Bugatti Serena, Manzo Antonio, Montecucco Carlomaurizio, Caporali Roberto
Division of Rheumatology and Early Arthritis Clinic, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy.
Front Med (Lausanne). 2018 Dec 3;5:339. doi: 10.3389/fmed.2018.00339. eCollection 2018.
Rheumatoid arthritis (RA) is a highly heterogeneous syndrome in terms of clinical presentation, progression, and response to therapy. In such a complicated context, the identification of disease-related biomarkers would be undoubtedly helpful in assisting tailored approaches for every patient. Despite remarkable efforts, however, progress in new biomarker development and validation is dramatically slow. At present, none of the candidate genetic, cellular, or molecular biomarker has yet surpassed the clinical value of RA-specific autoantibodies, including rheumatoid factor (RF) and anti-citrullinated protein autoantibodies (ACPA). Rather, recent years have witnessed significant advancements in our understanding of the multiple roles that RF and ACPA play in RA pathophysiology. This has helped clarifying the mechanistic basis of the clinical associations of autoantibodies in RA. In this short review, we will briefly summarize the effector functions of RF and ACPA, and analyse how autoantibodies may help subclassifying RA patients in terms of clinical presentation and response to therapy.
类风湿性关节炎（RA）在临床表现、病情进展及对治疗的反应方面是一种高度异质性的综合征。在如此复杂的情况下，识别疾病相关生物标志物无疑有助于为每位患者制定个性化治疗方案。然而，尽管付出了巨大努力，新型生物标志物的开发和验证进展却极为缓慢。目前，候选的基因、细胞或分子生物标志物均未超越类风湿因子（RF）和抗瓜氨酸化蛋白自身抗体（ACPA）等RA特异性自身抗体的临床价值。相反，近年来我们对RF和ACPA在RA病理生理学中所起的多重作用有了重大进展。这有助于阐明RA中自身抗体临床关联的机制基础。在这篇简短的综述中，我们将简要总结RF和ACPA的效应功能，并分析自身抗体如何根据临床表现和对治疗的反应帮助对RA患者进行亚分类。
