Zhang Lingzhao, Pi Jiangshan, Wang Jinsong, Chen Jingsi, Zhang Yunxuan, Li Jie, Wang Lingling, Li Yue, Chen Anwei, Luo Xiaoyan, Wang Hua
Department of Dermatology, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Chongqing Key Laboratory of Child Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
J Inflamm Res. 2025 Jan 7;18:271-282. doi: 10.2147/JIR.S501883. eCollection 2025.
Dupilumab is a safe and effective treatment for moderate to severe atopic dermatitis (AD), but real-world data in pediatric patients in China are limited. Currently, there is no exploration of changes in blood cell counts derived indexes in pediatric patients, especially under 6 years old.
To investigate the changes in blood cell counts derived indexes before and after dupilumab treatment in Chinese children with AD, the relationship with clinical scores, and the potential role of these indexes on treatment efficacy.
We conducted a retrospective study of 109 children with moderate to severe AD treated with dupilumab. Derived inflammatory indexes, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), eosinophil-to-lymphocyte ratio (ELR), eosinophil-to-neutrophil Ratio (ENR), monocyte-to-lymphocyte ratio (MLR), inflammation response index (SIRI), systemic inflammation index (SII), and aggregate inflammation systemic index (AISI) were calculated. The correlation between clinical scores and inflammatory indexes at different treatment time points were analyzed. Logistic regression and ROC curve was employed to explore factors associated with treatment efficacy.
Baseline ELR and ENR were positively correlated with the baseline Eczema Area and Severity Index (EASI) and the Scoring Atopic Dermatitis (SCORAD). Additionally, baseline ENR levels showed a positive correlation with the baseline Peak Pruritus Numeric Rating Scale (PP-NRS). At 4 and 16 weeks of treatment, the percentage reduction in ELR was significantly associated with the percentage reduction in EASI and PP-NRS. Logistic regression results indicated that high baseline ELR could predict a poor response to dupilumab treatment.
ELR was significantly correlated with disease severity score during the treatment with dupilumab. Baseline ELR could act as a predictor of the efficacy of dupilumab in the treatment of children with atopic dermatitis under 6 years of age.
度普利尤单抗是治疗中度至重度特应性皮炎（AD）的一种安全有效的药物，但中国儿科患者的真实世界数据有限。目前，尚未对儿科患者，尤其是6岁以下患者血细胞计数衍生指标的变化进行探索。
探讨度普利尤单抗治疗中国AD儿童前后血细胞计数衍生指标的变化、与临床评分的关系以及这些指标对治疗疗效的潜在作用。
我们对109例接受度普利尤单抗治疗的中度至重度AD儿童进行了一项回顾性研究。计算了衍生炎症指标，包括中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、嗜酸性粒细胞与淋巴细胞比值（ELR）、嗜酸性粒细胞与中性粒细胞比值（ENR）、单核细胞与淋巴细胞比值（MLR）、炎症反应指数（SIRI）、全身炎症指数（SII）和综合炎症全身指数（AISI）。分析了不同治疗时间点临床评分与炎症指标之间的相关性。采用逻辑回归和ROC曲线探讨与治疗疗效相关的因素。
基线ELR和ENR与基线湿疹面积和严重程度指数（EASI）以及特应性皮炎评分（SCORAD）呈正相关。此外，基线ENR水平与基线瘙痒峰值数字评定量表（PP-NRS）呈正相关。在治疗的第4周和第16周，ELR的降低百分比与EASI和PP-NRS的降低百分比显著相关。逻辑回归结果表明，高基线ELR可预测度普利尤单抗治疗反应不佳。
在度普利尤单抗治疗期间，ELR与疾病严重程度评分显著相关。基线ELR可作为度普利尤单抗治疗6岁以下特应性皮炎儿童疗效的预测指标。
