Unpredictable treatment responses have been an obstacle for the successful management of rheumatoid arthritis. Although numerous serum proteins have been proposed, there is a lack of integrative survey to compare their relevance in predicting treatment outcomes in rheumatoid arthritis. Also, little is known about their applications in various treatment stages, such as dose modification, drug switching or withdrawal. Here we present an in-depth exploration of the potential usefulness of serum proteins in clinical decision-making and unveil the spectrum of immunopathology underlying responders to different drugs. Patients with robust autoimmunity and inflammation are more responsive to biological treatments and prone to relapse during treatment de-escalation. Moreover, the concentration changes of serum proteins at the beginning of the treatments possibly assist early recognition of treatment responders. With a better understanding of the relationship between the serum proteome and treatment responses, personalized medicine in rheumatoid arthritis will be more achievable in the near future.

中文翻译：

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使用蛋白质组学策略定制类风湿性关节炎的治疗决策：如何开始以及何时停止？

不可预测的治疗反应一直是成功治疗类风湿性关节炎的障碍。尽管已经提出了许多血清蛋白，但缺乏综合调查来比较它们在预测类风湿性关节炎治疗结果方面的相关性。此外，人们对它们在不同治疗阶段的应用知之甚少，例如剂量调整、药物转换或戒断。在这里，我们深入探讨了血清蛋白在临床决策中的潜在用途，并揭示了不同药物反应者的免疫病理学谱。具有强烈自身免疫和炎症的患者对生物治疗更敏感，并且在治疗降级期间容易复发。而且，治疗开始时血清蛋白浓度的变化可能有助于早期识别治疗反应者。随着对血清蛋白质组与治疗反应之间关系的更好理解，类风湿性关节炎的个体化治疗将在不久的将来更容易实现。