Wow, there are a lot of liver diseases and we've got decent diagnostics for....well...liver damage.... that's about it. A small panel of liver damage markers finalized around the time Stan Lee and Jack Kirby went on a creative bender and wrote everything from the Fantastic Four, through Spiderman and the X-Man comics. I'm not kidding, there really has been almost zero forward movement in liver diagnostics since the 1960s. The liver protein panel was old when I was running them in the clinic in 2003. And it's still the same thing.
Could top down proteomics be the answer?
Given the current limits of top-down it sounds unlikely, but you'll find what appears to be some pretty clear differentials in these small intact proteins (they seem to get up to 38kDa) in this study.
Is it the simplest way forward to getting some modern liver diagnostics out there? Maybe? But for a field that seems to have completely hit a wall 60 f'ing years ago, it's time to try everything!
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