Biomarkers in Primary Systemic Vasculitides: Narrative Review.

Area of Science:

• Rheumatology
• Immunology
• Internal Medicine

Background:

• Vasculitides involve blood vessel inflammation, causing organ damage.
• Current markers like ESR and CRP lack specificity for diagnosing vasculitis subtypes.
• There is a need for more precise biomarkers to guide diagnosis and management.

Purpose of the Study:

• To review current evidence on validated and emerging biomarkers for various vasculitis types.
• To explore biomarkers reflecting systemic inflammation, endothelial activation, and organ-specific damage.
• To assess the clinical utility and limitations of novel diagnostic markers.

Main Methods:

• Systematic review of existing literature on vasculitis biomarkers.
• Analysis of key analytes across large-, medium-, small-, and variable-vessel vasculitis.
• Identification of promising biomarkers in specific vasculitis entities like Kawasaki disease and ANCA-associated vasculitis.

Main Results:

• Several biomarkers show potential, including SAA, IL-6, PTX3, MMP-9, NT-proBNP, S100 proteins, Gd-IgA1, AGT, TIMP-1, and complement C3.
• These analytes offer mechanistic insights into vasculitis pathogenesis.
• Most biomarkers currently lack disease specificity, external validation, and standardized assays.

Conclusions:

• Emerging biomarkers offer mechanistic insights into vasculitis but require further validation.
• Future progress depends on multicenter studies, harmonized assays, and integrated biomarker panels.
• Improved diagnostic accuracy and monitoring may be achieved by combining biomarkers with imaging modalities.