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新型免疫性血小板减少症诊断和监测生物标志物。

Novel Biomarkers for Diagnosis and Monitoring of Immune Thrombocytopenia.

机构信息

Division of Hematology, Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, 98100 Messina, Italy.

Department of Biomedical, Dental, Morphological and Functional Imaging Sciences (BIOMORF), University of Messina, 98100 Messina, Italy.

出版信息

Int J Mol Sci. 2023 Feb 23;24(5):4438. doi: 10.3390/ijms24054438.

Abstract

Lower-than-normal platelet counts are a hallmark of the acquired autoimmune illness known as immune thrombocytopenia, which can affect both adults and children. Immune thrombocytopenia patients' care has evolved significantly in recent years, but the disease's diagnosis has not, and it is still only clinically achievable with the elimination of other causes of thrombocytopenia. The lack of a valid biomarker or gold-standard diagnostic test, despite ongoing efforts to find one, adds to the high rate of disease misdiagnosis. However, in recent years, several studies have helped to elucidate a number of features of the disease's etiology, highlighting how the platelet loss is not only caused by an increase in peripheral platelet destruction but also involves a number of humoral and cellular immune system effectors. This made it possible to identify the role of immune-activating substances such cytokines and chemokines, complement, non-coding genetic material, the microbiome, and gene mutations. Furthermore, platelet and megakaryocyte immaturity indices have been emphasized as new disease markers, and prognostic signs and responses to particular types of therapy have been suggested. Our review's goal was to compile information from the literature on novel immune thrombocytopenia biomarkers, markers that will help us improve the management of these patients.

摘要

血小板计数低于正常水平是一种获得性自身免疫性疾病的标志,这种疾病被称为免疫性血小板减少症,可影响成人和儿童。近年来,免疫性血小板减少症患者的治疗方法有了显著的发展,但该疾病的诊断方法却没有,并且仍然只能通过排除其他血小板减少症的原因来实现临床诊断。尽管一直在努力寻找,但由于缺乏有效的生物标志物或金标准诊断测试,疾病的误诊率仍然很高。然而,近年来,多项研究有助于阐明该疾病病因的一些特征,强调了血小板减少不仅是由于外周血小板破坏增加引起的,还涉及许多体液和细胞免疫系统效应物。这使得识别免疫激活物质(如细胞因子和趋化因子、补体、非编码遗传物质、微生物组和基因突变)的作用成为可能。此外,血小板和巨核细胞不成熟指数已被强调为新的疾病标志物,并提出了预后指标和对特定类型治疗的反应。我们的综述旨在从文献中收集有关新型免疫性血小板减少症生物标志物的信息,这些标志物将有助于我们改善对这些患者的管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3bfa/10003036/c099141232c6/ijms-24-04438-g001.jpg

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