Biomarkers

生物标志物
  • 文章类型: Journal Article
    循环淀粉样β1-40(Ab40)具有促动脉粥样硬化性质,并且可以用作动脉粥样硬化性心血管疾病(ASCVD)的生物标志物。然而,Ab40水平与反映动脉粥样硬化斑块回声和组成的形态学特征之间的关联尚不清楚.通过超声检查对连续招募的无ASCVD患者(n=342)进行颈动脉粥样硬化评估。主要终点是内膜-中膜复合体(IMC)和斑块的灰度中位数(GSM),使用专用软件进行分析。在两个时间点(中位随访35.5个月)评估血管标志物。在56例接受颈动脉内膜切除术的患者中,分析了组织学斑块特征。在基线测量血浆Ab40水平。在多变量调整后,Ab40与较低的IMCGSM和斑块GSM以及较高的斑块面积相关。在多变量调整后,Ab40水平的增加也与IMC和斑块GSM的降低或持续低相关(p<0.05)。在组织学分析中,Ab40水平与钙化斑块和无高风险特征的斑块发生率较低相关。在非狭窄动脉壁和严重狭窄斑块中,Ab40水平与颈动脉壁组成的超声和组织学标记相关。这些发现支持了将Ab40与斑块易损性联系起来的实验证据,可能介导其与主要不良心血管事件的既定关联。
    Circulating amyloid-beta 1-40 (Αb40) has pro-atherogenic properties and could serve as a biomarker in atherosclerotic cardiovascular disease (ASCVD). However, the association of Ab40 levels with morphological characteristics reflecting atherosclerotic plaque echolucency and composition is not available. Carotid atherosclerosis was assessed in consecutively recruited individuals without ASCVD (n = 342) by ultrasonography. The primary endpoint was grey scale median (GSM) of intima-media complex (IMC) and plaques, analysed using dedicated software. Vascular markers were assessed at two time-points (median follow-up 35.5 months). In n = 56 patients undergoing carotid endarterectomy, histological plaque features were analysed. Plasma Αb40 levels were measured at baseline. Ab40 was associated with lower IMC GSM and plaque GSM and higher plaque area at baseline after multivariable adjustment. Increased Ab40 levels were also longitudinally associated with decreasing or persistently low IMC and plaque GSM after multivariable adjustment (p < 0.05). In the histological analysis, Ab40 levels were associated with lower incidence of calcified plaques and plaques without high-risk features. Ab40 levels are associated with ultrasonographic and histological markers of carotid wall composition both in the non-stenotic arterial wall and in severely stenotic plaques. These findings support experimental evidence linking Ab40 with plaque vulnerability, possibly mediating its established association with major adverse cardiovascular events.
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    目的:重度狼疮性肾炎(LN)后停止或继续维持免疫抑制治疗(MIST)需要测量复发风险,但缺乏可靠的临床和生物学标志物。WIN-IgE研究评估血清抗dsDNAIgE自身抗体作为预测严重LN复发的生物标志物的价值。
    方法:WIN-IgE是WIN-Lupus研究的辅助研究(NCT01284725),一项前瞻性对照临床试验,该试验评估了有活动性病变的III级或IV±V级LN在2-3年后停用MIST的情况。WIN-IgE包括在随机分组时收集的所有患者,用于继续或停止MIST。在这些血清中,抗dsDNA抗体,IgE和IgG,通过ELISA定量,并在24个月随访期间发生LN复发的患者和未发生LN复发的患者之间进行比较。
    结果:纳入52例患者,MIST延续组25人,MIST停药组27人,12经历了活检证实的LN复发。在随后的LN复发的患者中,初始抗dsDNAIgE抗体水平较高。抗dsDNAIgG与复发无关。在抗dsDNAIgE水平高于和低于阈值1.9任意单位的患者中,无LN复发的生存率较低(p=0.019),特别是在随机停止MIST的患者亚组(p=0.002).在所有患者中,抗dsDNAIgE高于1.9任意单位对严重LN复发的阳性预测值为0.8.
    结论:这些结果表明血液抗dsDNAIgE是LN复发的非侵入性预测标志物。
    OBJECTIVE: Discontinuation or continuation of maintenance immunosuppressive therapy (MIST) after a severe lupus nephritis (LN) requires measuring the risk of relapse but reliable clinical and biological markers are lacking. The WIN-IgE study assesses the value of serum anti-dsDNA IgE autoantibodies as a biomarker for the prediction of relapse in severe LN.
    METHODS: WIN-IgE is an ancillary study of the WIN-Lupus study (NCT01284725), a prospective controlled clinical trial which evaluated the discontinuation of MIST after 2-3 years in class III or IV±V LN with active lesions. WIN-IgE included all patients with available serum collected at randomisation for continuation or discontinuation of MIST. In these sera, anti-dsDNA antibodies, IgE and IgG, were quantified by ELISA and compared between patients who experienced LN relapse and those who did not during the 24 months of follow-up.
    RESULTS: 52 patients were included, 25 in the MIST continuation group and 27 in the MIST discontinuation group, 12 experienced a biopsy-proven relapse of LN. Initial anti-dsDNA IgE antibodies levels were higher in patients with subsequent LN relapse. Anti-dsDNA IgG was not associated with relapse. Survival without LN relapse was lower in patients with anti-dsDNA IgE levels above vs below a threshold of 1.9 arbitrary units (p=0.019), particularly in the subgroup of patients randomised to discontinue MIST (p=0.002). In all patients, anti-dsDNA IgE above 1.9 arbitrary units had a positive predictive value of 0.8 for severe LN relapse.
    CONCLUSIONS: These results suggest blood anti-dsDNA IgE as a non-invasive predictive marker of LN relapse.
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  • 文章类型: Journal Article
    背景:炎症之间关系的性质,轴性脊柱关节炎(axSpA)的心血管危险因素(CV)和动脉粥样硬化在很大程度上还不清楚,在这方面的性别差异还有待评估.
    方法:研究包括来自西班牙多中心AtheSpAin队列的611名男性和302名女性,以评估axSpA中的CV疾病。在疾病诊断和登记时都收集了CV疾病危险因素的数据,和疾病活动的数据,仅在招募时进行功能指数和颈动脉超声检查。
    结果:中位病程为9年后,诊断为疾病的男女患者急性期反应物(APRs)升高,更常见的是高血压和肥胖。男性血脂异常和女性糖尿病也是如此。在入学时,CV危险因素与APR以及活动和功能指数独立相关,有各种性别差异。C反应蛋白(CRP)值与男性HDL-胆固醇呈负相关(β系数:-1.2(95%CI:-0.3至-0.07)mg/dL,p=0.001),而红细胞沉降率值与女性甘油三酯呈正相关(β系数:0.6(95%CI:0.04至1)mg/dL,p=0.035)。此外,只有女性显示胰岛素抵抗参数与APR或疾病活动性之间的独立关系。根据冠状动脉风险评估系统评估2,具有高-非常高CV风险的男性和女性,在诊断该疾病时CRP水平高于3mg/L,其颈动脉斑块的频率明显高于CRP水平正常的患者。诊断。
    结论:在axSpA中,炎症与动脉粥样硬化和CV疾病相关。在这种关系中观察到性别驱动的效应。
    BACKGROUND: The nature of the relationship between inflammation, cardiovascular (CV) risk factors and atherosclerosis in axial spondyloarthritis (axSpA) remains largely unknown and sex differences in this regard are yet to be assessed.
    METHODS: Study including 611 men and 302 women from the Spanish multicentre AtheSpAin cohort to assess CV disease in axSpA. Data on CV disease risk factors were collected both at disease diagnosis and at enrolment, and data on disease activity, functional indices and carotid ultrasonography only at enrolment.
    RESULTS: After a median disease duration of 9 years, patients of both sexes who at disease diagnosis had elevated acute phase reactants (APRs), more frequently had hypertension and obesity. The same occurred with dyslipidaemia in men and with diabetes mellitus in women. At enrolment, CV risk factors were independently associated with APR and with activity and functional indices, with various sex differences. C reactive protein (CRP) values were inversely associated with HDL-cholesterol in men (β coefficient: -1.2 (95% CI: -0.3 to -0.07) mg/dL, p=0.001), while erythrocyte sedimentation rate values were positively associated with triglycerides in women (β coefficient: 0.6 (95% CI: 0.04 to 1) mg/dL, p=0.035). Furthermore, only women showed an independent relationship between insulin resistance parameters and APR or disease activity. Both men and women with high-very high CV risk according to the Systematic Assessment of Coronary Risk Evaluation 2 and CRP levels higher than 3 mg/L at diagnosis of the disease presented carotid plaques significantly more frequently than those with normal CRP levels at disease diagnosis.
    CONCLUSIONS: Inflammation is associated with atherosclerosis and CV disease in axSpA. A gender-driven effect is observed in this relationship.
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  • 文章类型: Journal Article
    间质性肺病(ILD)使结缔组织疾病(CTD)复杂化,发病率可变,是这些患者死亡的主要原因。为了改善CTD-ILD结果,ILD的早期识别和管理至关重要。长期以来,人们一直在研究辅助诊断CTD-ILD的血液和放射学生物标志物。最近的研究,包括-组学调查,也开始识别可能有助于预测此类患者的生物标志物。这篇综述概述了CTD-ILD患者的临床相关生物标志物。强调最近的进展,以协助诊断和预测CTD-ILD。
    Interstitial lung disease (ILD) complicates connective tissue disease (CTD) with variable incidence and is a leading cause of death in these patients. To improve CTD-ILD outcomes, early recognition and management of ILD is critical. Blood-based and radiologic biomarkers that assist in the diagnosis CTD-ILD have long been studied. Recent studies, including -omic investigations, have also begun to identify biomarkers that may help prognosticate such patients. This review provides an overview of clinically relevant biomarkers in patients with CTD-ILD, highlighting recent advances to assist in the diagnosis and prognostication of CTD-ILD.
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  • 文章类型: Journal Article
    多发性硬化症(MS)生物学的概念继续发展,与“独立于疾病活动的进展”等观察结果挑战了传统的表型分类。铁敏感,基于磁化率的成像技术正在作为高度可翻译的MR成像序列出现,该序列允许可视化至少2种临床上有用的生物标志物:中央静脉征和顺磁边缘病变(PRL).两种生物标志物在区分MS与其他模拟物方面均显示出高特异性,并且可以在1.5T和3T场强下看到。此外,PRL代表完整血脑屏障背后的“闷烧”分隔炎症中的慢性活动性病变的子集。
    Concepts of multiple sclerosis (MS) biology continue to evolve, with observations such as \"progression independent of disease activity\" challenging traditional phenotypic categorization. Iron-sensitive, susceptibility-based imaging techniques are emerging as highly translatable MR imaging sequences that allow for visualization of at least 2 clinically useful biomarkers: the central vein sign and the paramagnetic rim lesion (PRL). Both biomarkers demonstrate high specificity in the discrimination of MS from other mimics and can be seen at 1.5 T and 3 T field strengths. Additionally, PRLs represent a subset of chronic active lesions engaged in \"smoldering\" compartmentalized inflammation behind an intact blood-brain barrier.
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  • 文章类型: Journal Article
    结核病(TB)是一种传染病,仍然是全球主要的公共卫生问题之一。因此,早期发现活动性肺结核对于控制致死率和疾病传播至关重要。目前可用的结核病诊断可以大致分为显微镜,以文化为基础,和分子方法,所有这些都伴随着敏感性受损,功效有限,和高费用。因此,快速,敏感,和负担得起的结核病诊断方法是目前疾病管理的先决条件。这篇综述总结了来自血清的宿主特异性生物标志物的蛋白质组学研究。痰,唾液,结核病患者的尿液样本,以及患有合并症的患者。从现有文献中进行彻底的数据挖掘使我们得出结论,参与免疫和防御的宿主特异性蛋白质,代谢调节,细胞粘附,和运动性,炎症反应,和组织重塑在结核分枝杆菌(Mtb)感染后显示出明显的失调。值得注意的是,与非结核病人相比,活动性结核病中的免疫调节蛋白类(ORM)上调,正如在来自不同样本类型的多项研究中观察到的那样。甘露糖受体C2型(MRC2)被鉴定为上调,两个独立的血清蛋白质组学研究中的治疗反应生物标志物。对这些候选蛋白质进行彻底的机械研究将是吸引人的,以挖掘潜在的药物靶标和针对结核病患者的定制疗法。以及他们的诊断潜力。
    Tuberculosis (TB) is an infectious disease that remains one of the major global public health concerns. Early detection of Active Pulmonary TB is therefore of utmost importance for controlling lethality and disease spreading. Currently available TB diagnostics can be broadly categorized into microscopy, culture-based, and molecular approaches, all of which come with compromised sensitivity, limited efficacy, and high expenses. Hence, rapid, sensitive, and affordable diagnostic methods for TB is the current prerequisite for disease management. This review summarizes the proteomics investigations for host-specific biomarkers from serum, sputum, saliva, and urine samples of TB patients, along with patients having comorbidity. Thorough data mining from available literature led us to conclude that the host-specific proteins involved in immunity and defense, metabolic regulation, cellular adhesion, and motility, inflammatory responses, and tissue remodelling have shown significant deregulation upon Mycobacterium tuberculosis (Mtb) infection. Notably, the immunoregulatory protein orosomucoid (ORM) was up-regulated in active TB compared to non-TB individuals, as observed in multiple studies from diverse sample types. Mannose receptor C type 2 (MRC2) was identified as an upregulated, treatment response biomarker in two independent serum proteomics investigations. Thorough mechanistic investigation on these candidate proteins would be fascinating to dig into potential drug targets and customized therapeutics for TB patients, along with their diagnostic potentials.
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  • 文章类型: Journal Article
    背景:尽管高超加工食品(UPF)消费量与普通人群的死亡风险增加有关,目前尚不清楚UPFs是否对有癌症史的参与者造成伤害.
    目的:本研究旨在评估有癌症史的参与者中UPF消费与死亡率的关系。
    方法:对来自英国生物库的13640名具有癌症史的参与者进行了前瞻性队列分析。UPFs由Nova分类定义。UPF消耗量计算为总食物消耗量中UPFs的重量比例。Cox比例风险模型用于评估有癌症史的参与者的UPF消耗和死亡率之间的关联。
    结果:在有癌症史的参与者的总饮食中,男性的UPF消耗中位数为29.25%(四分位距:19.46%-40.62%),女性为25.81%(四分位距:16.61%-36.35%)。在10.77年的中位随访中,记录了1611例死亡。在UPF消耗最高四分位数的参与者中,相对于最低四分位数的多变量校正风险比(95%置信区间)为全因死亡率1.17(1.02,1.35)和癌症死亡率1.22(1.03,1.44)。
    结论:在有癌症史的参与者中,诊断后较高的UPF消耗与较高的死亡风险相关。
    BACKGROUND: Although high ultra-processed food (UPF) consumption has been linked with increased mortality risk in the general population, whether UPFs harm participants with a history of cancer remains unclear.
    OBJECTIVE: This study aimed to evaluate the association of UPF consumption with mortality among participants with a history of cancer.
    METHODS: Prospective cohort analysis was conducted on 13640 participants with a history of cancer from the UK Biobank. UPFs were defined by the Nova classification. UPF consumption was calculated as the weight proportion of UPFs in the total food consumption. Cox proportional hazard models were used to assess the association between UPF consumption and mortality among participants with a history of cancer.
    RESULTS: The median UPF consumption was 29.25% (interquartile range: 19.46%-40.62%) for males and 25.81% (interquartile range: 16.61%-36.35%) for females in the total diet among participants with a history of cancer. During a median follow-up of 10.77 years, 1611 deaths were documented. Multivariable-adjusted hazard ratios (95% confidence intervals) among participants in the highest quartile of UPF consumption relative to the lowest were 1.17 (1.02, 1.35) for all-cause mortality and 1.22 (1.03, 1.44) for cancer mortality.
    CONCLUSIONS: Higher UPF consumption after the diagnosis among participants with a history of cancer is associated with higher risk of mortality.
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  • 文章类型: Journal Article
    背景:在表皮生长因子受体(EGFR)突变的晚期非小细胞肺癌患者中,与奥希替尼相比,阿米万坦单抗-拉泽替尼显著延长了无进展生存期(PFS)[NSCLC;风险比(HR)0.70;P<0.001],包括有脑转移病史的患者(HR0.69)。TP53共同突变的患者,可检测的循环肿瘤DNA(ctDNA),基线肝转移,那些在治疗中没有ctDNA清除的人预后很差。我们评估了这些高风险亚组的结果。
    方法:该分析包括未接受治疗的患者,在MARIPOSA中,EGFR突变的晚期非小细胞肺癌随机分为阿米伐他单抗-拉泽尔替尼(n=429)或奥希替尼(n=429)。通过使用Guardant360CDx对基线血液ctDNA进行下一代测序(NGS)来鉴定致病性改变。在基线和第3周期第1天(C3D1)用Biodesix液滴数字聚合酶链反应(ddPCR)分析血液中的Ex19del和L858RctDNA。
    结果:636例患者可获得NGS致病性改变的基线ctDNA(阿米伐他单抗-拉泽尔替尼,n=320;奥希替尼,n=316)。与奥希替尼相比,Amivantamab-lazertinib改善了TP53共同突变患者的中位PFS(mPFS){18.2对12.9个月;HR0.65[95%置信区间(CI)0.48-0.87];P=0.003}和野生型TP53患者[22.1对19.9个月;HR0.75(95%CI0.52-1.07)]。在EGFR突变的患者中,ddPCR-可检测基线ctDNA,amivantamab-lazertinib与奥希替尼相比显著延长了mPFS[20.3个月对14.8个月;HR0.68(95%CI0.53-0.86);P=0.002].Amivantamab-lazertinib在C3D1[16.5对9.1个月;HR0.49(95%CI0.27-0.87);P=0.015]和清除[24.0对16.5个月;HR0.64(95%CI0.48-0.87);P=0.004]时未清除ctDNA的患者中,mPFS明显优于奥希替尼。Amivantamab-lazertinib在[18.2对11.0个月;HR0.58(95%CI0.37-0.91);P=0.017]和无基线肝转移[24.0对18.3个月;HR0.74(95%CI0.60-0.91);P=0.004]的随机患者中显著延长了mPFS。
    结论:Amivantamab-lazertinib有效克服了高风险特征的影响,代表了EGFR突变型晚期NSCLC患者的有希望的新治疗标准。
    BACKGROUND: Amivantamab-lazertinib significantly prolonged progression-free survival (PFS) versus osimertinib in patients with epidermal growth factor receptor (EGFR)-mutant advanced non-small-cell lung cancer [NSCLC; hazard ratio (HR) 0.70; P < 0.001], including those with a history of brain metastases (HR 0.69). Patients with TP53 co-mutations, detectable circulating tumor DNA (ctDNA), baseline liver metastases, and those without ctDNA clearance on treatment have poor prognoses. We evaluated outcomes in these high-risk subgroups.
    METHODS: This analysis included patients with treatment-naive, EGFR-mutant advanced NSCLC randomized to amivantamab-lazertinib (n = 429) or osimertinib (n = 429) in MARIPOSA. Pathogenic alterations were identified by next-generation sequencing (NGS) of baseline blood ctDNA with Guardant360 CDx. Ex19del and L858R ctDNA in blood was analyzed at baseline and cycle 3 day 1 (C3D1) with Biodesix droplet digital polymerase chain reaction (ddPCR).
    RESULTS: Baseline ctDNA for NGS of pathogenic alterations was available for 636 patients (amivantamab-lazertinib, n = 320; osimertinib, n = 316). Amivantamab-lazertinib improved median PFS (mPFS) versus osimertinib for patients with TP53 co-mutations {18.2 versus 12.9 months; HR 0.65 [95% confidence interval (CI) 0.48-0.87]; P = 0.003} and for patients with wild-type TP53 [22.1 versus 19.9 months; HR 0.75 (95% CI 0.52-1.07)]. In patients with EGFR-mutant, ddPCR-detectable baseline ctDNA, amivantamab-lazertinib significantly prolonged mPFS versus osimertinib [20.3 versus 14.8 months; HR 0.68 (95% CI 0.53-0.86); P = 0.002]. Amivantamab-lazertinib significantly improved mPFS versus osimertinib in patients without ctDNA clearance at C3D1 [16.5 versus 9.1 months; HR 0.49 (95% CI 0.27-0.87); P = 0.015] and with clearance [24.0 versus 16.5 months; HR 0.64 (95% CI 0.48-0.87); P = 0.004]. Amivantamab-lazertinib significantly prolonged mPFS versus osimertinib among randomized patients with [18.2 versus 11.0 months; HR 0.58 (95% CI 0.37-0.91); P = 0.017] and without baseline liver metastases [24.0 versus 18.3 months; HR 0.74 (95% CI 0.60-0.91); P = 0.004].
    CONCLUSIONS: Amivantamab-lazertinib effectively overcomes the effect of high-risk features and represents a promising new standard of care for patients with EGFR-mutant advanced NSCLC.
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  • 文章类型: Editorial
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