Nephrology Unit and Immunology Clinic, ASST Santi Paolo e Carlo, Milan, Italy.
ASST Fatebenefratelli Sacco, Milan, Italy.
J Nephrol. 2019 Dec;32(6):871-882. doi: 10.1007/s40620-019-00628-9. Epub 2019 Jul 12.
ANCA-associated vasculitis (AAV) are the prototype of a disease characterised by the presence of a biomarker; ANCA positivity in fact is recorded in 90% of cases of GPA and MPA. The role of ANCA in the management of AAV ranges from diagnostic to prognostic purposes with also therapeutic implications. Changes in clinical practice with the increased use of rituximab have drawn attention to B-cells as a biomarker able to contribute to patient management. Cytokines and other circulating factors, although still at a research stage, may represent future biomarkers of interest or even therapeutic options. From the point of view of renal involvement in AAV, proteinuria and microhematuria are still the biomarkers employed in everyday clinical practice with a proposed role for emerging ones (MCP1, CD163 and CD25). The aim of this review is to discuss the role of well-known biomarkers in everyday clinical management of AAV patients as well as future perspectives for those that are still at a research stage with attention to therapeutic implications.
抗中性粒细胞胞质抗体（ANCA）相关性血管炎（AAV）是一种以生物标志物为特征的疾病的原型；事实上，在 GPA 和 MPA 的 90%的病例中都记录到了 ANCA 阳性。ANCA 在 AAV 的管理中的作用从诊断到预后，也具有治疗意义。随着利妥昔单抗的使用增加，临床实践发生了变化，这引起了人们对 B 细胞作为能够有助于患者管理的生物标志物的关注。细胞因子和其他循环因子，尽管仍处于研究阶段，可能代表着未来有意义的生物标志物或甚至是治疗选择。从 AAV 的肾脏受累的角度来看，蛋白尿和镜下血尿仍然是日常临床实践中使用的生物标志物，对于新兴的生物标志物（MCP1、CD163 和 CD25）提出了作用。本综述的目的是讨论在 AAV 患者的日常临床管理中已知生物标志物的作用，以及对于那些仍处于研究阶段的生物标志物的未来展望，同时关注治疗意义。
