New blood test detects asymptomatic liver damage in less than an hour

A robust, less invasive blood test for detecting early-stage liver fibrosis in less than 1 hour has been designed and verified using clinical samples, say researchers.

Developed in a joint effort by University College London (UCL), UK and the University of Massachusetts, US, the test uses a fluorescent-polymer sensor array which was reportedly able to accurately and specifically detect signs of liver fibrosis from low-volume serum samples in 30 to 35 minutes. [Adv Mater 2018; doi: 10.1002/adma.201800634]

Fingerprick-volume blood samples from 65 individuals in three groups (healthy, early-stage and late-stage fibrosis) were tested, with the Enhanced Liver Fibrosis (ELF) test used as a benchmark. The sensor was able to detect fibrotic samples from healthy samples 80 percent of the time, reaching standard thresholds of clinical relevance.

In addition, as the sensor could discern different patterns of protein levels in blood serum, the researchers found that mild-to-moderate fibrosis could be distinguished from severe fibrosis 60 percent of the time.

"By comparing the different samples, the sensor array identified a 'fingerprint' of liver damage. This method is known as a chemical nose, as it can recognise the difference between healthy and unhealthy blood samples without relying on known disease markers," said co-lead author Dr William Peveler, of the UCL Chemistry department.

Polymers in the sensor were coated with fluorescent dyes that bound to blood proteins based on specific chemical properties. Changes in sensor brightness and colour yielded different patterns of fluorescence depending on the protein composition of each blood sample.

According to Peeler and his team, with further refinement, the test could address a huge need for early detection of liver disease, as it distinguishes between samples taken from healthy individuals and those with varying degrees of liver damage.

"Liver disease is the third biggest cause of premature mortality in the UK, and one of the only leading causes of death that's on the increase,” said co-lead author Professor William Rosenberg, of the UCL Institute for Liver & Digestive Health. “The major problem is that it's asymptomatic, meaning that it goes unnoticed until late stages of the disease when the damage is irreversible."

Current strategies for detection of liver fibrosis rely on more invasive biopsy or fragile lab‐based antibody technologies which require samples to be sent out of a clinic for analysis.

"We hope that our new test could be used on a routine basis in GP surgeries and hospital clinics to screen people who face an elevated risk of liver disease, but don't yet show signs of liver damage to identify those with serious fibrosis, so that they can access treatment before it's too late. This may open the door to a cost-effective regular screening programme thanks to its simplicity, low cost and robustness," added Rosenberg.