Información del artículo
Resumen
El lupus eritematoso sistémico es una enfermedad crónica, autoinmune, en la cual factores genéticos, epigenéticos, ambientales, hormonales e inmunológicos han demostrado tener un papel. El lupus eritematoso sistémico afecta prácticamente a todos los órganos con manifestaciones cutáneas, musculoesqueléticas, cardiopulmonares, renales y neuropsiquiátricas, estas últimas agrupadas como lupus neuropsiquiátrico cuya prevalencia varía entre 12-95%. Las manifestaciones neuropsiquiátricas ocupan un lugar importante en la morbilidad y mortalidad de la enfermedad y, por ende, se han asociado a un pobre pronóstico. Hasta la fecha el diagnóstico de lupus neuropsiquiátrico se basa en las características clínicas, utilizando la nomenclatura y descripción de caso del Colegio Americano de Reumatología-1999, sin embargo, la inespecificidad de estos síndromes clínicos hace aún difícil el diagnóstico. Esta dificultad es consecuencia de la etiopatogenia compleja, la gran heterogeneidad de presentaciones clínicas, el curso impredecible de la enfermedad y, adicionalmente, las pruebas de laboratorio y de imaginología médica utilizadas no son contundentes para el diagnóstico. Es por ello que ha sido imperativa la búsqueda de biomar, entre los que se han reportado auto-anticuerpos y otras proteínas. Sin embargo, estos reportes requieren de estudios complementarios para ser validados como prueba diagnóstica y así poder ser utilizados en la práctica clínica. Se presenta, entonces, una revisión de tema acerca de algunos de estos biomarcadores evaluados hasta el momento.
Palabras clave:
Biomarcadores
lupus neuropsiquiátrico
líquido cefalorraquídeo
proteómica
Summary
Systemic lupus erythematosus is a chronic auto-immune disease in which genetic, epigenetic, environmental, hormonal and immunological are involved. Systemic lupus erythematosus affects almost all organs with clinical manifestations such as skin disorders, musculoskeletal, cardio, renal and neuropsychiatric compromise, the latter neuropsychiatric lupus, has a prevalence that varies between 12-95%. Neuropsychiatric manifestations have been associated with morbidity and mortality of the disease so these account for a poor prognosis. To date, the diagnosis of neuropsychiatric lupus is performed using the nomenclature and description of case reported by the American College of Rheumatology (ACR) in 1999, however, the use of this nomenclature has not been effective for the diagnosis of neuropsychiatric lupus because the complex pathogenesis, heterogeneity of clinical presentations, an unpredictable course of the disease and the laboratory tests and imaging used are not conclusive. For these reason it is therefore imperative the search of biomarkers, among which are reported auto-antibodies and other proteins. However, these reports require additional studies to be validated and that they can be used in clinical practice. This paper is a review about these biomarkers evaluated until today.
Key words:
Biomarkers
neuropsychiatric systemic lupus erythematosus
cerebrospinal fluid
proteomics
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