Tissue inhibitor of metalloproteinase-1 (TIMP-1) – Elevated in liver fibrosis

Liver diseases, ranging from mild hepatitis to cirrhosis and hepatocellular carcinoma, represent a significant global health burden. Early diagnosis and accurate staging are critical for effective management. Biomarkers have emerged as essential tools in evaluating liver function, injury, inflammation, fibrosis, and regeneration. Among these, Tissue Inhibitor of Metalloproteinase-1 (TIMP-1) has gained considerable attention for its role in liver fibrogenesis. TIMP-1 inhibits matrix metalloproteinases, thereby contributing to extracellular matrix accumulation and fibrosis progression. This review categorizes liver biomarkers into functional, inflammatory, fibrotic, and genomic classes, with a particular focus on TIMP-1 and its diagnostic, prognostic, and therapeutic relevance. Additionally, we explore non-invasive biomarker panels such as the ELF panel, which incorporates TIMP-1, to assess liver fibrosis severity without the need for biopsy. Despite their utility, biomarker application faces challenges including variability, sensitivity, and standardization. Emerging tools like omics technologies and AI-driven diagnostics offer promising avenues to overcome these limitations and enhance biomarker-based liver disease management.