Ammonium quantification in human plasma by 1H-NMR for staging of liver fibrosis in alcohol and non-alcoholic-related liver disease

Invasive and painful liver biopsy is the gold standard for liver disease diagnosis. Non-invasive methods to assess liver fibrosis in patients with alcohol-related liver disease (ArLD) and non-alcoholic fatty liver disease (NAFLD) are an unmet clinical need. We have developed a robust and reliable 1H NMR protocol to quantify the endogenous ammonium concentration in biological fluids. The measurement of ammonium in blood plasma samples of ArLD and NAFLD patients discerned between some stages of the disease retrospectively and showed that ammonium readout is a robust diagnostic marker of fibrosis stage, more so than current clinically assessed blood hepatic biomarkers.