ANCA 相关性血管炎的分类标准--准备好了吗?

IF 5.7 2区 医学 Q1 RHEUMATOLOGY
Current Rheumatology Reports Pub Date : 2024-09-01 Epub Date: 2024-06-24 DOI:10.1007/s11926-024-01154-9
Jens Rathmann, Aladdin J Mohammad
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引用次数: 0

摘要

综述目的:本综述旨在总结 ANCA 相关性血管炎(AAV)分类的演变和最新进展,并总结 2022 年 ACR/EULAR AAV 分类标准在多个队列中的评估情况:一段时间以来,AAV 的分类一直存在争议。分类标准和疾病定义的并行存在造成了分类上的一些重叠,导致在比较不同队列时面临挑战。2022 年 ACR/EULAR 分类标准源于有史以来最大规模的脉管炎研究,考虑到了 ANCA 和现代影像学在脉管炎分类中的重大变化。与以前的标准相比,这些标准表现良好,但也提出了一些问题,因为 ANCA 血清型对分类有很大影响。此外,AAV 疾病表型的组织病理学特征与之前达成的共识也存在一些差异。在过去的 35 年中,已经形成了几套分类标准,以促进 AAV 的流行病学研究和临床试验。虽然其中一些标准已使用多年,但由于未使用 ANCA 或未整合血管炎的替代标记物,以及在并行使用时出现重叠,这些标准饱受诟病。人们期待已久的 ACR/EULAR AAV 新标准于 2022 年发布,它是一项大型国际研究的成果,首次在 AAV 分类中引入了 ANCA 和现代成像技术。虽然该标准显示出良好的性能,但在实际应用中也带来了其他一些挑战。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Classification Criteria for ANCA Associated Vasculitis - Ready for Prime Time?

Classification Criteria for ANCA Associated Vasculitis - Ready for Prime Time?

Purpose of review: This review aims to summarize the evolution and recent developments in the classification of ANCA associated vasculitis (AAV) and to summarize evaluations of the 2022 ACR/EULAR classification criteria of AAV in several cohorts.

Recent findings: The classification of AAV has been a field of controversy for some time. The parallel existence of classification criteria and disease definitions produced some overlap in classification, leading to challenges when comparing different cohorts. The 2022 ACR/EULAR classification criteria derived from the largest study ever conducted in vasculitis account for significant changes in vasculitis classification with the integration of ANCA and modern imaging. These criteria show good performance compared to previous ones but also raise questions as ANCA serotypes have substantial impact on classification. In addition, there are some discrepancies with earlier agreed histopathological features of AAV disease phenotypes. During the last 35 years, several sets of classification criteria have evolved to facilitate epidemiologic studies and clinical trials in AAV. While some of these criteria have been in use for many years, they were criticized due to either not using ANCA or not integrating surrogate markers for vasculitis but also due to overlapping when used in parallel. The long-awaited new ACR/EULAR criteria for AAV were published in 2022 and are the result of a large international study, introducing for the first time ANCA and modern imaging in the classification of AAV. Though the criteria show good performance, they bring several other challenges with practical application.

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来源期刊
CiteScore
11.20
自引率
0.00%
发文量
41
期刊介绍: This journal aims to review the most important, recently published research in the field of rheumatology. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care and prevention of rheumatologic conditions. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas such as the many forms of arthritis, osteoporosis and metabolic bone disease, and systemic lupus erythematosus. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also occasionally provided.
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