Bizzaro Nicola
Laboratorio di Patologia Clinica, Ospedale Civile, via Morgagni, 33028 Tolmezzo, Italy.
Autoimmun Rev. 2007 Jun;6(6):325-33. doi: 10.1016/j.autrev.2007.01.006. Epub 2007 Jan 30.
Several studies have shown that autoimmune diseases are preceded by a long pre-clinical phase, and that many autoantibodies can be detected in the serum of asymptomatic subjects years before the clinical manifestations become evident. Tests for these autoantibodies could therefore be used in principle in screening studies on unselected populations to identify individuals predisposed to the development of the disease at an early stage, and start treatment or adopt preventive measures where possible. This aspect has aroused particular interest, as multiplex investigation techniques are already available, and microarray methods are under development, which will probably allow tens or hundreds of autoantibodies to be measured simultaneously. However, as no antibody assay offers 100% specificity, and the results are strongly dependent on the assay method used to measure the autoantibodies, it is essential to use assay methods with high diagnostic specificity, to minimize false positives and obtain a high positive predictive value. This review examines the various autoantibodies for which a role in predicting the development of an autoimmune disease has been demonstrated in long-term prospective studies.
多项研究表明，自身免疫性疾病之前存在很长的临床前期，并且在临床表现明显出现的数年之前，就可以在无症状受试者的血清中检测到许多自身抗体。因此，这些自身抗体检测原则上可用于对未选择人群的筛查研究，以在早期识别易患该疾病的个体，并在可能的情况下开始治疗或采取预防措施。这一方面引起了特别的关注，因为已经有了多重检测技术，并且微阵列方法也在开发中，这可能会使同时检测数十种或数百种自身抗体成为可能。然而，由于没有一种抗体检测具有100%的特异性，并且结果强烈依赖于用于检测自身抗体的检测方法，因此必须使用具有高诊断特异性的检测方法，以尽量减少假阳性并获得高阳性预测值。本综述探讨了在长期前瞻性研究中已证明在预测自身免疫性疾病发展中起作用的各种自身抗体。
