Centre for Immune Regulation and Department of Immunology, University of Oslo and Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Division of Clinical Immunology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Immunol Lett. 2017 Sep;189:13-18. doi: 10.1016/j.imlet.2017.05.010. Epub 2017 May 16.
Early diagnosis and immediately started appropriate treatment are mandatory for the prevention of radiographic progression, functional disability and unfavourable disease outcome in rheumatoid arthritis (RA). The current classification criteria for RA include two different types of biomarkers representing inflammatory processes, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) or immune processes including autoantibodies, such as rheumatoid factor (RF) and antibodies against citrullinated proteins (ACPA). After the discovery of RF, the recent recognition of various autoantibodies against post-translationally modified proteins opened new avenues to diagnosing RA and predicting the course of the disease. Citrullination and carbamylation of amino acids generate new epitopes that can potentially promote the production of novel autoantibodies. In spite of growing knowledge, the pathogenic role of these autoantibodies is still not fully elucidated in RA. In this paper, we review the currently available and novel promising immune biomarkers, which may help in early diagnosis and estimating prognosis in RA.
早期诊断和立即开始适当的治疗对于预防类风湿关节炎 (RA) 的放射学进展、功能障碍和不良疾病结局是强制性的。目前的 RA 分类标准包括两种不同类型的生物标志物，代表炎症过程，如 C 反应蛋白 (CRP) 和红细胞沉降率 (ESR)，或免疫过程，包括自身抗体，如类风湿因子 (RF) 和抗瓜氨酸化蛋白抗体 (ACPA)。在发现 RF 后，最近对各种翻译后修饰蛋白的自身抗体的认识为诊断 RA 和预测疾病进程开辟了新途径。氨基酸的瓜氨酸化和氨甲酰化产生新的表位，可能促进新的自身抗体的产生。尽管知识不断增加，但这些自身抗体在 RA 中的致病作用仍未完全阐明。本文综述了目前可用的和有前途的新型免疫生物标志物，这些标志物可能有助于 RA 的早期诊断和预后评估。
