Biomarkers of tolerance in immune-mediated inflammatory diseases: a new era in clinical management?
Biomarkers of tolerance in immune-mediated inflammatory diseases: a new era in clinical management?
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免疫介导的炎症性疾病耐受性的生物标志物：临床管理的新时代？
DOI：
10.1016/s2665-9913(21)00069-2
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Baker K
中科院分区：
文献类型：
--
作者：
Baker K
现代治疗药物和治疗方案已经使许多免疫介导的炎症性疾病患者的持续缓解成为可实现的目标，尽管存在不良事件的风险，并且需要花费药物处方和安全监测的费用。因此，临床医生和患者越来越多地面临着一个新的治疗困境：是否以及如何最好地停止获得缓解的患者的免疫调节治疗。在治疗性耐受诱导系列的最后一篇文章中，我们总结了我们目前对免疫介导的炎症性疾病中免疫稳态生物标志物的了解，以及它们在预测和实现持续无药缓解方面的应用。我们总结了一系列免疫介导的炎症性疾病（包括类风湿关节炎、青少年特发性关节炎和炎症性肠病）中免疫调节药物停止的前瞻性研究证据。我们还考虑了免疫稳态的临床、血清学、蛋白质组学、代谢组学、细胞和微生物组生物标志物的现有证据。最后，我们讨论了这些生物标志物临床翻译的必要步骤，以及如果成功实现临床翻译，这些生物标志物对免疫介导的炎症性疾病患者管理的潜在转化作用。
Modern therapeutic agents and treatment regimens have made sustained remission an attainable target for many patients across a spectrum of immune-mediated inflammatory diseases, albeit at the risk of adverse events and the expense of drug prescription and safety monitoring. Clinicians and patients are thus increasingly faced with a novel treatment dilemma: whether and how best to stop immunomodulatory treatment in patients who achieve remission. In this final paper in a Series on therapeutic tolerance induction, we summarise our current knowledge of biomarkers of immune homeostasis in immune-mediated inflammatory diseases and their application to the prediction and attainment of sustained drug-free remission. We summarise evidence from prospective studies of immunomodulatory drug cessation across a range of immune-mediated inflammatory diseases, including rheumatoid arthritis, juvenile idiopathic arthritis, and inflammatory bowel disease. We also consider current evidence for clinical, serological, proteomic, metabolomic, cellular, and microbiomic biomarkers of immune homeostasis. Finally, we discuss the steps necessary for clinical translation of these biomarkers, as well as the potential transformative effect of these biomarkers on management of patients with immune-mediated inflammatory diseases if clinical translation is successfully achieved.
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DOI：
--
发表时间：
2016
期刊：
影响因子：
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