类风湿关节炎相关间质性肺疾病的生物标志物：系统评价和荟萃分析。
Biomarkers of rheumatoid arthritis-associated interstitial lung disease: a systematic review and meta-analysis.
机构信息
Department of Respiratory Diseases, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan, China.
The First Clinical Medical College of Henan University of Chinese Medicine, Henan, China.
出版信息
Front Immunol. 2024 Oct 29;15:1455346. doi: 10.3389/fimmu.2024.1455346. eCollection 2024.
BACKGROUND
Interstitial Lung Disease (ILD) represents the most common extra-articular manifestation of Rheumatoid Arthritis (RA) and is a major cause of mortality. This study aims to identify and evaluate biomarkers associated with Rheumatoid Arthritis-Associated Interstitial Lung Disease (RA-ILD).
METHODS
We searched PubMed, Cochrane Library, EMBASE, and Web of Science databases for studies related to biomarkers of RA-ILD up until October 7, 2023. The Newcastle-Ottawa Scale (NOS) and standards recommended by the Agency for Healthcare Research and Quality (AHRQ) were used for quality assessment, and meta-analysis was conducted using Stata18.0 software.
RESULTS
A total of 98 articles were assessed for quality, 48 of which were included in the meta-analysis. 83 studies were of high quality, and 15 were of moderate quality. The meta-analysis showed significant differences in biomarkers such as C-Reactive Protein (CRP), Erythrocyte Sedimentation Rate (ESR), Anti-Cyclic Citrullinated Peptide (anti-CCP) antibody, Rheumatoid Factor (RF), Krebs von den Lungen-6 (KL-6), Surfactant Protein D (SP-D), Carcinoembryonic Antigen (CEA), Carbohydrate Antigen 19-9 (CA19-9), Matrix Metalloproteinase-7 (MMP-7), C-X-C Motif Chemokine Ligand 10 (CXCL-10), and Neutrophil-to-Lymphocyte Ratio (NLR) between RA-ILD patients and RA patients. However, Platelet-to-Lymphocyte Ratio [Platelet-to-Lymphocyte Ratio (PLR)], Cancer Antigen 125 [Cancer Antigen 125 (CA-125)], and Cancer Antigen 153 [Cancer Antigen 153 (CA-153)] did not show significant differences between the two groups. KL-6, MMP-7, and Human Epididymis Protein 4 (HE4) are negatively correlated with lung function, and KL-6 is associated with the prognosis of RA-ILD.
CONCLUSIONS
Biomarkers hold promising clinical value for prediction, diagnosis, severity assessment, and prognosis evaluation in RA-ILD. However, these findings need to be validated through multicenter, large-sample, prospective cohort studies.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier CRD42023448372.
背景
间质性肺病（ILD）是类风湿关节炎（RA）最常见的关节外表现，也是导致死亡的主要原因。本研究旨在确定和评估与类风湿关节炎相关的间质性肺病（RA-ILD）相关的生物标志物。
方法
我们检索了PubMed、Cochrane 图书馆、EMBASE 和 Web of Science 数据库，以获取截至 2023 年 10 月 7 日与 RA-ILD 生物标志物相关的研究。使用纽卡斯尔-渥太华量表（NOS）和医疗保健研究与质量局（AHRQ）推荐的标准进行质量评估，并使用 Stata18.0 软件进行荟萃分析。
结果
共评估了 98 篇文章的质量，其中 48 篇被纳入荟萃分析。83 项研究质量较高，15 项研究质量中等。荟萃分析显示，C-反应蛋白（CRP）、红细胞沉降率（ESR）、抗环瓜氨酸肽（anti-CCP）抗体、类风湿因子（RF）、KL-6、表面活性蛋白 D（SP-D）、癌胚抗原（CEA）、糖抗原 19-9（CA19-9）、基质金属蛋白酶-7（MMP-7）、C-X-C 基序趋化因子配体 10（CXCL-10）和中性粒细胞与淋巴细胞比值（NLR）等生物标志物在 RA-ILD 患者和 RA 患者之间存在显著差异。然而，血小板与淋巴细胞比值[血小板与淋巴细胞比值（PLR）]、癌抗原 125[癌抗原 125（CA-125）]和癌抗原 153[癌抗原 153（CA-153）]在两组之间无显著差异。KL-6、MMP-7 和人附睾蛋白 4（HE4）与肺功能呈负相关，KL-6与 RA-ILD 的预后相关。
结论
生物标志物对 RA-ILD 的预测、诊断、严重程度评估和预后评估具有有前景的临床价值。然而，这些发现需要通过多中心、大样本、前瞻性队列研究来验证。
系统评价注册
https://www.crd.york.ac.uk/prospero/，标识符 CRD42023448372。
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