矽肺血清标志物研究进展

Serum biomarkers in silicosis:current perspectives

矽肺是我国的主要职业病之一。早期诊断和预测矽肺发生是控制矽肺的有效手段,但依据放射学和呼吸功能异常做出的矽肺诊断往往限于较晚期的患者。寻找由于矽尘沉积及肺纤维化而出现变化的血清标志物是矽肺研究的热点领域之一。本文复习了近年来矽肺血清标志物研究的进展情况,内容包括炎症性细胞因子(肿瘤坏死因子α、白细胞介素17、转化生长因子β1和含有IL-12p40的细胞因子等)、miRNAs(miR-21、miR-200c等)、血清酶类(脯氨酸肽酶、血红素加氧酶1、超氧化物歧化酶、谷胱甘肽过氧化物酶和血管紧张素转化酶)、免疫球蛋白及肾连接蛋白、克拉拉细胞蛋白16等。有关矽肺血清标志物的研究很多,有些标志物显示了其在矽肺早期检出和诊断中的潜在价值。矽肺血清标志物敏感度和特异度的进一步完善和多中心大规模验证仍是矽肺血清标志物在临床实际应用必需的工作。

Silicosis is still one of the main occupational diseases in China.Early diagnosis or prediction may be very useful to control the disease,yet only relatively late stage patients with silicosis could be diagnosed based on radiological and lung function abnormalities.Seeking for biomarkers in blood serum that change their values with deposition of silica dust in the lung and onset of lung fibrosis has been one of the hot areas in the study of silicosis.This particular review focusses on the recent advances in the study of serum biomarkers for silicosis including inflammatory cytokines(tumor necrosis factor-α,interleukin-17,transforming growth factor-β1 and IL-12p40-containing cytokines,etc),miRNAs(miR-21,miR-200c,etc),serum enzymes(proline peptidase,heme oxygenase-1,superoxide dismutase,glutathione peroxidase and angiotensin-converting enzyme),immunoglobins and nephronectin,Clara cell protein 16,etc.There have been quite a lot of biomarkers being studied and some showed potential usefulness in the early detection and diagnosis of silicosis.Further improvement in the sensitivity and specificity of biomarkers and large scale multicenter validation are needed for the application in the future.