[New biomarker-based diagnostic tests : Early and precise diagnosis of rheumatological diseases].

Abstract

Biomarkers play a central role in rheumatology for early detection, prognostic assessment, treatment stratification, and evaluation of the disease course, as early and targeted therapies are crucial for prognosis. In rheumatoid arthritis, rheumatoid factors and anti-citrullinated protein (CCP) antibodies are established diagnostic and prognostic biomarkers. For seronegative spondyloarthritis, HLA-B27 is the most important diagnostic marker, particularly in axial spondyloarthritis. In connective tissue diseases, antinuclear antibodies are essential for diagnosis, but their use for assessing activity is limited. Specific autoantibodies, complement factors, and urinary biomarkers are prognostically particularly relevant in systemic lupus erythematosus. In vasculitis diagnostics, anti-neutrophil cytoplasmic antibodies (ANCAs; anti-myeloperoxidase and anti-proteinase 3) are essential for small-vessel vasculitis, while serological markers for large-vessel vasculitis are lacking.