摘要
近年来,目标治疗策略明显改善了类风湿关节炎(rheumatoid arthritis,RA)患者的预后,因此,监测RA患者的疾病活动度极为重要,对更理想的评估疾病活动度方法的探索始终没有停止。目前已知,细胞因子在RA发病中发挥重要作用,基于细胞因子寻找新的评估疾病活动度的方法,可能会更客观地反映类风湿关节炎的疾病活动度。Michael Centola等从396种生物学标记物中选择了包括表皮生长因子、血管内皮生长因子、瘦素、白细胞介素-6、血清淀粉样蛋白A、C反应蛋白、血管细胞黏附分子-1、基质金属蛋白酶-1、基质金属蛋白酶-3、肿瘤坏死因子受体1、人软骨糖蛋白-39和抵抗素在内的12种生物学标记物,通过权重计算得到评分,用来评价RA疾病活动度,简称多生物学标记疾病活动性(multi-biomarker disease activity,MBDA)评分。目前已有研究表明,MBDA评分与改良28关节MBDA评分(DAS28)-红细胞沉降率、DAS28-C反应蛋白、临床疾病活动指数、美国风湿病学协会/欧洲抗风湿病联盟Boolean缓解标准及健康评估问卷显著相关。同时与传统的评价RA疾病活动度的指标相比,MBDA评分可以更好地预测影像学进展、疾病复发,并且对治疗策略的选择具有一定的指导价值,仍需进一步研究。
Recently,the promotion of Treat to Target has significantly improved the outcome of rheumatoid arthritis（RA） patients. Thus it is important to make continuous effort to find a better assessment of disease activity. It is proven that cytokines were largely contribute to the pathogenesis of RA. A new assessment of disease activity in terms of cytokines might be an objective measurement for RA disease activity. Michael Centola et al chose 12 biomarkers,including EGF,VEGF-A,leptin,resistin,IL-6,SAA,CRP,VCAM-1,MMP-1,MMP-3,TNFR1 and YKL-40 from 396 biomarkers,to measure the disease activity,which were called multi-biomarker disease activity（MBDA） score. Some studies revealed that MBDA score was significantly associated with DAS28-ESR,DAS28-CRP,CDAI,SDAI,HAQ and ACR/EULAR Boolean remission standard. Compared with traditional assessment methods,MBDA score is also advanced in disease activity assessment,predicting radiographic outcome and guide the management,however,it needs further study.
出处
《中华临床免疫和变态反应杂志》
2017年第1期53-56,共4页
Chinese Journal of Allergy & Clinical Immunology
