狼疮生物学标记物的最新进展

目的：尽管数十年来，人们对系统性红斑狼疮的发病机制进行了广泛研究，但很少有确认并广泛接受的生物学标记物。缺乏可靠而特异的生物学标记物不仅不利于狼疮的治疗，而且也不利于新药开发。本综述简单回顾了狼疮生物学标记物的历史，并对最近有代表性的几个生物学标记物进行了总结。最近的发现：鉴于意识到迫切需要狼疮生物学标记物，最近成立了狼疮生物学标记物工作组，以加强努力和合作，证实和确认狼疮生物学标记物。基于现行的资料，有几种实验项目作为易感性、诊断和病情活动的狼疮标记物有一定希望，包括Fc受体基因（疾病易感性）、补体C4d结合的红细胞（诊断或病情活动）、CD27浆细胞（病情活动）、干扰素指纹（病情活动）和抗C1q抗体（病情活动和器官受累）。总结：长期以来，尤其是最近，人们更为热切地希望发现一些精确而又特异地反映狼疮病理生理和临床改变的生物学标记物，虽已证实了一些有希望的生物学标记物，但还须经过严格的大规模多中心研究来得到确认。

附原文：PURPOSE OF REVIEW: Despite decades of extensive work in the understanding of the etiopathogenesis of systemic lupus erythematosus, few biomarkers have been validated and widely accepted for this disease. The lack of reliable, specific biomarkers not only hampers clinical management of systemic lupus erythematosus but also impedes development of new therapeutic agents. This paper reviews briefly the historical aspects of systemic lupus erythematosus biomarkers and summarizes recent studies on candidate biomarkers. RECENT FINDINGS: Recognizing the urgent need for lupus biomarkers, a Lupus Biomarker Working Group has recently been initiated to facilitate collaborative efforts aimed at identifying and validating biomarkers for systemic lupus erythematosus. Based on available data, several laboratory markers have shown promise as biomarkers for susceptibility, diagnosis, and disease activity. These include Fc receptor genes (disease susceptibility), complement C4d-bound erythrocytes (diagnosis or disease activity), CD27 plasma cells (disease activity), 'interferon signature' (disease activity), and anti-C1q antibodies (disease activity and organ involvement). SUMMARY: There is a longstanding and recently rejuvenated enthusiasm for biomarkers that precisely and specifically reflect the pathophysiologic and clinical changes in systemic lupus erythematosus. Promising candidate biomarkers have been identified but must still be validated through rigorous, large-scale multicenter studies.

摘自：Liu CC, Manzi S, Ahearn JM.Biomarkers for systemic lupus erythematosus: a review and perspective. Curr Opin Rheumatol，2005，17(5):543-9.