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World J Hepatol. Mar 27, 2018; 10(3): 371-378
Published online Mar 27, 2018. doi: 10.4254/wjh.v10.i3.371
Metabolomics: From liver chiromancy to personalized precision medicine in advanced chronic liver disease
Bogdan Procopet, Petra Fischer, Oana Farcau, Horia Stefanescu
Bogdan Procopet, Petra Fischer, Oana Farcau, 3rd Medical Clinic, University of Medicine and Pharmacy, Cluj 400162, Romania
Bogdan Procopet, Horia Stefanescu, Hepatology Unit, Regional Institute of Gastroenterology and Hepatology, Cluj 400162, Romania
Author contributions: Procopet B and Stefanescu H designed the study; Fischer P and Farcau O drafted the first version of the manuscript; all authors reviewed the manuscript and approved the final version of the paper.
Supported by Romanian Agency for Scientific Research, No. PN-II-RU-TE-2014-4-0356 (awarded to Stefanescu H), and No. PN-II-RU-TE-2014-4-0709 (awarded to Procopet B).
Conflict-of-interest statement: None.
Open-Access: 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/
Correspondence to: Horia Stefanescu, MSc, MD, PhD, Doctor, Staff Physician, Hepatology Unit, Regional Institute of Gastroenterology and Hepatology, 19-21 Croitorilor Str., Cluj 400162, Romania. horia.stefanescu@irgh.ro
Telephone: +4-766-318283
Received: October 28, 2017
Peer-review started: October 29, 2017
First decision: November 28, 2017
Revised: January 19, 2018
Accepted: January 29, 2018
Article in press: January 29, 2018
Published online: March 27, 2018
Abstract

Currently there is a lack of accurate biomarkers for diagnosis and prognosis in advanced liver diseases. Either the occurrence of first decompensation, or diagnosis of acute on chronic liver failure, severe alcoholic hepatitis, or hepatocellular carcinoma (HCC), none of the available biomarkers are satisfactory. Metabolomics is the newest of omics, being much closer than the others to the actual phenotype and pathologic changes that characterizes a certain condition. It deals with a much wider spectrum of low molecular weight bio-compounds providing a powerful platform for discovering novel biomarkers and biochemical pathways to improve diagnostic, prognostication and therapy. Until now metabolomics was applied in a wide spectrum of liver conditions, but the findings were contradictory. This review proposes a synthesis of the existing evidences of metabolomics use in advanced chronic liver diseases, decompensated liver cirrhosis, severe alcoholic hepatitis and HCC.

Keywords: Metabolomics, Biomarker, Prediction, Advanced chronic liver disease, Decompensation, Alcoholic hepatitis, Hepatocellular carcinoma

Core tip: Currently there is a lack of accurate biomarkers for diagnosis and prognosis in advanced liver diseases. Either the occurrence of first decompensation, or diagnosis of acute on chronic liver failure, severe alcoholic hepatitis, or hepatocellular carcinoma (HCC), none of the available biomarkers are satisfactory. This review proposes a synthesis of the existing evidences of metabolomics use in advanced chronic liver diseases, decompensated liver cirrhosis, severe alcoholic hepatitis and HCC.