系统性红斑狼疮的诊断、预测和预后生物标志物：最新见解。
Diagnostic, predictive and prognostic biomarkers in systemic lupus erythematosus: current insights.
机构信息
Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Department Biomedical Engineering, University of Houston, Houston, Texas, USA.
出版信息
Curr Opin Rheumatol. 2022 Mar 1;34(2):139-149. doi: 10.1097/BOR.0000000000000862.
PURPOSE OF REVIEW
Biomarkers for diagnosis, monitoring and prognosis still constitute an unmet need for systemic lupus erythematosus (SLE). Focusing on recent findings, this review summarises the current landscape of biomarkers in lupus.
RECENT FINDINGS
Urine activated leukocyte cell adhesion molecule (ALCAM) exhibited good diagnostic ability in SLE and lupus nephritis (LN) whereas cerebrospinal fluid neutrophil gelatinase-associated lipocalin (NGAL) showed promise in neuropsychiatric SLE. Urine ALCAM, CD163 and vascular cell adhesion molecule 1 (VCAM-1) may be useful in surveillance of LN. Urine monocyte chemoattractant protein 1 was found to predict treatment response in SLE, and urine CD163 and NGAL treatment response in LN. Serum complement component 3 (C3) and urinary VCAM-1 have been reported to portend long-term renal prognosis in LN.
SUMMARY
NGAL holds promise as a versatile biomarker in SLE whereas urine ALCAM, CD163 and VCAM-1 displayed good performance as biomarkers in LN. The overall lack of concerted corroboration of leading candidates across multiple cohorts and diverse populations leaves the current biomarker landscape in SLE in an urgent need for further survey and systematic validation.
目的综述
生物标志物在系统性红斑狼疮（SLE）的诊断、监测和预后方面仍然存在未满足的需求。本文聚焦于最新发现，总结了目前狼疮生物标志物的研究现状。
最近的发现
尿液活化白细胞细胞间黏附分子（ALCAM）在 SLE 和狼疮肾炎（LN）中具有良好的诊断能力，而脑脊液中性粒细胞明胶酶相关脂质运载蛋白（NGAL）在神经精神性 SLE 中显示出一定的应用前景。尿液 ALCAM、CD163 和血管细胞黏附分子 1（VCAM-1）可能有助于监测 LN。尿液单核细胞趋化蛋白 1 可预测 SLE 的治疗反应，尿液 CD163 和 NGAL 可预测 LN 的治疗反应。血清补体成分 3（C3）和尿液 VCAM-1 已被报道可预测 LN 的长期肾脏预后。
总结
NGAL 有望成为 SLE 中一种多功能的生物标志物，而尿液 ALCAM、CD163 和 VCAM-1 在 LN 中具有良好的性能，可作为生物标志物。目前，SLE 中缺乏多个队列和不同人群中主要候选标志物的一致验证，迫切需要进一步调查和系统验证。
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