ArticleAlimentary pharmacology & therapeutics2026
Biomarkers of Extracellular Matrix Remodelling Are Linked to Severity and Outcome of Advanced Chronic Liver Disease.
Article in Alimentary pharmacology & therapeutics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03267615 (VICIS - Vienna Cirrhosis Study), which is not on this map. Cited by 2 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
VICIS - Vienna Cirrhosis Study
Who cites it
2 citing papers in PubMed.
- Circulating fibronectin levels are linked to liver function, matrix remodeling, and hemostatic complications in advanced chronic liver disease.Hepatology international · 2026Article
- Imaging-based fibrosis assessment and risk stratification in MASLD.Frontiers in medicine · 2026Review
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Authors and funding
18 authors.
Funding
Abstract
backgroundExtracellular matrix (ECM) remodelling in advanced chronic liver disease (ACLD) is characterised by hepatic fibrosis and (sinusoidal) basement membrane development contributing to portal hypertension (PH) and clinical complications.
methodsPatients with stable ACLD (n = 232) undergoing hepatic venous pressure gradient (HVPG) measurement were included. Blood biomarkers reflecting fibrosis formation (PRO-C3, PRO-C6, PRO-C4 and PRO-C18L) and degradation (C3M, C4M and C6Ma3), as well as the Enhanced Liver Fibrosis (ELF) score were measured. Associations with disease severity and liver-related events (LRE: decompensation, acute-on-chronic liver failure, or liver-related death) were analysed.
resultsThe cohort included 131 (57%) patients with decompensated ACLD (dACLD), median HVPG 18 (13-21) mmHg and MELD 11 (9-14). ECM remodelling biomarkers increased in patients with dACLD and with PH severity (HVPG 6-9: n = 28, 10-19: n = 124, ≥ 20 mmHg: n = 80; all p < 0.05), except PRO-C18L (p = 0.231). Collagen degradation markers C3M and C4M-but not C6Ma3-also increased with HVPG (p < 0.01). Median follow-up was 28.9 (IQR 12.0-43.6) months. Fibrogenesis biomarkers (ELF, PRO-C3/-C4/-C6) were predictive of first decompensation in cACLD, while no clinically meaningful association with LRE was observed in dACLD. In multivariate Cox regression models adjusted for HVPG, MELD, albumin, and decompensation state, PRO-C4 (aHR per 100 ng/mL: 1.22, p < 0.001), C3M (aHR per ng/mL: 0.98, p = 0.044), and C4M (aHR per ng/mL: 0.98, p = 0.084) displayed independent prognostic value for LRE. The predictive value of fibrogenesis biomarkers for first decompensation (ELF, PRO-C3, PRO-C6) was validated in an independent cACLD cohort (n = 185).
conclusionECM remodelling biomarkers reflect PH and disease severity in ACLD. Their prognostic value for disease progression is largely restricted to cACLD. Future studies should investigate whether repeated measurements improve risk stratification.
trial registrationNCT03267615.
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