Zhu Jane L, Black Samantha M, Chong Benjamin F
Department of Dermatology, University of Texas at Southwestern Medical Center, Dallas, TX, USA.
Ann Transl Med. 2021 Mar;9(5):429. doi: 10.21037/atm-20-5232.
Cutaneous lupus erythematosus (CLE) is a connective tissue disease with varying presentations, and clinical sequelae including itching, dyspigmentation, and scarring. CLE can occur as its own entity or in conjunction with systemic disease, known as systemic lupus erythematosus (SLE). Because CLE is clinically diverse, identification of a biomarker may help not only facilitate early diagnosis and management but also identify individuals at risk for poor prognosis and development of SLE. While potential biomarkers in SLE have been extensively studied, few biomarkers for CLE have been identified and incorporated into clinical practice. Anti-SS-A antibody is a commonly used biomarker for diagnosis of subacute CLE patients. Type I interferon-related proteins such as MxA and guanylate binding protein-1 (GBP-1) and chemokines such as CXCR3, CXCL9, and CXCL10 have been identified as biomarkers that may support diagnosis and track disease activity. First-line oral treatment for CLE currently consists of anti-malarials such as hydroxychloroquine (HCQ), chloroquine (CQ), and quinacrine (QC). Studies have found that an increased myeloid dendritic cell population with higher TNF-α expression may be predictive of poor treatment response to HCQ in CLE patients. Autoantibodies against nuclear antigens (e.g., anti-double-stranded DNA and anti-Smith antibodies) and elevated erythrocyte sedimentation rate have been more commonly found in CLE patients progressing to SLE than those who have not. This review aims to summarize previous and emerging biomarkers for CLE patients.
皮肤红斑狼疮（CLE）是一种临床表现多样的结缔组织病，其临床后遗症包括瘙痒、色素沉着异常和瘢痕形成。CLE可单独出现，也可与系统性疾病（即系统性红斑狼疮，SLE）合并出现。由于CLE临床表现多样，鉴定一种生物标志物不仅有助于促进早期诊断和管理，还能识别预后不良和有发展为SLE风险的个体。虽然SLE的潜在生物标志物已得到广泛研究，但针对CLE的生物标志物却鲜有被鉴定并应用于临床实践的。抗SS - A抗体是诊断亚急性CLE患者常用的生物标志物。I型干扰素相关蛋白如Mx A和鸟苷酸结合蛋白-1（GBP - 1）以及趋化因子如CXCR3、CXCL9和CXCL10已被鉴定为可能有助于诊断和追踪疾病活动的生物标志物。CLE的一线口服治疗目前包括抗疟药，如羟氯喹（HCQ）、氯喹（CQ）和奎纳克林（QC）。研究发现，髓样树突状细胞数量增加且肿瘤坏死因子-α表达较高可能预示着CLE患者对HCQ治疗反应不佳。与未进展为SLE的CLE患者相比，进展为SLE的CLE患者中更常见针对核抗原的自身抗体（如抗双链DNA和抗史密斯抗体）以及红细胞沉降率升高。本综述旨在总结既往及新出现的针对CLE患者的生物标志物。
