接受生物制剂治疗的银屑病患者实验室指标变化与疾病活动度变化的相关性
Association of Transition of Laboratory Markers with Transition of Disease Activity in Psoriasis Patients Treated with Biologics.
作者信息
Annen Setsuaki, Horiguchi Go, Teramukai Satoshi, Ichiyama Susumu, Ito Michiko, Hoashi Toshihiko, Kanda Naoko, Saeki Hidehisa
机构信息
Department of Dermatology, Nippon Medical School.
Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine.
出版信息
J Nippon Med Sch. 2022;89(6):587-593. doi: 10.1272/jnms.JNMS.2022_89-613.
BACKGROUND
Three categories of biologics-tumor necrosis factor (TNF) inhibitors, interleukin (IL) -17 inhibitors, and IL-23 inhibitors-are available for treatment of refractory psoriasis. Recent studies have shown that laboratory biomarkers such as peripheral blood neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), and serum C-reactive protein (CRP) levels are associated with psoriasis or its severity. This study evaluated associations of transition of NLR, PLR, MLR, and CRP with transition of disease activity in psoriasis patients treated with the three categories of biologics.
METHODS
Data from 67 patients were analyzed. Associations of transition of psoriasis area and severity index (PASI) score with the abovementioned laboratory markers were evaluated by using a mixed effects model with PASI as the response variable, laboratory markers as fixed effects collectively, and patients as random effects.
RESULTS
In an analysis of all the patients, serum CRP and NLR were associated with PASI score (P=0.006 and P=0.001, respectively). In patients treated with TNF inhibitors, CRP and NLR were associated with PASI score (P=0.043 and P=0.002, respectively). In patients treated with IL-17 inhibitors, NLR was associated with PASI score (P=0.001).
CONCLUSIONS
NLR appears to be the most reliable biomarker of the effect of treatment with biologics, especially IL-17 inhibitors.
背景
三类生物制剂——肿瘤坏死因子（TNF）抑制剂、白细胞介素（IL）-17抑制剂和IL-23抑制剂——可用于治疗难治性银屑病。最近的研究表明，外周血中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、单核细胞与淋巴细胞比值（MLR）以及血清C反应蛋白（CRP）水平等实验室生物标志物与银屑病或其严重程度相关。本研究评估了接受这三类生物制剂治疗的银屑病患者中NLR、PLR、MLR和CRP的变化与疾病活动度变化之间的关联。
方法
分析了67例患者的数据。以银屑病面积和严重程度指数（PASI）评分作为反应变量，上述实验室指标作为固定效应，患者作为随机效应，采用混合效应模型评估PASI评分变化与上述实验室指标之间的关联。
结果
在对所有患者的分析中，血清CRP和NLR与PASI评分相关（分别为P = 0.006和P = 0.001）。在接受TNF抑制剂治疗的患者中，CRP和NLR与PASI评分相关（分别为P = 0.043和P = 0.002）。在接受IL-17抑制剂治疗的患者中，NLR与PASI评分相关（P = 0.001）。
结论
NLR似乎是生物制剂治疗效果最可靠的生物标志物，尤其是IL-17抑制剂。
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