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慢性关节疾病的分子特征:定义个体化医学的内型。

Molecular portrait of chronic joint diseases: Defining endotypes toward personalized medicine.

机构信息

Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, UK.

University Eastern Piedmont and Maggiore della Carita Hospital, Novara, Italy.

出版信息

Joint Bone Spine. 2024 May;91(3):105692. doi: 10.1016/j.jbspin.2024.105692. Epub 2024 Jan 19.

Abstract

Joint diseases affect hundreds of millions of people worldwide, and their prevalence is constantly increasing. To date, despite recent advances in the development of therapeutic options for most rheumatic conditions, a significant proportion of patients still lack efficient disease management, considerably impacting their quality of life. Through the spectrum of rheumatoid arthritis (RA), psoriatic arthritis (PsA), and osteoarthritis (OA) as quintessential and common rheumatic diseases, this review first provides an overview of their epidemiological and clinical features before exploring how the better definition of clinical phenotypes has helped their clinical management. It then discusses the recent progress in understanding the diversity of endotypes underlying disease phenotypes. Finally, this review highlights the current challenges of implementing molecular endotypes towards the personalized management of RA, PsA and OA patients in the future.

摘要

关节疾病影响着全球数以亿计的人群,且其发病率在不断上升。尽管近年来治疗大多数风湿疾病的方法有了新的进展,但仍有相当一部分患者的疾病管理效果欠佳,极大地影响了他们的生活质量。本文以类风湿关节炎(RA)、银屑病关节炎(PsA)和骨关节炎(OA)这三种典型且常见的风湿性疾病为例,首先概述了它们的流行病学和临床特征,然后探讨了临床表型定义的改善如何有助于其临床管理。接着讨论了目前对疾病表型背后的各种内型的认识进展。最后,本文强调了当前在将分子内型应用于 RA、PsA 和 OA 患者的个体化治疗方面所面临的挑战。

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