Institute of Immunology, Rikshospitalet, University of Oslo, Norway.
Mol Diagn Ther. 2011 Oct 1;15(5):247-54. doi: 10.1007/BF03256416.
Early diagnosis and effective management of rheumatoid arthritis (RA) are pivotal, given the progressive, chronic, inflammatory, multi-systemic nature of the disease. Currently, proper initiation of adequate, individually tailored interventions in RA is delayed by the difficulty of early diagnosis and the limitations of disease activity and therapeutic response assessment tools. This is a significant challenge to rheumatologists, further complicated by the dynamic and progressively evolving autoimmune nature of RA, which is characterized by several immune mediators in a complex network that regulates the perpetuation of inflammation. Protein arrays constitute the most advanced current technology that can provide a comprehensive parallel analysis of this diverse network in RA, providing an individualized insight into immune status and host immune response. The last few years have seen significant transitions in the field of protein arrays, demonstrated by a technologic shift from the bench to the bedside, paving the way for the medical and scientific community to deliver patient-specific assessments and personalized management. Screening of protein arrays with sera or tissues from patients with RA enables the probing of immune responses and the identification of autoantibody signatures that can be used for the diagnosis and therapeutic management of patients. This article reviews the technology and the applications for protein arrays in the diagnosis and prognosis of RA. Clinical assessment tools could be derived from protein arrays, which may provide a means to continually track patients, allowing better evaluation of intervention strategies on a patient-specific basis and identification of diagnostic and disease activity biomarkers that could be used to guide optimal therapy in RA.
早期诊断和有效管理类风湿关节炎（RA）至关重要，因为这种疾病具有进行性、慢性、炎症性、多系统的性质。目前，由于早期诊断的困难以及疾病活动度和治疗反应评估工具的局限性，RA 的适当起始足够、个体化干预的时机被推迟。这对风湿病学家来说是一个重大挑战，RA 的动态和不断发展的自身免疫性质进一步使问题复杂化，其特征是在一个复杂的网络中存在几种免疫介质，该网络调节炎症的持续存在。蛋白质芯片构成了目前最先进的技术，可以对 RA 中的这种多样化网络进行全面的平行分析，为了解免疫状态和宿主免疫反应提供个体化的见解。过去几年，蛋白质芯片领域发生了重大转变，技术从实验室转移到床边，为医疗和科学界提供患者特异性评估和个性化管理铺平了道路。用 RA 患者的血清或组织筛选蛋白质芯片可以探测免疫反应并确定自身抗体特征，从而可用于诊断和治疗管理患者。本文综述了蛋白质芯片在 RA 诊断和预后中的技术和应用。可以从蛋白质芯片中得出临床评估工具，这可能为连续跟踪患者提供一种手段，从而能够更好地根据患者的具体情况评估干预策略，并确定可用于指导 RA 最佳治疗的诊断和疾病活动生物标志物。
