Thilo Gambichler, Zenaida Numanovic, Imke Apel, Schapoor Hessam, Laura Susok, Xenofon Baraliakos, Philipp Sewerin
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引用次数: 0
摘要
背景:能准确显示系统性红斑狼疮(SLE)疾病活动的实验室生物标志物在临床常规治疗中可能具有实用价值。正如在许多其他疾病中显示的那样,全血细胞计数(CBC)衍生的生物标志物也可能在系统性红斑狼疮中发挥作用:我们旨在首次研究系统性红斑狼疮患者的泛发性免疫炎症值(PIV,单核细胞×血小板×中性粒细胞/淋巴细胞)和更成熟的系统性免疫炎症指数(SII,中性粒细胞×血小板/淋巴细胞),并将其与血清学和临床结果(包括疾病预后)相关联:在这项回顾性多中心调查中,我们查阅了 148 名系统性红斑狼疮患者的临床病历,这些患者在基线时均有全血细胞计数。后者用于测定中性粒细胞与淋巴细胞比值(NLR)、SII 和 PIV。同时还对对照组进行了研究。研究采用了单变量和多变量统计方法:所研究的全身免疫炎症生物标志物(SIIB)基线值明显高于健康对照组(P < 0.0001),但与其他炎症患者的基线值相当。多变量分析显示,ANA 滴度 > 1:640 仍是唯一显著(p < 0.0001)的系统性红斑狼疮复发基线预测因子(几率比:7.6,95% CI 3.1 至 18.8)。治疗后系统性红斑狼疮的改善与无淋巴细胞减少以及 ANA > 1:640 相关(p = 0.041)。SLEDAI-2K仅在单变量测试中与NLR、SII、CRP、淋巴细胞和单核细胞明显相关:与健康对照组相比,系统性红斑狼疮患者基于 CBC 的 SIIB 调查明显增加。结论:与健康对照组相比,系统性红斑狼疮患者基于全血细胞计数的SIIB明显升高,但SIIB似乎对临床治疗系统性红斑狼疮没有帮助。不过,我们证实,较高的 ANA 滴度可以预测系统性红斑狼疮的复发。
Do novel inflammation biomarkers arising from routine complete blood count play a role in patients with systemic lupus erythematosus?
Background: Laboratory-based biomarkers accurately presenting systemic lupus erythematosus (SLE) disease activity may have a practical value in clinical routine. As shown in many other conditions, complete blood count (CBC)-derived biomarkers may also play a role in SLE.
Objectives: We aimed to study for the first time the pan-immune-inflammation value (PIV, monocytes x platelets x neutrophils/lymphocytes) and the more established systemic immune-inflammation index (SII, neutrophils x platelets /lymphocytes) in SLE patients and correlate it with serological and clinical findings including disease outcomes.
Methods: In this retrospective multicentric investigation, we reviewed the clinical records of 148 SLE who had an available CBC at baseline. The latter served for the determination of the neutrophil-to-lymphocyte ratio (NLR), SII, and the PIV. Control groups were studied as well. Univariable as well as multivariable statistics were employed.
Results: The values for baseline systemic immune-inflammation biomarkers (SIIB) studied were significantly (p < 0.0001) higher than those observed in healthy controls but comparable to those obtained from patients with other inflammatory conditions. Multivariable analysis revealed that ANA titer > 1:640 remained the only significant (p < 0.0001) baseline predictor of SLE flare (odds ratio: 7.6, 95% CI 3.1 to 18.8). Improvement of SLE following treatment was associated with the absence of lymphopenia as well as ANA > 1:640 (p = 0.041). The SLEDAI-2K significantly correlated with NLR, SII, CRP, lymphocytes, and monocytes only on univariable testing.
Conclusions: Compared to healthy controls the CBC-based SIIB investigated are significantly increased in SLE patients. However, SIIB do not appear to be useful in managing SLE clinically. Nevertheless, we confirm that higher ANA titers can predict flares of SLE.
期刊介绍:
The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…