问题是:什么时候应该认为炎症和自身免疫性类风湿性疾病是"早期"的?
Elvis Hysa1,2, Emanuele Gotelli1,3, Carmen Pizzorni1,3
1Laboratory of Experimental Rheumatology and Academic Division of Clinical Rheumatology, Department of Internal Medicine (DiMI), University of Genova, Genoa, Italy.
European journal of clinical investigation
|October 21, 2025
概括
早期诊断炎症性和自身免疫性类风湿性疾病 (IARDs),如RA,SSc和PMR至关重要. 生物标志物和成像技术的进步有助于风险分层,并为RA提供了有希望的干预措施.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 内部医学 内部医学
背景情况:
- 炎症性和自身免疫性类风湿性疾病 (IARDs) 的早期诊断对于有效的患者管理和预防器官损伤至关重要.
- 本综述侧重于风湿性关节炎 (RA),全身性硬化症 (SSc) 和多肌痛性风湿性疾病 (PMR) 中的大血管血管炎 (LVV) 的早期诊断和治疗策略.
研究的目的:
- 总结关于早期识别和治疗方法的现有证据,以对不同的IARD进行总结.
- 为突出诊断工具和治疗干预措施的进展,RA,SSc和PMR.
主要方法:
- 进行了全面的叙事文献综述.
- 搜索包括PubMed,Scopus和最近的EULAR/ACR会议摘要 (2023-2025),重点是过去五年的研究.
主要成果:
- 在RA中,血清阳性和超声波/MRI发现预测了进展;在高危人群中,阿巴塔切普显示出有前途.
- 在SSc中,雷诺现象,自身抗体和指甲毛细镜预测疾病发病;早期识别方法存在,但缺乏干预数据.
- 在PMR中,成像检测到亚临床LVV,与更高的复发率相关,但最佳管理需要前性验证.
结论:
- 精细的临床标准,生物标志物和成像改善了早期的IARD识别和风险分层.
- 个性化管理策略正在出现,特别是在RA,但需要进一步的研究,以获得最佳的患者选择和治疗方案.
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