Лабораторные биомаркеры анкилозирующего спондилита

Автор: Александрова Е.Н., Новиков А.А.

Журнал: Научно-практическая ревматология @journal-rsp

Статья в выпуске: 1 т.55, 2017 года.

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Анкилозирующий спондилит (АС) - хроническое воспалительное заболевание из группы спондилоартритов (СпА), характеризующееся поражением крестцово-подвздошных суставов и позвоночника с частым вовлечением в патологический процесс энтезисов и периферических суставов. Достижения современной лабораторной медицины способствовали существенному расширению спектра патогенетических, диагностических и прогностических биомаркеров АС. В настоящее время выделены ключевые патогенетические биомаркеры АС (терапевтические «мишени»), к которым относятся фактор некроза опухоли а (ФНОа), интерлейкин 17 (ИЛ17) и ИЛ23. Среди диагностических и прогностических лабораторных биомаркеров АС наибольшее значение в клинической практике имеют HLA-B27 (для ранней диагностики заболевания) и С-реактивный белок (СРБ; для оценки активности, риска рентгенологического прогрессирования и эффективности терапии). Новым биомаркером, позволяющим с высокой чувствительностью и специфичностью осуществлять диагностику аксиального СпА на ранней стадии, являются антитела к CD74. Ряд лабораторных биомаркеров, включая кальпротектин, матриксную металлопротеиназу 3 (ММП3), васкуло-эндотелиальный фактор роста, Dickkopf-1 (Dkk-1) и С-терминальный телопептид коллагена II типа (CTX II), недостаточно хорошо отражают активность заболевания, но могут быть предикторами прогрессирования структурных изменений позвоночника и крестцово-подвздошных сочленений при АС. Мониторинг уровня кальпротектина в крови позволяет эффективно прогнозировать ответ на терапию ингибиторами ФНОа и моноклональными антителами к ИЛ17А. Перспективы лабораторной диагностики АС связаны с клинической валидацией кандидатных биомаркеров в ходе больших проспективных когортных исследований и поиском новых протеомных, транскриптомных и геномных маркеров на основе инновационных молекулярно-клеточных технологий.

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Анкилозирующий спондилит, аксиальный спондилоартрит, генетические полиморфизмы, аутоантитела, маркеры воспаления, цитокины, факторы ангиогенеза, маркеры ремоделирования костной и хрящевой ткани

Короткий адрес: https://sciup.org/14945800

IDR: 14945800 | DOI: 10.14412/1995-4484-2017-96-103

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