Villalta Danilo, Tozzoli Renato, Tonutti Elio, Bizzaro Nicola
Immunologia Clinica e Virologia, Azienda Ospedaliera S. Maria degli Angeli, via Montereale 24, 33170 Pordenone, Italy.
Autoimmun Rev. 2007 Jun;6(6):359-65. doi: 10.1016/j.autrev.2007.01.009. Epub 2007 Feb 7.
Array technology and proteomics are about to launch the era of multiplexed analysis, which allows simultaneous detection of numerous autoantibody specificities and the possibility of defining broad autoantibody profiles. This will probably improve disease staging, risk stratification, prognosis and treatment. However, although these technologies are very promising, they are still in their infancy, and therefore need to undergo strict analytical and clinical validation processes. The latter should involve clinicians and pathologists in prospective, multicentric studies conducted on large numbers of patients to define the specific significance of the various autoantibody profiles. Establishing common standards for the publication and sharing of microarray-generated data will be important for this purpose. Only when these studies have been completed will these new technologies find a place in clinical laboratories. Although we are entering a decade which will probably see a radical change in the diagnostic approach to autoimmune diseases, we do not yet have sufficient knowledge to apply proteomic technologies on a large scale. For the time being, therefore, it is advisable to continue using well-established approaches and diagnostic algorithms such as those reported in the international guidelines, which have been prepared in accordance with the principles of appropriateness and evidence-based medicine.
芯片技术和蛋白质组学即将开启多重分析时代，这使得同时检测多种自身抗体特异性以及定义广泛的自身抗体谱成为可能。这可能会改善疾病分期、风险分层、预后及治疗。然而，尽管这些技术前景广阔，但仍处于起步阶段，因此需要经过严格的分析和临床验证过程。后者应让临床医生和病理学家参与针对大量患者开展的前瞻性多中心研究，以确定各种自身抗体谱的具体意义。为此，建立微阵列产生数据的发布和共享通用标准至关重要。只有当这些研究完成后，这些新技术才会在临床实验室中占有一席之地。尽管我们正步入一个可能会使自身免疫性疾病诊断方法发生根本性变革的十年，但我们目前还没有足够的知识来大规模应用蛋白质组学技术。因此，目前明智的做法是继续使用诸如国际指南中所报道的那些成熟方法和诊断算法，这些指南是根据恰当性和循证医学原则制定的。
