Department of Medicine, Nephrology and Kidney Transplantation Section, Medical College of Georgia, 1120 15th Street, BA 9413, Augusta, GA 30912-3140, USA.
Rheum Dis Clin North Am. 2010 Feb;36(1):131-43, ix. doi: 10.1016/j.rdc.2009.12.009.
Biomarkers have the potential to be useful tools for noninvasively evaluating and managing patients with lupus nephritis. Many candidate biomarkers have been identified, but they require validation in larger cohorts. It is likely that combinations or biomarker profiles, rather than individual markers, will emerge to help better predict the severity of inflammation, the extent of fibrosis, degree of drug responsiveness, and other variables. This approach has the potential to reduce the use of the renal biopsy, improve therapeutic efficacy, and limit toxicity. We predict algorithms based on genotype and biomarkers combined with clinical presentation will emerge to help guide physicians in management. Assays that show the most potential include serum erythrocyte bound complement C4d, interleukin 17, interleukin 23, interferon score/chemokine score ratio, and anti-C1q antibodies. Such urinary biomarkers as fractional excretion of endothelial-1, monocyte chemoattractant protein-1, vascular cell adhesion molecule-1, and TWEAK (tumor necrosis factor-like weak inducer of apoptosis) may also be useful but require validations.
生物标志物有可能成为评估和管理狼疮肾炎患者的非侵入性有用工具。已经确定了许多候选生物标志物，但它们需要在更大的队列中进行验证。很可能是组合或生物标志物谱，而不是单个标志物，将出现以帮助更好地预测炎症的严重程度、纤维化的程度、药物反应的程度和其他变量。这种方法有可能减少肾活检的使用、提高治疗效果并限制毒性。我们预测基于基因型和生物标志物与临床表现相结合的算法将出现，以帮助指导医生进行治疗。显示出最大潜力的检测包括血清红细胞结合补体 C4d、白细胞介素 17、白细胞介素 23、干扰素评分/趋化因子评分比和抗 C1q 抗体。尿中内皮素-1、单核细胞趋化蛋白-1、血管细胞黏附分子-1 和 TWEAK（肿瘤坏死因子样凋亡弱诱导剂）等生物标志物也可能有用，但需要验证。
