Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 14, 2015; 21(2): 379-383
Published online Jan 14, 2015. doi: 10.3748/wjg.v21.i2.379
Telomere shortening as genetic risk factor of liver cirrhosis
Lucia Carulli
Lucia Carulli, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41126 Modena, Italy
Author contributions: Carulli L solely contributed to this paper.
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: Lucia Carulli, MD, PhD, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126 Modena, Italy. lucia.carulli@unimore.it
Telephone: +39-59-3961804 Fax: +39-59-3961335
Received: October 8, 2014
Peer-review started: October 9, 2014
First decision: October 29, 2014
Revised: November 4, 2014
Accepted: December 1, 2014
Article in press: December 21, 2014
Published online: January 14, 2015
Abstract

Cirrhosis is the main complication of chronic liver disease, leads to progressive liver function impairment and is the main risk factor for the development of liver cancer. Liver failure at endstage cirrhosis is associated with increased mortality with liver transplantation as the only possible treatment at this stage. The pathogenesis of liver cirrhosis is not completely elucidated. Although the common factors leading to liver injury, such as viral hepatitis, alcohol consume or fatty liver disease can be identified in the majority of patients a small percentage of patients have no apparent risk factors. Moreover given the same risk factors, some patients progress to cirrhosis whereas others have a benign course, the reason remains unclear. In order to develop new diagnostic and therapeutic tools, it is s essential to understand the pathogenesis of cirrhosis. The identification of genetic risk factors associated with cirrhosis is one of the possible approach to achieve these goal. In the past years several studies have supported the role of telomere shortening and cirrhosis. In the recent year several studies on the relation between several single nucleotide polymorphism (SNPs) and cirrhosis have been published; it has been proposed also a cirrhosis risk score based on seven SNPs. Also epidemiological studies on identical twins and in different ethnic groups have been supporting the importance of the role of genetic risk factors. Finally in the very recent years it has been suggested that telomere shortening may represent a genetic risk factor for the development of cirrhosis.

Keywords: Liver cirrhosis, Genes, Single nucleotide polymorphism, Gene mutation, Telomere, Telomerase

Core tip: Common risk factors leading to chronic liver injury can be identified in most patients with cirrhosis, but approximately 5% of patients have no apparent risk factors. Understanding the pathogenesis of cirrhosis formation is essential to develop new diagnostic and therapeutic tools and for its prevention. The identification of genetic risk factors associated with cirrhosis is one of the possible way to approach this issue. Evidence supporting the role of genetic risk factors has been accumulating during the past years and recently it has been also suggested that telomere shortening may represent a genetic risk factor.