identified by reactive oxygen species (ROS), persistent oxidative stress leads to cellular dysfunction. ROS degrade hyaluronic acid polymers. Elevated HA upregulates pro-fibrotic transforming growth factor beta (TGF-B), indicating HA's active role in disease progression.

Tissue inhibitor matrix metalloproteinase (TIMP1): 

Matrix metalloproteinases (MMPs) are a family of enzymes responsible for breaking down the extracellular matrix. TIMP1 inhibits MMP activity to support the structural integrity of liver cells. Chronic overexpression of TIMP1 indicates liver cells are working overtime in response to sustained injury from steatosis/inflammation. 

Aberrant TIMP1 signaling is noted in tumor-associated fibroblasts, mediated by the aforementioned TGF-B. TIMP1 as a biomarker can indicate fibrotic activity as well as potentially identify cancerous progression.

Type 3 Procollagen Peptide (PIIINP): 

Collagen supports wound repair at the site of injury. Deposition of collagen often becomes excessive when wound regeneration pathways are dysfunctional. PIIINP in serum indicates excessive collagen synthesis or degradation, which is associated with fibroproliferative disorders. PIIINP works synergistically with the other biomarkers to paint a comprehensive picture of fibrotic activity.

The combination of these three novel biomarkers provide deep insight into liver fibrosis, specifically at the threshold of disease progression most associated with cancer risk. If we overlook opportunities for early detection, the so-called "silent killers" will remain inaudible. ELF Testing provides a unique opportunity to hear the footsteps of an otherwise silent killer. 

NAFLD and its advanced form, NASH, are among the most common but often overlooked liver conditions, quietly affecting millions. These diseases can progress for years without noticeable symptoms, ultimately leading to liver damage, cirrhosis, or even cancer if left unchecked. The ELF test offers a non-invasive way to identify fibrosis early, providing critical insights before significant liver damage occurs, empowering you to take proactive steps in your health journey.