Research and Development, Takeda Pharmaceuticals Inc. Co., Cambridge, MA, United States.
Celiac Disease Research Program, Harvard Medical School, Boston, MA, United States.
Front Immunol. 2021 Apr 7;12:665756. doi: 10.3389/fimmu.2021.665756. eCollection 2021.
Celiac disease is a common immune-mediated disease characterized by abnormal T-cell responses to gluten. For many patients, symptoms and intestinal damage can be controlled by a gluten-free diet, but, for some, this approach is not enough, and celiac disease progresses, with serious medical consequences. Multiple therapies are now under development, increasing the need for biomarkers that allow identification of specific patient populations and monitoring of therapeutic activity and durability. The advantage of identifying biomarkers in celiac disease is that the underlying pathways driving disease are well characterized and the histological, cellular, and serological changes with gluten response have been defined in gluten challenge studies. However, there is room for improvement. Biomarkers that measure histological changes require duodenal biopsies and are invasive. Less invasive peripheral blood cell and cytokine biomarkers are transient and dependent upon gluten challenge. Here, we discuss established biomarkers and new approaches for biomarkers that may overcome current limitations.
乳糜泻是一种常见的免疫介导性疾病，其特征是对麸质的异常 T 细胞反应。对于许多患者来说，无麸质饮食可以控制症状和肠道损伤，但对于某些患者来说，这种方法还不够，乳糜泻会进展，导致严重的医疗后果。目前正在开发多种治疗方法，这增加了对生物标志物的需求，以便识别特定的患者群体，并监测治疗的效果和持久性。在乳糜泻中识别生物标志物的优势在于，驱动疾病的潜在途径已得到很好的描述，并且在麸质挑战研究中已经定义了与麸质反应相关的组织学、细胞和血清学变化。然而，仍有改进的空间。测量组织学变化的生物标志物需要进行十二指肠活检，具有侵入性。不太侵入性的外周血细胞和细胞因子生物标志物是短暂的，并且依赖于麸质挑战。在这里，我们讨论了已建立的生物标志物和新的生物标志物方法，这些方法可能克服当前的局限性。
