Neutrophil–lymphocyte ratio, platelet–lymphocyte ratio and mean platelet volume in Japanese patients with psoriasis and psoriatic arthritis: Response to therapy with biologics

Abstract

Recent studies indicate the presence of systemic inflammation in psoriatic patients, and this inflammatory status is significantly associated with a range of comorbidities. The aim of this study was to evaluate the clinical significance of novel inflammatory biomarkers, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and mean platelet volume (MPV) in Japanese patients with plaque-type psoriasis (PsV) and psoriatic arthritis (PsA). One hundred and eighty-six patients with PsV and 50 patients with PsA treated with biologics, including infliximab, adalimumab and ustekinumab, were retrospectively analyzed before and after treatment. At baseline, NLR and PLR, as well as C-reactive protein (CRP), were significantly higher in PsA patients than those in PsV patients, and a significant correlation was found between NLR and PLR. In PsV patients, the NLR-high and PLR-high subgroups exhibited significantly higher Psoriasis Area and Severity Index scores compared with the NLR-low and PLR-low subgroups, respectively, and the NLR-high subgroup also showed higher CRP levels. MPV value was negatively associated with the presence of arthritis, but its association with inflammation was less clear than that of NLR or PLR. After treatment of the patients with biologics for up to 12 months, NLR and PLR decreased promptly in parallel with a decrease of CRP, irrespective of the type of biologics used. Altogether, these results indicate that both NLR and PLR may be useful markers to evaluate systemic inflammation in psoriatic patients. They may serve as simple, convenient and cost-effective biomarkers to monitor the disease course after systemic therapy.

The clinical value of hematological markers in rheumatoid arthritis patients treated with tocilizumab

“…In other words, this study also implies that △NLR could be used to monitor clinical response to TCZ in RA patients. Furthermore, in a study consisting of 186 patients with plaque‐type psoriasis (PsV) and 50 patients with psoriatic arthritis (PsA) treated with biologics, NLR and PLR decreased sharply in parallel with a decrease in CRP after treatment for up to 12 months, irrespective of the type of biologics used, indicating that NLR and PLR might serve as biomarkers to monitor the disease course after systemic therapy . Similar to the results of abovementioned studies, NLR and PLR decreased significantly after TCZ treatment in our study, and the decrease could be attributed to the inhibition of systemic inflammation by TCZ.…”

“…NLR and PLR decreased sharply in parallel with a decrease in CRP after treatment for up to 12 months, irrespective of the type of biologics used, indicating that NLR and PLR might serve as biomarkers to monitor the disease course after systemic therapy 24. Similar to the results of abovementioned studies, NLR and PLR decreased significantly after TCZ treatment in our study, and TA B L E 2 The correlation between disease activity and interested hematological markers at baseline…”

A Correlative Study between Platelet Count, Mean Platelet Volume and Red Cell Distribution Width with the Disease Severity Index in Psoriasis Patients

“…In an attempt to find a reliable biological marker, some of the recent studies have explored the suitability of platelets and their products for that purpose as platelets are known to play an important role not only in haemostasis but also in inflammation. The platelet related parameters that have been evaluated so far thus, include platelet-lymphocyte ratio (PLR), CD-62, p-selectin, PDW and MPV [10,11,16]. Some of these are indicators of platelet activation.…”

Alteration of serum thymus and activation‐regulated chemokine level during biologic therapy for psoriasis: Possibility as a marker reflecting favorable response to anti‐interleukin‐17A agents

“…These biomarkers include genotypes of human leukocyte antigen, cytokine‐related genes and inflammation signal‐related genes, miRNA, serum proteins, such as C‐reactive protein, and cytokine‐related inflammation and leucine‐rich α2‐glycoprotein . Among them, neutrophil : lymphocyte ratio can be easily and regularly measured in daily clinical examination . However, there are few studies suggesting biomarkers for suspension or interval elongation of biologic therapy in psoriasis.…”

“…24 Among them, neutrophil : lymphocyte ratio can be easily and regularly measured in daily clinical examination. 25 However, there are few studies suggesting biomarkers for suspension or interval elongation of biologic therapy in psoriasis.…”