Cui Shuang, Qian Jie
Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001, People's Republic of China.
J Inflamm Res. 2023 Jun 29;16:2719-2726. doi: 10.2147/JIR.S413579. eCollection 2023.
Rheumatoid arthritis (RA) increases the susceptibility to a variety of infections that are often difficult to diagnose and can be asymptomatic or symptoms are atypical. Usually, this is a great challenge for rheumatologists, because it is difficult to distinguish infection and aseptic inflammation at an early stage. Prompt diagnosis and treatment of bacterial infections in immunosuppressed individuals is critical for clinicians, and early exclusion of infection allows for specific treatment of inflammatory diseases and avoids the unnecessary use of antibiotics. However, for patients with clinically suspected infection, traditional laboratory markers are not specific for bacterial infection and cannot be used to distinguish outbreaks from infections. Therefore, new infection markers that can distinguish infection from underlying disease are urgently needed for clinical practice. Here, we review the novel biomarkers in RA patients with infection. These biomarkers include presepsin, serology and haematology, as well as neutrophils, T cells, and natural killer cells. Meanwhile, we discuss meaningful biomarkers that distinguish infection from inflammation and develop novel biomarkers for clinical applications, allowing clinicians to make better decisions when diagnosing and treating RA.
类风湿关节炎（RA）会增加对多种感染的易感性，这些感染往往难以诊断，可能无症状或症状不典型。通常，这对风湿病学家来说是一个巨大的挑战，因为在早期很难区分感染和无菌性炎症。对免疫抑制个体的细菌感染进行及时诊断和治疗对临床医生至关重要，早期排除感染可对炎症性疾病进行特异性治疗，并避免不必要地使用抗生素。然而，对于临床怀疑有感染的患者，传统实验室指标对细菌感染并不具有特异性，无法用于区分病情发作与感染。因此，临床实践迫切需要能够区分感染与基础疾病的新型感染标志物。在此，我们综述了RA感染患者中的新型生物标志物。这些生物标志物包括可溶性髓系细胞触发受体-1、血清学和血液学指标，以及中性粒细胞、T细胞和自然杀伤细胞。同时，我们讨论了区分感染与炎症的有意义的生物标志物，并开发用于临床应用的新型生物标志物，使临床医生在诊断和治疗RA时能够做出更好的决策。
