Department Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen, RB 9700, the Netherlands.
Department Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen, RB 9700, the Netherlands.
Semin Arthritis Rheum. 2021 Feb;51(1):43-48. doi: 10.1016/j.semarthrit.2020.11.006. Epub 2020 Dec 18.
Systemic lupus erythematosus (SLE) is a complex and heterogeneous autoimmune disease. A main challenge faced by clinicians is early identification of SLE, frequently resulting in diagnostic delay. Timely treatment, however, is important to limit disease progression, and prevent organ damage and mortality. Often, patients present with clinical symptoms and immunologic abnormalities suggestive of SLE, while not meeting classification criteria yet. This is referred to as incomplete SLE (iSLE). However, not all these patients will develop SLE. Therefore, there is need for predictive biomarkers that can distinguish patients at high risk of developing SLE, in order to allow early treatment. This article reviews the current literature on immunological changes in patients with stages preceding SLE, focusing on autoantibodies, type-I and -II interferons, and the complement system. We also provide an overview of possible predictive markers for progression to SLE that are applicable in daily clinical practice.
系统性红斑狼疮（SLE）是一种复杂且异质性的自身免疫性疾病。临床医生面临的主要挑战是早期识别 SLE，这常常导致诊断延迟。然而，及时治疗对于限制疾病进展、预防器官损伤和死亡率非常重要。通常，患者会出现提示 SLE 的临床症状和免疫异常，但尚未符合分类标准。这被称为不完全性 SLE（iSLE）。然而，并非所有这些患者都会发展为 SLE。因此，需要有预测生物标志物来区分处于 SLE 高风险的患者，以便进行早期治疗。本文综述了 SLE 前阶段患者的免疫变化的现有文献，重点关注自身抗体、I 型和 II 型干扰素以及补体系统。我们还概述了在日常临床实践中适用于 SLE 进展的可能预测标志物。
