Liu Chau-Ching, Manzi Susan, Ahearn Joseph M
Lupus Center of Excellence, School of Health Sciences, University of Pittsburgh, PA 15261, USA.
Curr Opin Rheumatol. 2005 Sep;17(5):543-9. doi: 10.1097/01.bor.0000174182.70159.22.
Despite decades of extensive work in the understanding of the etiopathogenesis of systemic lupus erythematosus, few biomarkers have been validated and widely accepted for this disease. The lack of reliable, specific biomarkers not only hampers clinical management of systemic lupus erythematosus but also impedes development of new therapeutic agents. This paper reviews briefly the historical aspects of systemic lupus erythematosus biomarkers and summarizes recent studies on candidate biomarkers.
Recognizing the urgent need for lupus biomarkers, a Lupus Biomarker Working Group has recently been initiated to facilitate collaborative efforts aimed at identifying and validating biomarkers for systemic lupus erythematosus. Based on available data, several laboratory markers have shown promise as biomarkers for susceptibility, diagnosis, and disease activity. These include Fc receptor genes (disease susceptibility), complement C4d-bound erythrocytes (diagnosis or disease activity), CD27 plasma cells (disease activity), 'interferon signature' (disease activity), and anti-C1q antibodies (disease activity and organ involvement).
There is a longstanding and recently rejuvenated enthusiasm for biomarkers that precisely and specifically reflect the pathophysiologic and clinical changes in systemic lupus erythematosus. Promising candidate biomarkers have been identified but must still be validated through rigorous, large-scale multicenter studies.
尽管在系统性红斑狼疮的发病机制研究方面已开展了数十年广泛工作,但针对该疾病的生物标志物仅有少数得到验证并被广泛接受。缺乏可靠、特异的生物标志物不仅阻碍了系统性红斑狼疮的临床管理,也妨碍了新型治疗药物的研发。本文简要回顾了系统性红斑狼疮生物标志物的历史,并总结了近期关于候选生物标志物的研究。
鉴于对狼疮生物标志物的迫切需求,近期成立了狼疮生物标志物工作组,以促进旨在识别和验证系统性红斑狼疮生物标志物的协作努力。基于现有数据,几种实验室标志物已显示出有望作为易感性、诊断和疾病活动度的生物标志物。这些标志物包括Fc受体基因(疾病易感性)、补体C4d结合红细胞(诊断或疾病活动度)、CD27浆细胞(疾病活动度)、“干扰素特征”(疾病活动度)以及抗C1q抗体(疾病活动度和器官受累情况)。
长期以来,人们一直热衷于寻找能够精确、特异反映系统性红斑狼疮病理生理和临床变化的生物标志物,近期这种热情再度高涨。已确定了一些有前景的候选生物标志物,但仍需通过严格的大规模多中心研究进行验证。