The IHU ICAN is proud to highlight a new scientific breakthrough published in the journal Gut (official publication of the British Society of Gastroenterology, Impact factor 26.2), with Prof. Vlad Ratziu (Gastroenterologist and Hepatologist – AP-HP / Sorbonne University / IHU ICAN / INSERM UMRS 1138 CRC) as the lead author: “Thrombospondin-2 is a performant biomarker of at-risk MASH and advanced MASH fibrosis in a large multicenter European cohort. “
This European multicenter study represents a significant advance in the non invasive diagnosis of metabolic steatohepatitis (MASH), the severe form of fatty liver disease associated with metabolic dysfunction (MASLD).
The urgent need to develop early, non-invasive diagnosis of metabolic steatosis (MASLD)
Metabolic liver steatosis is a liver disease affecting approximately 18% of the French population. If it is not managed and treated early on, it can silently progress to steatohepatitis (MASH), a form that can advance to advanced stages of fibrosis and even cirrhosis, thereby increasing the risk of serious liver complications that can lead to liver cancer and death.
Today, early detection of forms of steatohepatitis with advanced fibrosis that pose a risk remains a clinical challenge, particularly in large cohorts of patients with metabolic comorbidities.
In addition, metabolic steatosis is often associated with other metabolic syndrome conditions such as obesity or type 2 diabetes, which also lead to serious cardiovascular complications (heart failure, heart attack, etc.).
The study: a European multicenter collaboration
Under the direction of Prof. Vlad Ratziu, the research team analyzed a cohort of 469 patients from several European centers. The main objective was to evaluate several serum biomarkers derived from hepatic transcriptome data to determine their diagnostic performance in identifying active steatohepatitis and advanced hepatic fibrosis.
The biomarkers studied included thrombospondin-2 (TSP2), IGFBP7, GDF15, and CD163.
Thrombospondin-2: new biomarker confirmed for the diagnosis of forms of steatohepatitis at risk of progression
The results show that serum Thrombospondin-2 (TSP2) levels stand out as a reliable indicator, capable of:
- Effectively identify patients with steatohepatitis at risk of progression;
- Identify those with advanced fibrosis.
In terms of diagnostic performance, TSP2 showed higher AUROC values (0.812), significantly exceeding the other biomarkers tested as well as several commonly used clinical and biological scores.
Furthermore, when combined with clinical and biological variables (such as age, liver enzymes, platelet count), the diagnostic performance of TSP2 improves further, reinforcing its potential as a screening and risk stratification tool in clinical practice.
New prospects for early detection of high-risk steatohepatitis
The identification of thrombospondin-2 as an effective non-invasive biomarker opens up new possibilities for:
- early screening of patients at risk of liver complications
- optimization of personalized care strategies;
- the reduction in the use of liver biopsies, invasive procedures that are still often necessary to refine the diagnosis.
ICAN, a major player in metabolic steatosis research
This publication illustrates the ongoing commitment of the IHU ICAN and its teams to understanding the pathophysiological mechanisms of cardiometabolic diseases and developing advanced diagnostic tools.
Under the leadership of clinician-researchers such as Prof. Vlad Ratziu, the IHU ICAN actively contributes to advancing approaches to the diagnosis and management of patients with metabolic steatosis and steatohepatitis, its progressive form.
