# Blood protein TSP2 shows promise for spotting serious fatty liver scarring

> A large study comparing 30 tests for fatty liver disease found that one blood protein, thrombospondin-2, performs well at flagging advanced liver scarring without a biopsy.

- Published: 2026-11-02 by Tickety-Boo News
- Section: Health
- Location: Europe and the United States
- Web page: https://ticketyboonews.co.uk/stories/blood-protein-tsp2-shows-promise-for-spotting-serious-fatty-liver/
- Original report: [Single blood protein stands out among 30 tests for assessing fatty liver disease](https://medicalxpress.com/news/2026-10-blood-protein-fatty-liver-disease.html) (Medical Xpress)

## In brief

- The LITMUS study compared 30 biomarkers and tests for diagnosing fatty liver disease and its advanced form, MASH.
- It analysed 1,590 biopsy-diagnosed patients at 37 liver centres in 13 countries across Europe and the US.
- Blood protein TSP2 performed well at indicating advanced liver fibrosis, offering a possible alternative to biopsy.

A single protein in the blood has emerged as one of the most promising ways to spot serious scarring of the liver in people with fatty liver disease. The finding comes from a large international study that put 30 different tests side by side.

The research, known as LITMUS, focused on metabolic dysfunction-associated steatotic liver disease, or MASLD. Doctors have often had to rely on a liver biopsy to judge how far the condition has advanced. That means taking a tissue sample and examining it, which is an invasive procedure.

The team analysed data from 1,590 patients whose condition had been accurately diagnosed by biopsy. They were enrolled between 2018 and 2023 at 37 liver centres in 13 countries across Europe and the United States, which is no mean feat for a single study.

The tests under review covered individual biomarkers and combinations of them. They were assessed for diagnosing MASLD and its advanced, progressive form, metabolic dysfunction-associated steatohepatitis (MASH). Several performed very well at detecting significant fibrosis and cirrhosis, including more complex combinations that involve a specialised ultrasound technique called elastography.

Among the single markers, thrombospondin-2, or TSP2, stood out. It is a connective tissue protein, and its concentration in the blood gives reliable indications of fibrotic changes in the liver that carry a risk of developing into cirrhosis. It is described as one of the most promising blood-based markers for progressive, advanced fibrosis and inflammation (MASH at risk).

The picture was not uniformly rosy. None of the tests reached the threshold set in advance for diagnosing the early stages of fatty liver disease without significant scarring.

Even so, newly developed blood tests have the potential to offer a noninvasive and inexpensive way to assess liver health in the general population in the future.

## Why it matters

Accurate staging of fatty liver disease is essential for choosing the right treatment and tracking whether it is working, yet the current reliance on biopsy limits how often and how widely it can be done. A simple blood test that reliably flags dangerous scarring could make assessment easier for patients and health services alike, helping doctors identify those most at risk of cirrhosis sooner.