背景:这项研究的目的是确定文献中最可靠的生物标志物,这些生物标志物可用作系统性红斑狼疮(SLE)的耀斑预测因子。
方法:在2015年4月之前,使用两个数据库(MEDLINE和EMBASE)对文献进行了系统综述,并对2010年至2014年美国风湿病学会和欧洲抗风湿病联盟的大会摘要进行了综述。两名独立审稿人筛选了标题和摘要,并详细分析了选定的论文,使用特定的问卷。在系统评价中包括解决一个或多个确定的生物学测试与疾病恶化的发生之间的关系的报告。
结果:从所有数据库中,检索到4668条记录,其中69项研究或大会摘要被选中进行系统审查。评估了在临床实践中常规进行的七种类型的生物标志物和九种类型的新型生物标志物的性能。尽管抗双链DNA抗体取得了一些令人鼓舞的结果,抗C1q抗体,B淋巴细胞刺激因子和肿瘤坏死因子样弱诱导细胞凋亡,没有一个生物标志物在其他生物标志物中脱颖而出,作为耀斑预测的潜在黄金标准。结果是异质的,缺乏标准化数据使我们无法识别出强大的生物标志物。
结论:由于缺乏标准化数据,因此无法从该系统综述中得出有力的结论。应努力优化未来对潜在SLE生物标志物的研究,以开发经过验证的候选物。因此,我们为未来的研究提出了一个标准化的模式。
BACKGROUND: The aim of this study was to identify the most reliable biomarkers in the literature that could be used as flare predictors in systemic lupus erythematosus (SLE).
METHODS: A systematic
review of the literature was performed using two databases (MEDLINE and EMBASE) through April 2015 and congress abstracts from the American College of Rheumatology and the European League Against Rheumatism were reviewed from 2010 to 2014. Two independent reviewers screened titles and abstracts and analysed selected papers in detail, using a specific questionnaire. Reports addressing the relationships between one or more defined biological test(s) and the occurrence of disease exacerbation were included in the systematic
review.
RESULTS: From all of the databases, 4668 records were retrieved, of which 69 studies or congress abstracts were selected for the systematic
review. The performance of seven types of biomarkers performed routinely in clinical practice and nine types of novel biological markers was evaluated. Despite some encouraging results for anti-double-stranded DNA antibodies, anti-C1q antibodies, B-lymphocyte stimulator and tumour necrosis factor-like weak inducer of apoptosis, none of the biomarkers stood out from the others as a potential gold standard for flare prediction. The results were heterogeneous, and a lack of standardized data prevented us from identifying a powerful biomarker.
CONCLUSIONS: No powerful conclusions could be drawn from this systematic
review due to a lack of standardized data. Efforts should be undertaken to optimize future research on potential SLE biomarkers to develop validated candidates. Thus, we propose a standardized pattern for future studies.