Murariu-Gligor Emma Eugenia, Mureșan Simona, Cotoi Ovidiu Simion
Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania.
Internal Medicine IV, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania.
J Clin Med. 2025 Jan 2;14(1):205. doi: 10.3390/jcm14010205.
Venous thromboembolism (VTE), encompassing deep vein thrombosis and pulmonary embolism, is a significant burden on health and economic systems worldwide. Improved VTE management calls for the integration of biomarkers into diagnostic algorithms and scoring systems for risk assessment, possible complications, and mortality. This literature review discusses novel biomarkers with potential diagnostic and prognostic value in personalized VTE management. The pathophysiology of thrombosis starts with cell interactions in the vascular environment and continues with more complex, recently discussed processes such as immunothrombosis and thromboinflammation. Their clinical applicability is in the use of complete blood count (CBC)-derived immuno-inflammatory indices as attractive, readily available biomarkers that reflect pro-thrombotic states. Indices such as the neutrophil-to-lymphocyte ratio (NLR = neutrophil count divided by lymphocyte count), platelet-to-lymphocyte ratio (PLR = platelet count divided by lymphocyte count), and systemic immune-inflammation index (SII = NLR multiplied by platelet count) have demonstrated predictive value for thromboembolic events. Nevertheless, confounding data regarding cutoffs that may be implemented in clinical practice limit their applicability. This literature review aims to investigate neutrophil and platelet interactions as key drivers of immunothrombosis and thromboinflammation while summarizing the relevant research on the corresponding CBC-derived biomarkers, as well as their potential utility in day-to-day clinical practice.
静脉血栓栓塞症（VTE），包括深静脉血栓形成和肺栓塞，给全球的卫生和经济系统带来了沉重负担。改善VTE管理需要将生物标志物整合到诊断算法和风险评估、可能的并发症及死亡率评分系统中。这篇文献综述讨论了在个性化VTE管理中具有潜在诊断和预后价值的新型生物标志物。血栓形成的病理生理学始于血管环境中的细胞相互作用，并继续涉及更复杂的、最近讨论的过程，如免疫血栓形成和血栓炎症。它们的临床应用在于使用源自全血细胞计数（CBC）的免疫炎症指标作为有吸引力的、易于获得的生物标志物，以反映血栓前状态。诸如中性粒细胞与淋巴细胞比率（NLR = 中性粒细胞计数除以淋巴细胞计数）、血小板与淋巴细胞比率（PLR = 血小板计数除以淋巴细胞计数）以及全身免疫炎症指数（SII = NLR乘以血小板计数）等指标已显示出对血栓栓塞事件的预测价值。然而，关于临床实践中可能采用的临界值的混杂数据限制了它们的适用性。这篇文献综述旨在研究中性粒细胞和血小板的相互作用作为免疫血栓形成和血栓炎症的关键驱动因素，同时总结关于相应的源自CBC的生物标志物的相关研究，以及它们在日常临床实践中的潜在效用。
