Song Yujie, Kono Michihito
Department of Rheumatology, Endocrinology and Nephrology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
JMA J. 2025 Jul 15;8(3):689-698. doi: 10.31662/jmaj.2025-0190. Epub 2025 Jul 7.
Systemic lupus erythematosus (SLE) is a complex autoimmune disorder characterized by heterogeneous clinical manifestations and diverse autoantibody production. Despite advances in treatment, many patients experience disease flares throughout their lives, and current biomarkers like anti-double-stranded DNA antibodies and serum complement levels have limitations in accurately reflecting disease activity. This review examines emerging and established biomarkers for SLE diagnosis, disease activity monitoring, and treatment response prediction. We discuss immune cell subsets as potential biomarkers, focusing on plasmacytoid dendritic cells, T cell and B cell subsets, especially focused on T cell subsets. The review highlights how imbalances in these cellular populations correlate with disease activity and specific organ involvement. Furthermore, we discuss cytokines, chemokines, autoantibodies, and complement as biomarkers in SLE. The identification and validation of reliable biomarkers in SLE will ultimately improve clinical decision-making regarding treatment selection, glucocorticoid tapering, and prediction of disease remission, leading to more personalized and effective management strategies.
系统性红斑狼疮(SLE)是一种复杂的自身免疫性疾病,其临床表现异质性且会产生多种自身抗体。尽管治疗取得了进展,但许多患者一生中仍会经历疾病复发,并且目前的生物标志物,如抗双链DNA抗体和血清补体水平,在准确反映疾病活动方面存在局限性。本综述探讨了用于SLE诊断、疾病活动监测和治疗反应预测的新兴及已确立的生物标志物。我们讨论了免疫细胞亚群作为潜在生物标志物,重点关注浆细胞样树突状细胞、T细胞和B细胞亚群,尤其侧重于T细胞亚群。该综述强调了这些细胞群体的失衡如何与疾病活动和特定器官受累相关。此外,我们还讨论了细胞因子、趋化因子、自身抗体和补体作为SLE中的生物标志物。SLE中可靠生物标志物的识别和验证最终将改善关于治疗选择、糖皮质激素减量以及疾病缓解预测的临床决策,从而带来更个性化和有效的管理策略。