Güner Mehmet Enes, Öztürk Perihan, Kuş Mine Müjde
Sutcu Imam University Hospital of Health, Practice and Research, Kahramanmaras Sutcu Imam University, Department Of Dermatology, Kahramanmaras, Turkey.
Dermatol Pract Concept. 2025 Jan 30;15(1):4969. doi: 10.5826/dpc.1501a4969.
In recent years, various inflammatory markers that can change in inflammatory states have been investigated. On the basis of these, we thought that inflammatory markers could also be used in the follow-up of pemphigus disease and monitoring its activity.
In this study, our objective was to investigate changes in the inflammatory markers neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), lymphocyte to monocyte ratio (LMR), C-reactive protein (CRP) erythrocyte sedimentation rate (ESR), which are inflammatory markers, before treatment and during follow-up, and the correlation of disease severity with these markers in patients with pemphigus receiving intravenous immunoglobulin (IVIG) and/or systemic immunosuppressant agents.
Seventy-six pemphigus patients (69 had pemphigus vulgaris, 5 had pemphigus foliaceus, 2 had paraneoplastic pemphigus) who received IVIG and/or systemic immunosuppressant agents such as corticosteroids and azathioprine and used these treatments for at least 6 months were included. Changes in NLR, PLR, LMR, MPV, CRP and sedimentation values were examined in patients who received systemic treatment for at least 6 months, before the start of treatment and 3 and 6 months after the start of treatment.
Significant changes in inflammatory markers and correlation values were found in all patients.
We think that neutrophil, platelet, NLR and PLR values can be used to monitor the response to treatment in pemphigus, since they show a significant decrease with treatment and are significantly positively correlated with Pemphigus Disease Area Index, which indicates the severity of the disease. LMR values were indicators of a poor prognosis. We found that the duration of remission was longer in the group receiving IVIG. Although there was no difference between the treatments in terms of disease recovery, only IVIG prolonged the duration of remission.
近年来，人们对多种在炎症状态下会发生变化的炎症标志物进行了研究。基于此，我们认为炎症标志物也可用于天疱疮疾病的随访及病情活动监测。
本研究旨在调查炎症标志物中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、平均血小板体积（MPV）、淋巴细胞与单核细胞比值（LMR）、C反应蛋白（CRP）、红细胞沉降率（ESR）在接受静脉注射免疫球蛋白（IVIG）和/或全身免疫抑制剂治疗的天疱疮患者治疗前、随访期间的变化，以及这些标志物与疾病严重程度的相关性。
纳入76例接受IVIG和/或全身免疫抑制剂（如皮质类固醇和硫唑嘌呤）治疗且至少使用这些治疗6个月的天疱疮患者（69例寻常型天疱疮、5例落叶型天疱疮、2例副肿瘤性天疱疮）。对接受全身治疗至少6个月的患者，在治疗开始前、治疗开始后3个月和6个月时，检测其NLR、PLR、LMR、MPV、CRP和血沉值的变化。
所有患者的炎症标志物及相关值均有显著变化。
我们认为中性粒细胞、血小板、NLR和PLR值可用于监测天疱疮的治疗反应，因为它们随治疗显著下降，且与表示疾病严重程度的天疱疮疾病面积指数显著正相关。LMR值是预后不良的指标。我们发现接受IVIG治疗的组缓解期更长。尽管在疾病恢复方面各治疗方法之间无差异，但只有IVIG延长了缓解期。
