类风湿关节炎新型标志物临床应用与展望

Clinical application and prospect of novel markers of rheumatoid arthritis

类风湿关节炎(RA)是一种慢性侵蚀性关节炎,早诊断、规范治疗和定期监测病情,将有效缓解疾病发展,降低致残率。目前治疗RA的疾病改善抗风湿药(DMARD)存在传统合成类药单用,或分别与新型生物类药、靶向合成药联用的多种疗法,使部分难治性患者病情得到有效缓解,但不同疗法,特别是生物制剂疗法的疗效和毒副作用存在个体差异。随着蛋白质组学和表观遗传学技术发展,发现部分蛋白质、非编码RNA,以及抗药抗体(ADA)有望成为潜在的RA早期诊断,或伴随诊断和预后评估标志物。本文对近年来发现的RA诊疗新型标志物,包括血清蛋白、细胞膜蛋白、非编码RNA和ADA的应用前景进行总结、分析,旨在促进有价值的新型标志物转化、应用研究,推动RA的精准诊疗。

Rheumatoid arthritis(RA)is a chronic erosive arthritis.Early diagnosis,standardized treatment and regular monitoring of the disease will effectively mitigate disease progression and reduce the disability rate.Currently,traditional synthetic disease-modifying antirheumatic drugs(DMARDs)are used alone or in combination with new biological DMARDs or targeted synthetic DMARDS in the treatment of RA,resulting in effective remission in some refractory patients.However,the efficacy and toxicities of different treatments varies.With the development of proteomic and epigenetic technologies,some proteins,non-coding RNAs,and anti-drug antibodies(ADA)have been identified as potential markers for early diagnosis,concomitant diagnosis and disease assessment of RA.We summarized and analyzed the application prospects of novel RA diagnosis markers,including serum proteins,cell membrane proteins,non-coding RNAs,and ADA,with the aim of promoting the application of new markers that allow more precise diagnosis and treatment of RA.