Ahn Sung Soo, Park Yong Beom, Lee Sang Won
Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2021 Apr;62(4):279-287. doi: 10.3349/ymj.2021.62.4.279.
Small vessel vasculitis is composed of two types of vasculitis based on immune-complex deposits, immune-complex vasculitis and antineutrophil cytoplasmic antibody-associated vasculitis (AAV) according to the 2012 Chapel Hill Consensus Conferences Nomenclature of Vasculitis. In general, the current disease-states are assessed in three ways in real clinical practice such as activity, damage and functional status. Birmingham vasculitis activity score (BVAS, version 3) and five-factor score were calculated for assessing the cross-sectional activity and for predicting the prognosis of AAV, respectively. Since BVAS includes a wide spectrum of nine systemic items with differently weighted scores based on new-onset/worsening or persistent each symptom, it has been considered as the most reliable tool to assess AAV activity to date. However, since BVAS represents both cross-sectional and chronic clinical features, it has a limitation in flexibly reflecting the cross-sectional activity or severity of AAV. In addition, the heterogeneous items of BVAS are difficult to reflect the close correlation between BVAS and AAV pathogenesis. It is practically difficult to discover new biomarkers or indices that exceed the reliability of AAV-specific indices or acute-phase reactants established by long clinical experience. However, efforts to discover and develop new biomarkers or indices are expected to complement the clinical unmet need of existing AAV-specific indices and acute-phase reactants. In this review, we reviewed the serological biomarkers and indices that have been reported to date and introduced studies that investigated serological biomarkers and indices in Korean patients with AAV.
根据2012年《 Chapel Hill血管炎共识会议血管炎命名法》，小血管炎由基于免疫复合物沉积的两种血管炎组成，即免疫复合物性血管炎和抗中性粒细胞胞浆抗体相关性血管炎（AAV）。一般来说，在实际临床实践中，目前通过三种方式评估疾病状态，即活动度、损伤和功能状态。分别计算伯明翰血管炎活动评分（BVAS，第3版）和五因素评分，以评估AAV的横断面活动度和预测其预后。由于BVAS包括广泛的九个系统性项目，根据每种症状的新发/加重或持续情况给予不同加权分数，它被认为是迄今为止评估AAV活动度最可靠的工具。然而，由于BVAS既代表横断面特征，也代表慢性临床特征，它在灵活反映AAV的横断面活动度或严重程度方面存在局限性。此外，BVAS的异质性项目难以反映BVAS与AAV发病机制之间的密切相关性。实际上，很难发现超过长期临床经验确立的AAV特异性指标或急性期反应物可靠性的新生物标志物或指标。然而，发现和开发新生物标志物或指标的努力有望补充现有AAV特异性指标和急性期反应物在临床上未满足的需求。在本综述中，我们回顾了迄今为止报道的血清学生物标志物和指标，并介绍了在韩国AAV患者中研究血清学生物标志物和指标的研究。
