Szekanecz Zoltán
Debreceni Egyetem, Orvos- és Egészségtudományi Centrum Belgyógyászati Intézet, Reumatológiai Tanszék Debrecen Nagyerdei.
Orv Hetil. 2013 Mar 31;154(13):483-96. doi: 10.1556/OH.2013.29580.
In rheumatology, especially in arthritides, early diagnosis and aggressive therapy may open up new dimensions of expectations, such as improvement of pain, prevention of structural, functional damage and better quality of life. Targeted (biological) therapy has brought new horizons in rheumatology. As it is a rather expensive treatment modality, it has been urgent to develop tools suitable for the prediction of therapeutic responses. Several clinical, immunological and genetic biomarkers have been established for this purpose. Among clinical markers, male sex, younger age, lower or even higher disease activity at baseline, combination treatment and quitting smoking may lead to better treatment outcome. Immunological biomarkers, such as C-reactive protein, seropositivity, peripheral blood or synovial cellular content have been associated with therapeutic responses. Finally, numerous genes or gene signatures may also predict the efficacy or safety of immunosuppressive drugs. Although sometimes there have been only few studies conducted that led to some controversy, some biomarkers have also been validated. This may lead us to optimism in terms of wider acceptance of personalized medicine in rheumatology.
在风湿病学领域，尤其是在关节炎方面，早期诊断和积极治疗可能会开启新的期望维度，比如缓解疼痛、预防结构和功能损伤以及提高生活质量。靶向（生物）疗法为风湿病学带来了新的前景。由于这是一种相当昂贵的治疗方式，开发适用于预测治疗反应的工具变得十分迫切。为此已经建立了多种临床、免疫和遗传生物标志物。在临床标志物中，男性、年轻、基线时疾病活动度较低甚至较高、联合治疗以及戒烟可能会带来更好的治疗效果。免疫生物标志物，如C反应蛋白、血清阳性、外周血或滑膜细胞含量，都与治疗反应有关。最后，众多基因或基因特征也可能预测免疫抑制药物的疗效或安全性。尽管有时相关研究较少，导致出现了一些争议，但一些生物标志物也已得到验证。这可能会让我们对个性化医学在风湿病学中得到更广泛的接受持乐观态度。
