Exploring the untapped potential: a systematic review of novel enzymes as biomarkers over the past 12 years

Abstract

Background: Many enzymes were explored and used as biomarkers, but some were less specific and less sensitive, therefore, they were replaced with more reliable non-enzymatic biomarkers. Thus, to date, not so many enzyme biomarkers and their isotypes have been added to the menus of clinical chemistry laboratories. This review paper, therefore, attempts to summate published literature related to “novel” enzymes that have been studied as potential biomarkers through clinical trials and randomized control trials in the past 12 years. This review also aims to explore the trends, methodologies, gaps, and updates surrounding these enzymes and the progress of their application in clinical settings. Preferably, selecting only studies that used biological fluids as specimens, and analytical methods that are routinely done in clinical chemistry laboratories. Methods: Studies related to “novel” enzymes, published from January 2012 to December 2023, were systematically searched in PubMed following the PRISMA 2020 guidelines. The search term for potentially relevant studies was “enzyme activity”. The data was gathered using a data extraction template and was grouped into three categories according to their clinical applications. Results: The search yielded 42 eligible articles from the initial search of 3,255 articles via registers. The studies reported the potential use of “novel” enzymes as biomarkers for tumors or cancer, tissues and organ function, and other diseases or medical conditions not specified to an organ system. Conclusions: Numerous directions and opportunities within clinical enzymology exist, especially on how “novel” enzymes can serve as potential biomarkers for diagnosis, prognosis, and therapy monitoring of various diseases. As the recent advances in biochemistry and the continuing collaboration among researchers, clinicians, and industry stakeholders continue to unveil the complicated roles of enzymes in various diseases, the integration and recalibration of this “novel” enzymes into routine clinical practice holds promise for more accurate, timely, and personalized treatment strategies.