New opportunities for dynamic evaluation of systemic inflammatory response in patients with rheumatoid arthritis
- 作者: Aleksandrov V.A.1,2, Emelyanov N.I.1, Aleksandrov A.V.1,2, Zborovskaya I.A.2
-
隶属关系:
- Volgograd State Medical University
- А. Zborovsky Research Institute of Clinical and Experimental Rheumatology
- 期: 卷 28, 编号 3 (2025)
- 页面: 765-772
- 栏目: SHORT COMMUNICATIONS
- URL: https://journal-vniispk.ru/1028-7221/article/view/319932
- DOI: https://doi.org/10.46235/1028-7221-17118-NOF
- ID: 319932
如何引用文章
全文:
详细
Systemic inflammation in rheumatoid arthritis (RA) is associated with changes in both counts and composition of circulating inflammatory blood cells such as neutrophils and lymphocytes. Accurate monitoring of inflammation grade and disease status in patients with RA is important in the inpatient setting. Purpose of the study was to determine inflammatory indices derived from the general blood counts (GBC) in patients with active RA during inpatient treatment, and to search for association of these indices with clinical and laboratory parameters of the disease. The inflammatory indices (NLR, neutrophil-to-lymphocyte ratio; MLR, monocyte-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio; SII – systemic immune inflammation index, SIRI, systemic inflammatory response index) were determined as based on the results of GBC performed using automated hematology analyzers in 43 patients with RA (55.8% males; aged 22 to 78 years; 88% with high disease activity) twice (at admission to hospitalization and at discharge). The average length of hospitalization was 14 [9;14] days. Common inflammatory markers (ESR and CRP) correlated with each other (rs = 0.64), i.e., we have found correlations between CRP and leukocyte counts (rs = 0.47), with PLR (rs = 0.43), and age of patients (rs = 0.34), as well as correlations of ESR with PLR (rs = 0.37) and age of RA patients (rs = 0.33). The SII index correlated strongly with NLR (rs = 0.85) and PLR (rs = 0.86), moderately with MLR (rs = 0.49), but not with SIRI (p > 0.05). The SIRI index showed a correlation with DAS-28 degree (β = -0.072, p = 0.008). Markers obtained from GBC were not associated with age or sex of the examined individuals (except of SIRI, p = 0.027), no intergroup differences in the studied hematologic markers were found when classifying RA patients by the content of antibodies to cyclic citrullinated peptide, presence of erosions and systemic manifestations (except of PLR, p = 0.048). Only CRP and systemic immune inflammation index (SII) showed a significant decrease (p = 0.24 and p = 0.43, respectively) during hospitalization of patients with RA. No advantage was found for usage of two-component indices (NLR, MLR, PLR) as plausible tools, both for assessing inflammatory status and for management of patients with highly active RA. The SII index, combining the prognostic value of three parameters (platelets, neutrophils and lymphocytes), may be considered not only more powerful for predicting inflammation than single- or two-component hematologic markers, but also a valuable tool for monitoring inflammation and RA progression. Thus, the SII index (along with CRP) may be considered a potential biomarker for determining the outcome of inpatient treatment of patients with highly active RA.
作者简介
Vladislav Aleksandrov
Volgograd State Medical University; А. Zborovsky Research Institute of Clinical and Experimental Rheumatology
Email: alexandrow666@mail.ru
ORCID iD: 0000-0002-4500-7172
Assistant Professor, Department of Hospital Therapy, Junior Research Associate
俄罗斯联邦, Volgograd; VolgogradNikolay Emelyanov
Volgograd State Medical University
Email: post@volgmed.ru
PhD (Medicine), Associate Professor, Department of Hospital Therapy
俄罗斯联邦, VolgogradAndrey Aleksandrov
Volgograd State Medical University; А. Zborovsky Research Institute of Clinical and Experimental Rheumatology
编辑信件的主要联系方式.
Email: imlab@mail.ru
ORCID iD: 0000-0002-0686-4067
PhD, MD (Medicine), Associate Professor, Professor, Department of Clinical Laboratory Diagnostics, Head, Laboratory of Functional Research Methods, Ultrasound Diagnostics and Rehabilitation Therapy
俄罗斯联邦, Volgograd; VolgogradIrina Zborovskaya
А. Zborovsky Research Institute of Clinical and Experimental Rheumatology
Email: zborovskayaia@mail.ru
ORCID iD: 0000-0003-3898-7667
PhD, MD (Medicine), Professor, Director
俄罗斯联邦, Volgograd参考
- Муравьев Ю.В., Глухова С.И., Лебедева В.В. Способ оптимизации оценки степени активности ревматоидного артрита // Клиническая фармакология и терапия, 2022. Т. 31, № 1. С. 39-42. [Muravyov Yu.V., Glukhova S.I., Lebedeva V.V. A method for optimizing the assessment of the activity of rheumatoid arthritis. Klinicheskaya farmakologiya i terapiya = Clinical Pharmacology and Therapy, 2022, Vol. 31, no. 1, pp. 39-42. (In Russ.)]
- Giannini D., Antonucci M., Petrelli F., Bilia S., Alunno A., Puxeddu I. One year in review 2020: pathogenesis of rheumatoid arthritis. Clin. Exp. Rheumatol., 2020, Vol. 38, no. 3, pp. 387-397.
- Firestein G.S., McInnes I.B. Immunopathogenesis of rheumatoid arthritis. Immunity, 2017, Vol. 46, pp. 183-196.
- Smolen J.S., Aletaha D., McInnes I.B. Rheumatoid arthritis. Lancet, 2016, Vol. 388, no. 10055, pp. 2023-2038.
- Dervisevic A., Fajkic A., Jahic E., Dervisevic L., Ajanovic Z., Ademovic E., Zaciragic A. Systemic immune-inflammation index in evaluation of inflammation in rheumatoid arthritis patients. Medeni. Med. J., 2024, Vol. 39, no. 3, pp. 183-191.
- Satis S. New inflammatory marker associated with disease activity in rheumatoid arthritis: the systemic immune-inflammation index. Curr. Health Sci. J., 2021, Vol. 47, pp. 553-557.
- Xu Y., He H., Zang Y., Yu Z., Hu H., Cui J., Wang W., Gao Y., Wei H., Wang Z. Systemic inflammation response index (SIRI) as a novel biomarker in patients with rheumatoid arthritis: a multi-center retrospective study. Clin. Rheumatol., 2022, Vol. 41, no. 7, pp. 1989-2000.
- Pope J.E., Choy E.H. C-reactive protein and implications in rheumatoid arthritis and associated comorbidities. Semin. Arthritis Rheum., 2021, Vol. 51, pp. 219-229.
- Edilova M.I., Akram A., Abdul-Sater A.A. Innate immunity drives pathogenesis of rheumatoid arthritis. Biomed. J., 2021, Vol. 44, no. 2, pp. 172-182.
- Yang Z., Zhang Z., Lin F., Ren Y., Liu D., Zhong R., Liang Y. Comparisons of neutrophil-, monocyte-, eosinophil-, and basophil- lymphocyte ratios among various systemic autoimmune rheumatic diseases. APMIS, 2017, Vol. 125, no. 10, pp. 863-871.
- Zhang Y., Chen Z., Jin F. The value of the systemic immune-inflammation index in predicting survival outcomes in patients with brain metastases of non-small-cell lung cancer treated with stereotactic radiotherapy. Mediators Inflamm., 2021, Vol. 2021, 2910892. doi: 10.1155/2021/2910892.
- Zhang L., Yuan Y., Xu Q., Jiang Z., Chu C.Q. Contribution of neutrophils in the pathogenesis of rheumatoid arthritis. J. Biomed. Res., 2019, Vol. 34, pp. 86-93.
- Xie Y., Zhuang T., Ping Y. Elevated systemic immune inflammation index level is associated with disease activity in ulcerative colitis patients. Clin. Chim. Acta., 2021, Vol. 517, pp. 122-126.
- Choe J.Y., Lee C.U., Kim S.K. Association between novel hematological indices and measures of disease activity in patients with rheumatoid arthritis. Medicina (Kaunas), 2023, Vol. 59, no. 1, 117. doi: 10.3390/medicina59010117.
补充文件
