Abstract
Systemic lupus erythematosus (SLE) is a multifactorial autoimmune disease which can affect various tissues and organs, posing significant challenges for clinical diagnosis and treatment. The etiology of SLE is highly complex with contributions from environmental factors, stochastic factors as well as genetic susceptibility. The current criteria for diagnosing SLE is based primarily on a combination of clinical presentations and traditional lab testing. However, these tests have suboptimal sensitivity and specificity. They are unable to indicate disease cause or guide physicians in decision-making for treatment. Therefore, there is an urgent need to develop a more accurate and robust tool for effective clinical management and drug development in lupus patients. It is fortunate that the emerging Omics have empowered scientists in the discovery and identification of potential novel biomarkers of SLE, especially the markers from blood, urine, cerebrospinal fluids (CSF), and other bodily fluids. However, many of these markers have not been carefully validated for clinical use. In addition, it is apparent that individual biomarkers lack sensitivity or specificity. This review summarizes the sensitivity, specificity and diagnostic value of emerging biomarkers from recent studies, and discusses the potential of these markers in the development of biomarker panel based diagnostics or disease monitoring system in SLE.
Highlights
A Biomarker is generally defined as a measurable physical, genetic, biological, or biochemical factor that can reflect normal or abnormal biological process when altered
We reviewed the biomarkers derived from biological fluids including serum or plasma, cerebrospinal fluids (CSF), and urine based on sensitivity, specificity and Area-under-the-curve (AUC) as demonstrated by Receiver Operating Characteristic (ROC) curve analysis
The levels of circulating miR-21 was significantly increased in lupus nephritis (LN) patients compared to healthy controls, and ROC analysis indicated that miR-21 was better at discriminating LN patients from controls with an AUC of 0.912 [72]
Summary
A Biomarker is generally defined as a measurable physical, genetic, biological, or biochemical factor that can reflect normal or abnormal biological process when altered. Kaul A et al stated “Genetic interactions along with environmental factors, UV light exposure, EpsteinBarr virus infection, and hormonal factors might initiate the disease, resulting in immune dysregulation at the level of cytokines, T cells, B cells and macrophages” [5] This results in a breach in immune tolerance where the T cells identify self-antigens and deliver assistance to the auto-reactive B cells. The criteria for diagnosis of lupus is based primarily on the presence of clinical manifestations in the form of joint pain, skin rashes, glomerular nephritis, symptoms of neuropsychiatric illnesses as well as the results of lab tests such as the presence of antinuclear antibodies, ANA and anti-dsDNA antibodies in particular.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
