End-stage liver disease consists of advanced stages of liver fibrosis (F3-F4) due to chronic damage and scaring resulting in cirrhosis and acute liver failure. Severe fibrosis is characterized by the accumulation of extracellular matrix (ECM) components such as collagens. This, together with dysregulated liver regeneration impairs liver function leading to further complications, cirrhosis, and liver cancer/hepatocellular carcinoma. Nordic Bioscience developed biomarkers based on neo-epitope technology targeting the formation and degradation of collagens by detecting collagen fragments directly in the blood.

Twenty types of collagen have been identified in the liver, and their individual localization and structure reflect their function in the tissue. The interstitial matrix around the portal tract and the central veins is composed of fibrillar collagens such as type I, III and V collagen which provide structural support to the ECM.

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