17 October 2024
Understanding MASLD and Its Growing Global Prevalence
Raising Awareness About MASLD: Why Early Diagnosis is Key! In this campaign, we explore the critical role of early screening and how non-invasive diagnostics can help healthcare professionals manage high-risk patients.
Read more7 October 2024
Keratin 18 in Alcohol-associated Liver Disease
Read the brochure on the use of the VLVbio ELISA kits in ALD diagnosis, prognosis and theragnosis!
Read more23 May 2024
The EASL Congress 2024
Meet our team in Milan and let’s discuss M30® as a NIT in NASH, AH and DILI!
Read more17 April 2024
K18 – the Key to Unlocking Informed Decisions in MASH Drug Trials
Join us on April 23rd for a webinar on K18 as a biomarker in MASH drug trials, presented by Jessica Tuohy. Gain insights into MASH pathogenesis and the use of K18 for making informed decisions.
Read moreM30 Apoptosense® in NASH
The M30 Apoptosense® ELISA can be used as an aid in diagnosing patients with NASH which would allow for an early identification of patients at risk of developing late stage liver disease and would benefit from specialist care.
Diagnosing NASH also allows an earlier intervention prior to the onset of fibrosis and severe liver injury.
NAFLD NASH ALD ASH DILI ALF ACLF NAFLD NASH ALD ASH DILI ALF ACLF NAFLD NASH ALD ASH DILI ALF ACLF NAFLD NASH ALD ASH DILI ALF ACLF NAFLD NASH ALD ASH DILI ALF ACLF
NAFLD – a global disease
Non-alcoholic fatty liver disease (NAFLD), a condition where fat accumulates in the liver without the excess consumption of alcohol, has become the most common cause of liver disease in the Western world, and is quickly rising to become the primary cause of liver transplants.
Due to the rise in obesity and diabetes, NAFLD is estimated to affect 30% of the global population, with a high prevalence on all continents.
NASH
NAFLD starts out as steatosis which is an accumulation of fat in the liver and may further progress to non-alcoholic steatohepatitis (NASH), a more serious form of NAFLD, where the liver has become inflamed.
NASH is a potentially fatal condition that affects 5% of the global adult population and can further develop into creation of fibrotic tissue in the liver, with possible cirrhosis as a result.
The right to good health is a fundamental human right. Therefore we strive to offer and facilitate high-quality biomarker assays to detect and measure liver disease in an effective, sensitive and cost-effective way.
Long Experience
Based on antibody technology invented more than 20 years ago at the Karolinska Institute in Sweden, VLVbio has a deep and profound experience within epithelial cell death in different application fields.
Cost-effective and easy to use
Our M30 Apoptosense® ELISA is a non invasive, cost-effective tool for the aid in diagnosing NASH. The M30® can with adequate sensitivity and specificity aid in early detection of NAFLD patients while the disease is still reversible. Our products are easily available globally!
Clinical Validation
In order to validate and pin-point the adequate diagnostic solution in NAFLD healthcare, we are conducting several clinical trials worldwide to evaluate the use of M30 Apoptosense® in NASH diagnosis.
Clinical pharmacology trials
While there are still no FDA or EMA approved drugs for NASH, there are many trials ongoing in different phases to find a pharmaceutical treatment. Our products are used in over 60 active NAFLD trials as a screening tool and endpoint measurement for treatment effect.
Research Collaborations
As part of our mission to aid in finding and validating the best biomarkers to advance towards diagnosis and monitoring of NASH, we are collaborating with large joint governmental collaborations with leading clinical academic centers, regulatory bodies, and the industry. We are currently part of the LITMUS and NAIL-NIT consortiums.
Continuous Innovation
We are committed to satisfying customer requirements for quality, reliability, and support for all of our products. We are dedicated to continuous innovation and improvement in all aspects of our business, constantly looking to improve our products as well as expand our product portfolio.
17 April 2024
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K18 – the Key to Unlocking Informed Decisions in MASH Drug Trials
Join us for an enlightening webinar presented by Jessica Tuohy, a distinguished partner and colleague from the US, focusing on the significance of K18 as a biomarker in the development of treatments for MASH (Metabolic Associated Steatohepatitis). This webinar is essential for drug developers, doctors, researchers, and key opinion leaders in the field of metabolic liver diseases, offering deep insights and key research findings.
Event Details:
- Date: Tuesday, April 23
- Time: [1pm EDT, 7pm CET]
Webinar Overview: This session will cover several critical areas:
- – An Introduction to the Growing Epidemic of MASLD (Metabolic Associated Steatotic Liver Disease)
- – Challenges in Developing Therapies for the Treatment of MASH
- – An Overview of K18 and Its Role in MASH Pathogenesis
- – A Review of Data That Support the Value of K18 as a Biomarker for Assessing the Efficacy of Drug Candidates in MASH Clinical Trials
Who Should Attend:
- – Drug developers in the field of MASLD and MASH.
- – Physicians and healthcare professionals specializing in hepatology, gastroenterology, and related fields.
- – Medical researchers focusing on liver disease and drug development.
- – Key opinion leaders in metabolic liver diseases.
Registration: Please register here to secure your spot in this informative webinar. Registration is required to access this online event.
Additional Information: If you are unable to attend the live event, a recording will be made available to all registered participants, ensuring you can access this webinar at your convenience.
We look forward to welcoming you to what promises to be an informative and transformative session.
For more information, please contact us at marketing@vlvbio.com.
Don’t miss out on the chance to advance your knowledge in MASH treatment and diagnostics. Reserve your spot today!
23 January 2024
Blog
Launch of IMMUNIS Cytokeratin 18F EIA by Institute of Immunology, Japan
We are thrilled to share a momentous achievement in our longstanding collaboration with our esteemed Japanese partners, the Institute of Immunology. This announcement comes during a meeting filled with collaboration and shared successes as Mr. Ito, Mr. Akira, and Ms. Yukiko from the Institute of Immunology paid a visit to our headquarters in Stockholm.
During this collaborative visit, we had the pleasure of discussing plans for the imminent launch of the IMMUNIS Cytokeratin 18F EIA, a project that holds significant promise in the realm of diagnostic medicine. This project has been a work of dedication and innovation, and the collaboration between VLVbio and the Institute of Immunology has been instrumental in its success!
We are happy that the IMMUNIS Cytokeratin 18F EIA has gained official approval as an In Vitro Diagnostic (IVD) for the diagnosis of Non-Alcoholic Steatohepatitis (NASH) from the Pharmaceuticals and Medical Devices Agency (PMDA) in Japan! This recognition underscores the product’s efficacy and reliability in contributing to the diagnosis and management of NASH, a condition of growing concern globaly as the epidemiology of the disease keeps increasing at an alarming rate. The need for a biomarker to identify patients with NASH and who are at risk of significant liver disease is of utmost importance, and we are happy that the Keratin 18 assay can assist in that!
The IMMUNIS Cytokeratin 18F EIA ELISA kit
Of equal importance, the IMMUNIS Cytokeratin 18F EIA, developed by the Institute of Immunology, has been included in the national health insurance system in Japan. This recognition ensures widespread accessibility, facilitating broader usage of this diagnostic tool within the Japanese healthcare community.
We are pleased to announce that the official launch date for the IMMUNIS Cytokeratin 18F EIA is scheduled for February 26th to the Japanese market. This date signifies the conclusion of a meticulous research and development process and exemplifies the collaborative efforts between VLVbio and our esteemed partners at the Institute of Immunology. The IMMUNIS Cytokeratin 18F EIA, launched by the Institute of Immunology, is poised to make a substantial impact on the field of NASH diagnosis, providing healthcare professionals with an additional tool to enhance their diagnostic capabilities in Japan.
As we celebrate this milestone and the successful visit from our partners, we extend our gratitude to all individuals who have contributed to the realization of this project, including the dedicated team members and esteemed partners at the Institute of Immunology. Congratulations to you all!
Institute of Immunology president Mr. Ito Yukio and VLVbio CEO
Mrs. Slavica Brnjic holding the finished IMMUNIS Cytokeratin 18F assay.
17 October 2024
Blog
Understanding MASLD and Its Growing Global Prevalence
Metabolic Associated Steatotic Liver Disease (MASLD), also known as Non-Alcoholic Fatty Liver Disease (NAFLD), has emerged as a major global health challenge. Affecting roughly 30% of the world’s population, MASLD is closely tied to the rising rates of obesity, Type 2 diabetes, and metabolic syndrome. This condition, which can progress from simple liver fat accumulation to severe stages like MASH, fibrosis or cirrhosis, requires urgent attention from healthcare professionals to manage its growing prevalence.
What is MASLD?
MASLD is a spectrum of liver diseases where excess fat builds up in the liver without significant alcohol consumption. The condition ranges from simple steatosis (fatty liver) to more severe forms like metabolic dysfunction-associated steatohepatitis (MASH), liver fibrosis, and cirrhosis. The key risk factors driving MASLD are metabolic conditions such as obesity and insulin resistance.
The Growing Global Prevalence of MASLD
Over the past few decades, the prevalence of MASLD has steadily increased across the globe. Recent studies reveal that 30% of the world’s population is affected by MASLD, a significant rise from the 25% reported in 2016. In certain regions like Latin America and the Middle East, the prevalence rates exceed 40%, driven by the increasing rates of obesity and metabolic syndrome. By 2030, the number of MASLD cases is expected to surge, particularly in Southeast Asia, North America, and Western Europe, as the global burden of metabolic disorders continues to rise (The Global Epidemic of Metabolic Fatty Liver Disease, 2024).
This growing burden makes early detection more critical than ever. The silent progression of MASLD, particularly among high-risk groups such as those with Type 2 diabetes or obesity, often leads to late-stage liver disease by the time it’s detected. Early screening and intervention can prevent end-stage complications like cirrhosis and liver failure.
Why Early Diagnosis is Critical
Early diagnosis of MASLD is pivotal in preventing the disease from progressing to more severe stages, such as fibrosis, cirrhosis, or hepatocellular carcinoma (HCC). MASLD often develops silently, with patients experiencing few or no symptoms in the early stages. As a result, the disease can go undetected until it advances to a point where treatment options are limited, and the risk of irreversible liver damage increases.
Silent Progression to Severe Disease
Many patients with MASLD are unaware of their condition until it has progressed significantly. This is because MASLD often presents with normal liver enzyme levels, which may give a false sense of security during routine checkups. Without early intervention, MASLD can progress to MASH, a more severe form that involves liver inflammation and fibrosis. From there, the disease can further develop into cirrhosis or even liver cancer. The longer the disease goes undiagnosed, the fewer options remain for successful intervention. Detecting MASLD early provides a critical window for lifestyle changes and medical management that can reverse or slow its progression.
“I had no idea my liver was deteriorating for years. I felt fine until one day, my legs started swelling, and I felt extreme fatigue. By then, it was too late — my doctor told me I had cirrhosis, and my liver was severely damaged.” – MASLD patient with cirrhosis
Preventing Cirrhosis and Liver Cancer
Early diagnosis allows healthcare providers to implement interventions that can prevent patients from progressing to the advanced stages of liver disease. Patients with MASLD who are diagnosed early have a higher likelihood of responding to non-invasive treatments such as weight loss, dietary changes, and glucose control. Studies have shown that even a modest weight loss of 7-10% of body weight can significantly improve liver histology and prevent disease progression. When MASLD is detected at the stage of simple steatosis, the risk of developing cirrhosis or liver cancer is much lower than if the disease is allowed to progress without intervention.
In advanced stages like cirrhosis, the liver’s ability to function is severely compromised, and patients may require liver transplantation. Moreover, cirrhosis significantly increases the risk of developing hepatocellular carcinoma, a leading cause of cancer-related deaths worldwide. Therefore, detecting MASLD in its early stages can significantly reduce the incidence of both cirrhosis and liver cancer, which are often associated with poor prognoses.
Role of Non-Invasive Diagnostics
Recent advancements in non-invasive diagnostic tools have made early detection of MASLD easier and more accessible for clinicians. Tools such as imaging and serum biomarkers allow healthcare providers to assess liver fat and fibrosis without the need for invasive liver biopsies. This is particularly valuable in primary care settings, where regular screening of high-risk populations (such as those with obesity, diabetes, or metabolic syndrome) can be incorporated into routine check-ups.
These diagnostic tools also allow for risk stratification, enabling clinicians to categorize patients based on their likelihood of progressing to advanced liver disease. This helps in tailoring interventions and deciding when to refer patients to specialists for more advanced care, reducing unnecessary referrals and allowing for more efficient healthcare resource allocation.
Managing High-Risk Populations
Patients with Type 2 diabetes, obesity, and other metabolic disorders are at particularly high risk for MASLD. In fact, up to 70% of people with Type 2 diabetes and 90% of obese individuals have MASLD. Early diagnosis in these populations is crucial, as they are more likely to progress to severe liver disease. By integrating liver health assessments into regular diabetes or obesity management plans, healthcare providers can catch MASLD before it progresses, allowing for earlier lifestyle modifications and potentially reducing the burden of advanced liver disease in these high-risk groups.
Improving Patient Outcomes and Reducing Costs
Early diagnosis and intervention not only improve patient outcomes but also reduce healthcare costs in the long run. Treating MASLD in its early stages is far less costly than managing advanced liver disease, which often requires hospitalizations, expensive treatments, or even liver transplantation. Moreover, patients diagnosed early are more likely to adhere to preventative measures such as diet and exercise, which can greatly improve liver health and reduce the need for long-term medical intervention.
Conclusion
As MASLD continues to grow globally, healthcare providers must stay proactive in identifying, screening, and managing patients at risk. Early diagnosis and intervention are the keys to reducing the global burden of this disease and preventing it from reaching advanced stages.
VLVbio are dedicated to providing cutting-edge, non-invasive diagnostic solutions that enable healthcare providers to detect MASLD in its early stages. As the prevalence of MASLD rises, early detection will become increasingly vital to addressing this public health challenge. Read more on how VLVbio’s M30 Apoptosense® ELISA can be incorporated into clinics to help identify patients here!
7 October 2024
Brochures
Keratin 18 in Alcohol-associated Liver Disease
- Keratin 18 in Alcohol-associated Liver Disease
- – What is ALD and what is the role of K18 in ALD?
- – How can measuring K18 aid in ALD patient management?
- – Learn about the use of K18 in early ALD diagnosis, detecting severe Alcoholic Hepatitis (AH), prognosis for survival, and predicting treatment response in ALD patient!
23 May 2024
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The EASL Congress 2024
We are heading to Milan for the EASL Congress together with the European Association for the Study of the Liver!
We’re happy to yet again be exhibiting at the face-to-face #EASLcongress with EASL | The Home of Hepatology! We are happy to yet again be an industry partner for the biggest liver event in Europe!
The latest in hepatology is happening 📅 5–8 June.
🤝 Join us at the highlight of the year! Register today, and lets meet and discuss liver biomarkers at our booth.
4 March 2024
Blog
World Obesity Day
Today marks World Obesity Day, a global initiative aimed at raising awareness about the growing epidemic of obesity and its profound impact on health. While the visible effects of excess weight are well-known, it’s crucial to delve deeper into the associated health risks, such as Metabolically Associated Fatty Liver Disease (MASLD), a silent threat that often goes unnoticed until it reaches critical stages.
The Silent Threat: MASLD
MASLD, a condition linked to obesity, is a silent liver disease that often progresses without any overt symptoms. As the world grapples with rising obesity rates, MASLD has become a significant concern due to its subtle nature and potential to lead to severe liver damage. The liver, a vital organ responsible for various metabolic functions, can be adversely affected by the accumulation of fat, inflammation, and fibrosis associated with MASLD.
Raising Awareness: A Necessity for Change
This World Obesity Day, it’s imperative to shed light on MASLD, a condition that lurks beneath the surface, silently compromising one’s liver health. Awareness campaigns and educational initiatives play a pivotal role in encouraging individuals to make informed lifestyle choices, promoting early detection, and seeking medical advice.
Diagnostics and Treatments
In the fight against MASLD, advancements in diagnostic tools offer a glimmer of hope. Cutting-edge technologies, such as non-invasive biomarkers and imaging techniques, enable healthcare professionals to detect MASLD in its early stages, allowing for timely intervention and before last stage disease. Regular screenings for individuals at risk can make a substantial difference in preventing the progression of this silent liver disease.
As we recognize World Obesity Day, it’s essential to emphasize the need for innovative treatments for MASLD. Pharma companies and researchers are exploring novel therapeutic approaches, ranging from lifestyle interventions to pharmaceutical developments, aiming to mitigate the impact of MASLD on liver health. Collaborative efforts between healthcare providers, researchers, and policymakers are vital to develop effective strategies for preventing and managing MASLD in the context of the global obesity crisis.
Addressing the obesity epidemic and its associated health issues, including MASLD, requires a collective effort. Governments, healthcare professionals, community leaders, and individuals alike must collaborate to implement policies that promote healthy living, foster early detection, and ensure access to appropriate treatments.
On this World Obesity Day, let us come together to raise awareness, destigmatize health issues related to obesity, and advocate for the development of comprehensive strategies that address not only the visible consequences but also the silent threats like MASLD. By working together, we can pave the way for a healthier and more informed future.
Read more on how the M30 Apoptosense® ELISA can aid in diagnosing NASH and fibrotic NASH
Read more on how the M30 Apoptosense® ELISA can aid in diagnosing pediatric NASH
Read more on how the K18 assays can help in NAFLD clinical trials
Reda Elkhatib
21 December 2023
Blog
VLVbio – Reflecting on a Remarkable Year
As we bid farewell to another extraordinary year, the VLVbio team takes a moment to express our heartfelt gratitude to everyone who has been a part of our journey. The past year has been marked by incredible strides in liver disease research, groundbreaking innovations, and a surge in global awareness for chronic liver diseases. We are thrilled to be active contributors to this fast-growing and dynamic field, working towards a future where liver diseases are better understood and effectively addressed.
One of the highlights of our year was the opportunity to connect with professionals and experts from around the world at various conferences, including the EASL Congress and the AASLD Liver Meeting. These events allowed us to share insights, exchange ideas, and forge meaningful collaborations with individuals who share our passion for advancing liver disease research and treatment. The exchange of knowledge in these settings has been invaluable; reinforcing our commitment to pushing the boundaries of what is possible in liver health.
At VLVbio, we are especially proud to witness the growing awareness surrounding MAFLD a condition that often lurks in the shadows, asymptomatic and unnoticed until reaching advanced stages. Our dedication to shedding light on this silent liver disease is unwavering, and we are encouraged by the progress made by several patient advocacy groups and non-profits in increasing public awareness and understanding.
This year also marked a significant change in the nomenclature for Non-Alcoholic Fatty Liver Disease (NAFLD) to Metabolic Associated Fatty Liver Disease (MAFLD). This shift reflects an evolving understanding of the condition, acknowledging its metabolic roots and paving the way for more precise diagnostics and targeted treatments.
As we look ahead to the coming year, our team is filled with excitement and renewed energy. We anticipate a year of continued growth, exploration, and, most importantly, a year where we hope to finally see the approval of the first MASH treatment. This potential breakthrough holds the promise of transforming the lives of millions of patients affected by MAFLD. Our commitment to our vision of a world with no silent liver diseases is centered on the belief that every innovation, every discovery, brings us one step closer to a world where liver diseases are not only detectable but treatable.
The prospect of making a positive impact on the lives of patients motivates us daily. Our dedication to research, innovation, and collaboration remains steadfast, and we are eager to face the challenges and triumphs that the coming year will undoubtedly bring.
As we reflect on the accomplishments of the past year, we extend our deepest gratitude to our partners, collaborators, and the entire liver disease community. Your unwavering support has been instrumental in our success, and we look forward to continuing this incredible journey together.
Warm regards and Happy Holidays!
The VLVbio Team
Reda Elkhatib
15 December 2023
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XboXLab – Our new partner in the Nordics!
We are happy to announce that we have partnered up with XboXLab for the distribution of the VLVbio kits in Sweden, Denmark, Finland and Norway!
The M30® and M65® biomarker assays are widely used in the field of hepatology, mostly within the chronic liver diseases such as Metabolic dysfunction-associated steatohepatitis (MASH). The biomarkers are used for IVD in Europe for the identification and diagnosis of MASH patients, as well as for the follow up of intervention effect. Other than the clinical use, the kits are also used in clinical research, where the biomarkers are included in the reduction of screen failure and as a secondary or exploratory end-point to check for treatment effect of new drugs in MASH clinical trials.
To all our Nordic customers, for more information, please visit XboXLab’s webpage or contact them directly:
Peter Blom
peter.blom@xboxlab.se
Tel: +46 107 888 331
30 October 2023
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MEDICA Trade Fair
We are heading to Düsseldorf for the MEDICA Trade fair this November. Reach out to us to book in a meeting between November 14th-16th. We are happy to meet new business partners, customers, or start new collaborations!
6 October 2023
Blog
Liver Awareness Month
October is not just the month of pumpkins and Halloween; it’s also Liver Awareness Month, a time dedicated to shedding light on the importance of liver health! The liver plays a crucial role in our bodies, yet many people remain unaware of the silent threats that can affect it, particularly chronic liver diseases. In this blog post, we will delve into the significance of Liver Awareness Month, the prevalence of chronic liver diseases, with a focus on Non-Alcoholic Fatty Liver Disease (NAFLD), the challenges of diagnosing silent liver diseases, and the importance of raising awareness, finding, diagnosing, and treating patients effectively.
The Silent Threat: Chronic Liver Diseases
Chronic liver diseases are a growing global health concern. Often referred to as the “silent killers,” these conditions can quietly progress over many years without any noticeable symptoms until the damage is severe. The liver is essential for metabolizing nutrients, filtering toxins, and producing proteins, making its health vital for overall well-being.
One of the most common chronic liver diseases is Non-Alcoholic Fatty Liver Disease (NAFLD). NAFLD (or MAFLD) is characterized by the accumulation of excess fat in the liver cells of people who drink little to no alcohol. It is often associated with obesity, diabetes, and metabolic syndrome. NAFLD can progress to a more severe form known as Non-Alcoholic Steatohepatitis (NASH or MASH), which includes liver inflammation and can lead to cirrhosis, liver failure, and even liver cancer.
The Challenge of Diagnosing Silent Liver Diseases
One of the main challenges in addressing chronic liver diseases is the difficulty in diagnosing them early. Since these conditions typically manifest without symptoms until significant liver damage has occurred, many individuals are unaware of their condition until late later disease stages.
Standard biomarkers of liver injury can be valuable tools to indicate a problem with the liver, but are non-specific and may perform poorly in the early detecting of NAFLD and NASH. Therefore, it is essential to complement the use of standard biomarkers in order to increase the accuracy for detecting and stratifying NAFLD and NASH patients at an early stage, before advancements into end stage liver disease.
A Patient’s Perspective
To understand the challenges of diagnosing silent liver diseases better, let’s hear from one NAFLD patient:
“I had always thought I was in good health until a routine check-up revealed something unexpected. My doctor told me I had a fatty liver with possible inflammation and fibrosis, but I had no symptoms at all. It was purely coincidental that we found this out. I’m still uncertain about where I stand in the disease progression and what steps I need to take. It’s been quite confusing, not knowing whether I should be worried or if there’s something I can do to improve my liver health.”
Liver Awareness Month serves as a reminder of the importance of liver health. It is a crucial time to educate the public about chronic liver diseases, their risk factors, and the significance of early detection. Community awareness campaigns, healthcare professionals, and patient organizations play a vital role in spreading knowledge about liver health. Additionally, finding patients with silent liver diseases requires proactive efforts. Routine health check-ups should include liver function tests for those at risk, such as individuals with obesity, diabetes, or metabolic syndrome. Educating primary care providers about the importance of early screening can also lead to more timely diagnoses.
Here, measuring Keratin 18 (K18) has been shown to be a sensitive indicator of NAFLD and NASH, can aid in NAFLD staging, increase the accuracy of biomarker panels for fibrotic NASH, and follow up treatment effect on the liver.
Early diagnosis and intervention are key to managing chronic liver diseases effectively. While there is no specific medication for NAFLD or NASH as of today, lifestyle changes like weight loss, a balanced diet, exercise, and managing underlying conditions like diabetes can slow or even reverse liver damage in some cases.
Liver Awareness Month in October is a crucial opportunity to raise awareness about the silent threats posed by chronic liver diseases like NAFLD and NASH. By increasing public knowledge, advocating for routine testing in at-risk individuals, and promoting a healthy lifestyle, we can work together to prevent liver diseases from progressing to irreversible stages. Remember, early detection and intervention can make all the difference in preserving liver health and improving the lives of those affected. Let’s make liver health a priority this October and beyond!
Read more on how the M30 Apoptosense® ELISA can aid in diagnosing NASH and fibrotic NASH
Read more on how the M30 Apoptosense® ELISA can aid in diagnosing pediatric NASH
Read more on how the K18 assays can help in NAFLD clinical trials
Reda Elkhatib
For U.S. users: The VLVbio K18 assays have not been approved by the U.S. Food and Drug Administration