Şener Gülsen, İnan Yuksel Esma, Gökdeniz Osman, Karaman Kübra, Canat Harbiye Dilek
Biochemistry, Başakşehir Çam and Sakura City Hospital, İstanbul, TUR.
Dermatology, Biruni University Hospital, Istanbul, TUR.
Cureus. 2023 Aug 20;15(8):e43790. doi: 10.7759/cureus.43790. eCollection 2023 Aug.
Systemic inflammation has an important role in psoriasis, which is a chronic disease with an increasing prevalence and is associated with comorbidity. Our aim is to investigate the relationship of hematological parameters and C-reactive protein (CRP) with the presence and severity of the disease in patients with psoriasis. It is also to investigate whether it can be used as a biomarker in monitoring the response to systemic treatment.
This retrospective study was conducted with the participation of 139 psoriasis patients receiving biological therapy (BT) and conventional therapy (CT) and 140 healthy controls. Demographic, clinical, and laboratory data of patients and controls were examined and all parameters were compared with the psoriasis area severity index (PASI) score. In addition, the changes in these parameters before the treatment and in the third month of the treatment were examined in the patient groups who received BT and CT.
White blood cell (WBC), neutrophil, monocytes, platelet (PLT), plateletcrit, red blood cell, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) monocyte-lymphocyte ratio (MLR), red cell distribution width (RDW), CRP and erythrocytesedimentation (ESR) levels were higher compared to the healthy control group in psoriasis patients (p<0.05). Baseline PASI values were positively correlated with WBC, neutrophils, monocytes, NLR, MLR, and CRP. WBC, neutrophil, NLR, CRP, and ESR levels decreased in all patients in the third month of treatment (p<0.05). WBC, PLT, neutrophil, and NLR in patients receiving BT; while WBC, neutrophil, NLR, CRP, and ESR levels decreased in patients receiving CT, RDW levels increased (p<0.05). Adalimumab; NLR and basophil, methotrexate; WBC, NLR, neutrophil, and ESR levels caused a significant decrease (p<0.05).
The fact that increased WBC, neutrophils, monocytes, NLR, MLR, and CRP levels are associated with the severity of psoriasis indicates that these parameters reflect systemic inflammation in psoriasis. In addition, the decrease in these parameters after BT and CT suggests that they can be considered simple and reliable markers that can be used as a complement to the PASI score in assessing disease severity and response to treatment.
全身炎症在银屑病中起重要作用，银屑病是一种患病率不断上升的慢性疾病，且与合并症相关。我们的目的是研究血液学参数和C反应蛋白（CRP）与银屑病患者疾病的存在及严重程度之间的关系。同时还要研究它是否可作为监测全身治疗反应的生物标志物。
本回顾性研究纳入了139例接受生物治疗（BT）和传统治疗（CT）的银屑病患者以及140例健康对照者。对患者和对照者的人口统计学、临床和实验室数据进行检查，并将所有参数与银屑病面积严重程度指数（PASI）评分进行比较。此外，在接受BT和CT的患者组中，检查治疗前及治疗第三个月时这些参数的变化。
银屑病患者的白细胞（WBC）、中性粒细胞、单核细胞、血小板（PLT）、血小板压积、红细胞、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）、红细胞分布宽度（RDW）、CRP和红细胞沉降率（ESR）水平均高于健康对照组（p<0.05）。基线PASI值与WBC、中性粒细胞、单核细胞、NLR、MLR和CRP呈正相关。所有患者在治疗第三个月时WBC、中性粒细胞、NLR、CRP和ESR水平均下降（p<0.05）。接受BT的患者中WBC、PLT、中性粒细胞和NLR下降；而接受CT的患者中WBC、中性粒细胞、NLR、CRP和ESR水平下降，RDW水平升高（p<0.05）。阿达木单抗使NLR和嗜碱性粒细胞下降；甲氨蝶呤使WBC、NLR、中性粒细胞和ESR水平显著下降（p<0.05）。
WBC、中性粒细胞、单核细胞、NLR、MLR和CRP水平升高与银屑病严重程度相关，这一事实表明这些参数反映了银屑病中的全身炎症。此外，BT和CT后这些参数下降表明，它们可被视为简单可靠的标志物，在评估疾病严重程度和治疗反应时可作为PASI评分的补充。
