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Cell-bound complement activation products as lupus biomarkers: diagnosis, monitoring and stratification

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Ahearn JM1, Liu CC1, Manzi S1. Expert Rev Clin Immunol. 2017 Dec;13(12):1133-1142. doi: 10.1080/1744666X.2017.1392238. Epub 2017 Nov 6.

Abstract

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1 a Lupus Center of Excellence , Autoimmunity Institute, Allegheny Health Network , Pittsburgh , PA , USA.

Abstract

Cell-bound complement activation products (CB-CAPs) were first reported in 2004, since which time multiple laboratories have demonstrated their value as biomarkers for diagnosis, monitoring, and stratification of patients with systemic lupus erythematosus. Areas covered: This review summarizes the highlights of these 14 years of CB-CAPs discovery and validation, concluding with a view toward their future potential for precision medicine. Expert commentary: The practice of medicine is both art and science and each physician can be considered both artist and scientist with a variable blend of the two skill sets. There is arguably no disease that presents a greater challenge, nor a greater opportunity, for implementation of precision medicine, as does lupus. The physician who is presented with diagnosis and/or management of a patient suspected of having lupus will need to augment artistic skills with scientific guidance, and that science will be delivered in the form of biomarkers. Ultimately, we will likely have a 'lupus liquid biopsy' that will be 100% sensitive and 100% specific for a diagnosis of lupus. This will undoubtedly be a panel of biomarkers rather than an individual laboratory test. Such a liquid biopsy could transform lupus diagnosis to an entirely scientific process.