Molecular Biomarkers Associated with Inflammatory and Fibrotic Pathways in Chronic Liver Disease: A Systematic Review

Authors

  • Naveera Mazhar University of the Punjab, Lahore, Pakistan Author
  • Maha Aslam Khan Minhaj University, Lahore, Pakistan Author
  • Arslan  Majeed University of Punjab, Lahore, Pakistan Author
  • M Akram University of Health Sciences, Lahore, Pakistan Author https://orcid.org/0009-0000-5406-0760

DOI:

https://doi.org/10.68041/anjmls.v1i3/08

Keywords:

Biomarkers, Cytokines, Fibrosis, Inflammation, Liver Cirrhosis, Liver Diseases, Signal Transduction

Abstract

Objective: Chronic liver disease (CLD) is driven by chronic inflammation and progressive fibrosis, resulting in cirrhosis and hepatocellular carcinoma. Molecular biomarkers may enable non-invasive diagnosis, prognostication, and therapeutic targeting, but comprehensive synthesis remains limited. This systematic review aimed to evaluate the biomarkers involved in the inflammatory and fibrotic pathways in the etiology of CLD. Data Sources: Studies reporting molecular biomarkers in CLD inflammatory or fibrotic pathways were searched from January 2016 to December 2025 using PubMed, Scopus, Web of Science, and Google Scholar in accordance with PRISMA 2020 guidelines. Study Selection: Observational, cross-sectional, and preclinical experimental studies that provided therapeutic insights on inflammatory and fibrotic pathways were included, whereas reviews, editorials, and non-English articles were excluded. Data Extraction: Two reviewers extracted data independently. The Newcastle-Ottawa Scale, JBI Checklist, and SYRCLE tool were used to measure the risk of bias, and the GRADE approach was used to evaluate the quality of evidence. Data synthesis: Twelve studies were included. The most important inflammatory biomarkers identified in CLD were IL-17F (ACLF progression), IL-6/CRP (decompensated ACLD), NLRP3/CASP1 (HCV), CASP-11/4 (AH), and CK18 (NAFLD). Fibrotic markers included Sirt6 (TGF-β/Smad2 inhibition), TIMP-1, CHI3L1, CXCL6, platelet GPIbα, and GGT, indicating the severity of the disease and their diagnostic or therapeutic potential. Overall, the risk of bias was low to moderate, and GRADE rated certainty of evidence was moderate. Conclusion: Emerging molecular biomarkers offered non-invasive diagnostic, prognostic, and therapeutic potential by reflecting important inflammatory and fibrotic pathways in CLD.

Author Biographies

  • Naveera Mazhar, University of the Punjab, Lahore, Pakistan

    School of Biochemistry and  Biotechnology  

     

  • Maha Aslam Khan, Minhaj University, Lahore, Pakistan

    School of Biochemistry

  • Arslan  Majeed, University of Punjab, Lahore, Pakistan

    School of Biochemistry and  Biotechnology

  • M Akram, University of Health Sciences, Lahore, Pakistan

    Department of Pathology

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Published

2026-09-20

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Vol. 1 No. 3 (2026): September

Section

Systematic Review

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Copyright (c) 2026 Naveera Mazhar, Maha Aslam Khan, Arslan Majeed, M Akram

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How to Cite

Molecular Biomarkers Associated with Inflammatory and Fibrotic Pathways in Chronic Liver Disease: A Systematic Review. (2026). Al-Najam Journal of Medical and Life Sciences, 1(3), 93-99. https://doi.org/10.68041/anjmls.v1i3/08