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Научно-практическая ревматология

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Лабораторные биомаркеры анкилозирующего спондилита

https://doi.org/10.14412/1995-4484-2017-96-103

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Аннотация

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 α (ФНОα), 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 ФНОα 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.

Об авторах

Е. Н. Александрова
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»
Россия

Москва, Россия 115522 Москва, Каширское шоссе, 34А



А. А. Новиков
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»
Россия
Москва, Россия 115522 Москва, Каширское шоссе, 34А


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Для цитирования:


Александрова Е.Н., Новиков А.А. Лабораторные биомаркеры анкилозирующего спондилита. Научно-практическая ревматология. 2017;55(1):96-103. https://doi.org/10.14412/1995-4484-2017-96-103

For citation:


Aleksandrova E.N., Novikov A.A. LABORATORY BIOMARKERS FOR ANKYLOSING SPONDYLITIS. Rheumatology Science and Practice. 2017;55(1):96-103. (In Russ.) https://doi.org/10.14412/1995-4484-2017-96-103

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ISSN 1995-4484 (Print)
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