Allegheny Singer Research Institute,Temple University School of Medicine,320 East North Avenue Pittsburgh, PA 15212, USA.
Ther Adv Musculoskelet Dis. 2013 Aug;5(4):210-33. doi: 10.1177/1759720X13485503.
The search for lupus biomarkers to diagnose, monitor, stratify, and predict individual response to therapy is currently more intense than ever before. This effort is essential for several reasons. First, epidemic overdiagnosis and underdiagnosis of lupus, even by certified rheumatologists, leads to errors in therapy with concomitant side effects which may be more serious than the disease itself. Second, identification of lupus flares remains as much an art as it is a science. Third, the capacity to stratify patients so as to predict those who will develop specific patterns of organ involvement is not currently possible but would potentially lead to preventive therapeutic strategies. Fourth, only one new drug for the treatment of lupus has been approved by the US Food and Drug Administration in over 50 years. A major obstacle in this pipeline is the dearth of biomarkers available to prove a patient has responded to an experimental therapeutic intervention. This review will summarize the challenges faced in the discovery and validation of lupus biomarkers, the most promising lupus biomarkers identified to date, and the promise of future directions.
目前，寻找狼疮生物标志物来诊断、监测、分层和预测个体对治疗的反应比以往任何时候都更加迫切。这一努力至关重要，原因有几个。首先，狼疮的过度诊断和漏诊，即使是由认证的风湿病学家，也会导致治疗错误，伴随副作用，这些副作用可能比疾病本身更严重。其次，确定狼疮发作仍然既是一门艺术，也是一门科学。第三，分层患者以预测哪些患者将发展出特定模式的器官受累的能力目前尚不可能，但有可能导致预防性治疗策略。第四，在过去的 50 多年里，只有一种治疗狼疮的新药获得了美国食品和药物管理局的批准。这一领域的一个主要障碍是缺乏生物标志物来证明患者对实验性治疗干预有反应。这篇综述将总结狼疮生物标志物的发现和验证所面临的挑战，迄今为止发现的最有前途的狼疮生物标志物，以及未来的发展方向。
