Department of Dermatology, Second Xiangya Hospital, Central South University, Hunan Key Laboratory of Medical Epigenomics, Changsha, Hunan, China.
Department of Dermatology, Second Xiangya Hospital, Central South University, Hunan Key Laboratory of Medical Epigenomics, Changsha, Hunan, China.
Autoimmun Rev. 2017 Apr;16(4):391-397. doi: 10.1016/j.autrev.2017.02.011. Epub 2017 Feb 14.
Systemic lupus erythematosus (SLE) is a complex and highly heterogeneous disease, which affects multiple organs, including joints, skin, kidneys, heart, hematopoietic system, and nerve system. While the etiopathogenesis of SLE still remains unclear, genetic susceptibilities and aberrant epigenetic modifications are believed to be involved. For precision therapy, it is necessary to assess accurately and objectively organ involvements and disease activity, which is difficult by current clinical laboratory tests. Biomarkers, which are a biologic, genetic, epigenetic or a chemical characteristic and conveniently detectable, serve as measures of disease diagnosis, activity, prognosis, and manifestation prediction, thereby providing instruction for individualized therapy. In addition, biomarkers differ according to different manifestations, since the disease activity index and treatments vary significantly. For example, unlike other non-renal SLE, lupus nephritis requires significant immunosuppressive drugs. Over the past decades, the research on biomarkers in lupus has been strengthened and numerous promising biomarkers have been identified at levels of genomics, transcriptomics and proteomics. In this review, we summarize the conventional and novel biomarkers in the tissue-specific manner, and discuss their roles in specific organ diagnosis, future manifestation prediction, disease activity assessment and their correlation with histology results. By doing so, it aims to shed a light on individualized treatment.
系统性红斑狼疮（SLE）是一种复杂且高度异质的疾病，可影响多个器官，包括关节、皮肤、肾脏、心脏、造血系统和神经系统。虽然 SLE 的病因仍然不清楚，但遗传易感性和异常的表观遗传修饰被认为与之相关。为了进行精准治疗，有必要准确和客观地评估器官受累和疾病活动度，而这很难通过当前的临床实验室检测来实现。生物标志物是一种生物、遗传、表观遗传或化学特征，且易于检测，可作为疾病诊断、活动度、预后和表现预测的衡量指标，从而为个体化治疗提供指导。此外，由于疾病活动指数和治疗方法存在显著差异，生物标志物会因表现不同而有所差异。例如，狼疮肾炎与其他非肾脏 SLE 不同，需要使用大量免疫抑制剂。在过去几十年中，对狼疮生物标志物的研究得到了加强，在基因组学、转录组学和蛋白质组学水平上已经确定了许多有前途的生物标志物。在这篇综述中，我们按组织特异性总结了传统和新型生物标志物，并讨论了它们在特定器官诊断、未来表现预测、疾病活动评估以及与组织学结果的相关性中的作用。这样做旨在为个体化治疗提供启示。
