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REVIEW article

Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders: Autoinflammatory Disorders
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1394148
This article is part of the Research Topic Community Series in Recent Advances in Potential Biomarkers for Rheumatic Diseases and in Cell-based Therapies in the Management of Inflammatory Rheumatic Diseases: Volume II View all 11 articles

A Guideline on Biomarkers in the Diagnosis and Evaluation in Axial Spondyloarthritis

Provisionally accepted
Dong Liu Dong Liu 1Ya Xie Ya Xie 1Liudan Tu Liudan Tu 1Budian Liu Budian Liu 1Mingcan Yang Mingcan Yang 1Xinyu Wu Xinyu Wu 1Xuqi Zheng Xuqi Zheng 1Xiqing Luo Xiqing Luo 1Liuzhong Zhou Liuzhong Zhou 1Jialing Wu Jialing Wu 1Bin Liu Bin Liu 1Kun Wang Kun Wang 1Ou Jin Ou Jin 1Qing Lyu Qing Lyu 2Xiaohong Wang Xiaohong Wang 1Jie Qin Jie Qin 1Lijun Wu Lijun Wu 3Dongbao Zhao Dongbao Zhao 4Dongyi He Dongyi He 5Shanzhi He Shanzhi He 6Wen Hui Huang Wen Hui Huang 7Shanhui Ye Shanhui Ye 8Huiqiong Zhou Huiqiong Zhou 9Jinyu Wu Jinyu Wu 10Yongfu Wang Yongfu Wang 11Shengyun Liu Shengyun Liu 12Zhenbin Li Zhenbin Li 13Zhiming Tan Zhiming Tan 14Chiduo Xu Chiduo Xu 15Youlian Wang Youlian Wang 16Donghui Zheng Donghui Zheng 17Feng Zhan Feng Zhan 18Lin Changsong Lin Changsong 19Ya Wen Ya Wen 2Shenghui Wen Shenghui Wen 2Zetao Liao Zetao Liao 1Limin Rong Limin Rong 1Yan Shen Yan Shen 20Kehu Yang Kehu Yang 21*Jieruo Gu Jieruo Gu 1*
  • 1 Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
  • 2 Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong Province, China
  • 3 People's Hospital of Xinjiang Uygur Autonomous Region, Ürümqi, Xinjiang Uyghur Region, China
  • 4 Changhai Hospital, Second Military Medical University, Shanghai, Beijing Municipality, China
  • 5 Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, Shanghai Municipality, China
  • 6 Zhongshan People's Hospital (ZSPH), Zhongshan, Guangdong, China
  • 7 The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
  • 8 First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, China
  • 9 Fourth Medical Center of PLA General Hospital, Beijing, Beijing Municipality, China
  • 10 First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, Guangxi Zhuang Region, China
  • 11 First Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, Inner Mongolia, China
  • 12 First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
  • 13 Bethune International Peace Hospital, Shijiazhuang, Hebei Province, China
  • 14 Huizhou Central People's Hospital, Huizhou, Guangdong Province, China
  • 15 Shenzhen Second People's Hospital, Shenzhen, Guangdong Province, China
  • 16 Jiangxi Provincial People's Hospital, Nanchang, Jiangxi Province, China
  • 17 Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong Province, China
  • 18 Hainan General Hospital, Haikou, Hainan Province, China
  • 19 The First Affiliated Hospital of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
  • 20 State Key Laboratory of Medical Molecular Biology, Department of Biochemistry and Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Dongcheng, Beijing, China
  • 21 Lanzhou University, Lanzhou, Gansu Province, China

The final, formatted version of the article will be published soon.

    Objective: To develop a guideline for selecting biomarkers in the diagnosis and assessment in patients with axial spondyloarthritis (axSpA). Method: A joint effort was carried out by the core team, the literature review team and the multidisciplinary voting panel to formulate recommendations regarding biomarkers in axSpA, using an evidence-based and consensus-based strategy. Certainty of evidence and strength of recommendation were determined, and levels of agreement within the voting panel were calculated.Results: A total of 20 recommendations were formulated in this guideline, with levels of agreement ranging from 6.48 to 9.71. The two strong recommendations, HLA-B27 testing in patients suspected of axSpA and regular-interval monitoring of CRP/ESR represent the status quo of axSpA evaluation, while the 13 conditional recommendations represent the promising biomarkers with clinical utility in diagnosis, disease activity assessment, prediction of radiographic progression and therapeutic responses. This guideline does not dictate clinical choices of tests on axSpA, and decisions should be made based on comprehensive consideration of costs, accessibility, patients' values and willingness as well as the objective of testing in the local context. Conclusion: This guideline addresses the interpretation of the clinical significance of biomarkers in axSpA, and the biomarkers endorsed in this guideline composed a clinical toolkit for healthcare professionals to choose from.

    Keywords: Axial spondyloarthritis, biomarker, guideline, HLA-B27, C-Reactive Protein

    Received: 01 Mar 2024; Accepted: 08 Oct 2024.

    Copyright: © 2024 Liu, Xie, Tu, Liu, Yang, Wu, Zheng, Luo, Zhou, Wu, Liu, Wang, Jin, Lyu, Wang, Qin, Wu, Zhao, He, He, Huang, Ye, Zhou, Wu, Wang, Liu, Li, Tan, Xu, Wang, Zheng, Zhan, Changsong, Wen, Wen, Liao, Rong, Shen, Yang and Gu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Kehu Yang, Lanzhou University, Lanzhou, 730000, Gansu Province, China
    Jieruo Gu, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.