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The search for lupus biomarkers
Best Practice & Research: Clinical Rheumatology, 07/28/09

Liu CC et al. – The attempt to discover useful biomarkers for systemic lupus erythematosus (SLE) has traditionally been conducted based on hypothesis-driven approaches. Although these approaches have yielded many putative biomarkers, no biomarkers have been validated to date. This article briefly reviews the historical aspects of lupus biomarkers and summarises current efforts to advance the field.

• Discovery and development of biomarkers can be achieved through two distinct, yet, complementary, approaches:
  • By identifying potential biomarkers based on established cellular and molecular mechanisms of SLE
  • The ‘survey’ or ‘scan’ search of potential biomarkers driven by novel, high-throughput technology (e.g., genomics and proteomics)
• Large-scale multicentre and longitudinal studies are essential for successful validation of promising biomarkers
• Individual heterogeneity in clinical manifestations, disease progression rate and perhaps pathogenic mechanisms should be considered
• Validation of each biomarker in specific subgroups of SLE pts may yield more useful insight than validation performed using thepopulation of all SLE pts
• Many SLE biomarkers in the pipeline are currently ‘for research use only'
• Measurement of autoantibodies and complement are currently the assays of choice in daily clinical practice
• The results of autoantibody/complement tests are likely most informative if interpreted in a ‘personalised’ manner
• Physicians and patients should be educated and encouraged to actively participate in exploratory or validating studies of potential biomarkers

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