ELN and congenital secretory chloride diarrhea 1: Evidence for elastin turnover in vivo comes from studies showing elevated serum levels of MMP‐mediated elastin breakdown fragments15 and urinary concentrations of markers of degradation of mature cross‐linked elastin (desmosine and isodesmosine) in patients with cirrhosis.16 Furthermore, these urinary biomarkers correlated with liver fibrosis scores in biopsies from patients with CLD secondary to hepatitis C virus (HCV) infection and alcohol consumption.