Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA 94305, USA.
Nat Rev Rheumatol. 2012 May 31;8(6):317-28. doi: 10.1038/nrrheum.2012.66.
Rheumatologists see patients with a range of autoimmune diseases. Phenotyping these diseases for diagnosis, prognosis and selection of therapies is an ever increasing problem. Advances in multiplexed assay technology at the gene, protein, and cellular level have enabled the identification of 'actionable biomarkers'; that is, biological metrics that can inform clinical practice. Not only will such biomarkers yield insight into the development, remission, and exacerbation of a disease, they will undoubtedly improve diagnostic sensitivity and accuracy of classification, and ultimately guide treatment. This Review provides an introduction to these powerful technologies that could promote the identification of actionable biomarkers, including mass cytometry, protein arrays, and immunoglobulin and T-cell receptor high-throughput sequencing. In our opinion, these technologies should become part of routine clinical practice for the management of autoimmune diseases. The use of analytical tools to deconvolve the data obtained from use of these technologies is also presented here. These analyses are revealing a more comprehensive and interconnected view of the immune system than ever before and should have an important role in directing future treatment approaches for autoimmune diseases.
风湿科医生诊治患有各种自身免疫性疾病的患者。为了明确诊断、预测预后和选择治疗方案，对这些疾病进行表型分析的需求日益增加。在基因、蛋白质和细胞水平上，多重分析技术的进步使人们能够识别“可操作的生物标志物”，即能够为临床实践提供信息的生物学指标。这些生物标志物不仅可以深入了解疾病的发展、缓解和恶化，还无疑将提高诊断的敏感性和分类的准确性，并最终指导治疗。这篇综述介绍了这些强大的技术，它们可能有助于发现可操作的生物标志物，包括质谱流式细胞术、蛋白质阵列以及免疫球蛋白和 T 细胞受体高通量测序。我们认为，这些技术应该成为自身免疫性疾病管理常规临床实践的一部分。本文还介绍了用于解析使用这些技术获得的数据的分析工具的使用。这些分析揭示了比以往任何时候都更加全面和相互关联的免疫系统观点，应该在指导自身免疫性疾病的未来治疗方法方面发挥重要作用。
