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Biomarkers for systemic lupus erythematosus: has the right time finally arrived?

Arthritis Research & Therapy
Springer (Biomed Central Ltd.)
Publication Date
DOI: 10.1186/ar1186
  • Viewpoint
  • Ecology
  • Geography
  • Logic
  • Medicine


223SLE = systemic lupus erythematosus. Available online The concept of ‘biomarkers’ is a concept that is, at once, old and boring yet new and exciting. The notion that pathogenesis, risk, and prognosis can be apprehended by examining discrete aspects of the underlying disease process is not new. The identification of such markers is predicated on (1) understanding the disease process; (2) identifying aspects of pathogenesis that can be reliably and relatively easily determined; and (3) ascertaining that there is a close relationship between the marker and the outcome or characteristic of interest. In systemic lupus erythematosus (SLE), we have been using clinical indicators such as anti-double-stranded DNA antibodies and complement levels to monitor disease activity for just as long as we have been arguing about their sensitivity and specificity. The arguments arise from the heterogeneity of SLE patients with regard to clinical presentation, course, and response to therapy. Genetic factors and environmental contributors to risk and disease manifestations make the picture even more complex. Translate that to the modern era and you have ‘Biomarkers in systemic lupus erythematosus I’ [1]. Gabor Illei and colleagues have done a remarkable review of the literature in SLE in an attempt to identify markers, to assess their likely utility in SLE, and to propose a schema through which to test and apply them. The review of the literature was done by traditional methods: searching by key words and search engines, scouring the reference lists and doing deeper-level searches, and reading the more mechanistically inclined papers on SLE and immunology and imputing the utility of aspects of pathogenesis to the clinic. This comprehensive overview identifies possible, promising, and unlikely biomarkers in SLE, suggests schemata for validation, and makes the critical distinctions between biomarkers and clinical or surrogate endpoints. The latter distinction is of

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