泪液组织蛋白酶S是干燥综合征候选生物标志物
发表者：刘蕊
日期：2015-02-27
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摘要 目的：干燥综合征(SS)的诊断在常规实践中很大程度上是依赖临床治疗医生高度怀疑而做出诊断的。这种很大程度上依赖于临床判断而做出诊断经常导致延迟诊断或误诊。泪液蛋白表达谱已经被提议作为简单、可靠的SS诊断生物标记。鉴于组织蛋白酶S在泪腺和NOD老鼠(SS小鼠模型)的眼泪中的活性增加,我们研究了使用泪液组织蛋白酶S(CTSS)活动性作为SS生物标志物的临床效用。
方法：一种成熟的方法通过Schirmer's试纸条来衡量CTSS在泪液中的活动度。我们对278名女性患者进行Schirmer 实验和CTSS活动度检测,包括的患者分别为SS(n = 73)、类风湿关节炎(n = 79)、系统性红斑狼疮(n = 40),睑缘炎(n = 10),非特异性干眼(n = 31),或其他自身免疫性疾病(n = 12),还有33名健康对照。
结果:SS患者泪液CTSS活动中位数4.1倍高于非SS的自体免疫疾病患者, 2.1倍高于非特异性干眼患者,和41.1倍高于健康对照组。泪液CTSS水平无论在原发SS还是在继发SS患者中均升高，并独立于Schirmer实验值或循环中抗SSA或抗SSB抗体。
结论：高水平的泪液CTSS活性显著提示SS诊断。泪液CTSS活动性可以作为一个简单,快速,经济,和非侵入性的方式,成为一种新型生物标志物，应用于SS中对自身免疫性泪腺炎的诊断。
附原文：Objective: The diagnosis of Sjögren's Syndrome (SS) in routine practice is largely a clinical one and requires a high index of suspicion by the treating physician. This great dependence upon clinical judgment frequently leads to delayed diagnosis or misdiagnosis. Tear protein profiles have been proposed as simple and reliable biomarkers for SS diagnosis. Given that cathepsin S activity is increased in the lacrimal glands and tears of NOD mice (a murine model of SS), we explored the clinical utility of using tear cathepsin S (CTSS) activity as a biomarker for SS. Methods: A method to measure CTSS activity in tears eluted from Schirmer's strips was developed and validated. Schirmer's tests and CTSS activity measurements were performed on 278 female subjects, including patients with SS (n=73), rheumatoid arthritis (n=79), systemic lupus erythematosus (n=40), blepharitis (n=10), non-specific dry eye (n=31), or other autoimmune diseases (n=12), along with 33 healthy controls. Results: Median tear CTSS activity in SS patients was 4.1-fold higher than in patients with non-SS autoimmune diseases, 2.1-fold higher than in patients with non-specific dry eye, and 41.1-fold higher than in healthy controls. Tear CTSS levels were equally elevated in primary and secondary SS independent of the Schirmer's strip values or of circulating anti-SSA or anti-SSB autoantibodies. Conclusion: Markedly high levels of tear CTSS activity are suggestive of SS. CTSS activity in tears can be measured in a simple, quick, economical, and non-invasive fashion and may serve as a novel biomarker and indicator of autoimmune dacryoadenitis during the workup for SS.
引自：Hamm-Alvarez SF1, Janga SR, Edman MC, Madrigal S, et al. Tear cathepsin S-A candidate biomarker for sjögren's syndrome .Arthritis Rheumatol. 2014 Mar 18. doi: 10.1002/art.38633. （注：干燥综合症病人或亲属可加QQ群交流，群号： 118194945 ，本网站站长私人微信号： ssgzz88 ）
方法：一种成熟的方法通过Schirmer's试纸条来衡量CTSS在泪液中的活动度。我们对278名女性患者进行Schirmer 实验和CTSS活动度检测,包括的患者分别为SS(n = 73)、类风湿关节炎(n = 79)、系统性红斑狼疮(n = 40),睑缘炎(n = 10),非特异性干眼(n = 31),或其他自身免疫性疾病(n = 12),还有33名健康对照。
结果:SS患者泪液CTSS活动中位数4.1倍高于非SS的自体免疫疾病患者, 2.1倍高于非特异性干眼患者,和41.1倍高于健康对照组。泪液CTSS水平无论在原发SS还是在继发SS患者中均升高，并独立于Schirmer实验值或循环中抗SSA或抗SSB抗体。
结论：高水平的泪液CTSS活性显著提示SS诊断。泪液CTSS活动性可以作为一个简单,快速,经济,和非侵入性的方式,成为一种新型生物标志物，应用于SS中对自身免疫性泪腺炎的诊断。
附原文：Objective: The diagnosis of Sjögren's Syndrome (SS) in routine practice is largely a clinical one and requires a high index of suspicion by the treating physician. This great dependence upon clinical judgment frequently leads to delayed diagnosis or misdiagnosis. Tear protein profiles have been proposed as simple and reliable biomarkers for SS diagnosis. Given that cathepsin S activity is increased in the lacrimal glands and tears of NOD mice (a murine model of SS), we explored the clinical utility of using tear cathepsin S (CTSS) activity as a biomarker for SS. Methods: A method to measure CTSS activity in tears eluted from Schirmer's strips was developed and validated. Schirmer's tests and CTSS activity measurements were performed on 278 female subjects, including patients with SS (n=73), rheumatoid arthritis (n=79), systemic lupus erythematosus (n=40), blepharitis (n=10), non-specific dry eye (n=31), or other autoimmune diseases (n=12), along with 33 healthy controls. Results: Median tear CTSS activity in SS patients was 4.1-fold higher than in patients with non-SS autoimmune diseases, 2.1-fold higher than in patients with non-specific dry eye, and 41.1-fold higher than in healthy controls. Tear CTSS levels were equally elevated in primary and secondary SS independent of the Schirmer's strip values or of circulating anti-SSA or anti-SSB autoantibodies. Conclusion: Markedly high levels of tear CTSS activity are suggestive of SS. CTSS activity in tears can be measured in a simple, quick, economical, and non-invasive fashion and may serve as a novel biomarker and indicator of autoimmune dacryoadenitis during the workup for SS.
引自：Hamm-Alvarez SF1, Janga SR, Edman MC, Madrigal S, et al. Tear cathepsin S-A candidate biomarker for sjögren's syndrome .Arthritis Rheumatol. 2014 Mar 18. doi: 10.1002/art.38633. （注：干燥综合症病人或亲属可加QQ群交流，群号： 118194945 ，本网站站长私人微信号： ssgzz88 ）