Prognostic value of systemic inflammation biomarkers in patients with psoriasis

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

BACKGROUND: Standard systemic inflammation markers such as high-sensitivity C-reactive protein, erythrocyte sedimentation rate, and leukocyte count correlate only moderately with psoriasis severity. Therefore, novel in vivo measures of inflammation are essential to understand the extent of systemic inflammation in psoriasis. Currently, limited data are available on the role of emerging composite systemic inflammation indices such as SIRI, MLR, NLR, SII, PLR, and AISI in psoriasis monitoring.

AIM: To evaluate the role of novel hematologic biomarkers of systemic inflammation in patients with various forms of psoriasis.

METHODS: All patients with psoriasis and psoriatic arthritis included in the study had systemic inflammation indices calculated. The extent and severity of psoriatic skin involvement were assessed using the standardized PASI score.

RESULTS: The study group included 77 patients with psoriasis: 33 women (42.9%) and 44 men (57.1%), with a mean age of 41.3 ± 13.4 years. The median PASI score was 10.8 (3.2; 15.3). Of these, 58 patients (75.3%) had only cutaneous manifestations, and 19 (24.7%) had psoriatic arthritis. The diagnostic significance of SIRI, MLR, NLR, SII, PLR, and AISI varied among patients. Psoriatic nail dystrophy was associated with elevated SII (p = 0.005), NLR (p = 0.053), and PLR (p = 0.037) indices in the psoriasis subgroup. Scalp involvement was significantly associated with higher MLR values (p = 0.049). In patients with cutaneous psoriasis only, the mean SIRI was twice the reference value. The mean AISI was 1.5 times the reference value in patients with both psoriasis and psoriatic arthritis. Notably, AISI was significantly higher in patients with severe psoriatic arthritis (PASI 20–30) than in those with severe psoriasis.

CONCLUSION: Composite hematologic indices of systemic inflammation are sensitive tools for assessing and predicting psoriasis severity. Elevated SIRI and AISI are prognostically relevant for early detection of psoriatic arthritis. Increased SII, NLR, and PLR are significantly associated with the development of nail dystrophy, while elevated MLR is linked to scalp involvement.

About the authors

Nadezhda V. Batkaeva

Peoples' Friendship University of Russia

Author for correspondence.
Email: nbatkaeva.derm@yandex.ru
ORCID iD: 0000-0002-8350-5842
SPIN-code: 5884-1750

MD, Cand. Sci. (Medicine), Associate Professor

Russian Federation, Moscow

Olga Yu. Olisova

The First Sechenov Moscow State Medical University (Sechenov University)

Email: olisovaolga@mail.ru
ORCID iD: 0000-0003-2482-1754
SPIN-code: 2500-7989

MD, Dr. Sci. (Medicine), Professor, Corresponding Member of the Russian Academy of Sciences

Russian Federation, Moscow

References

  1. Reich K. The concept of psoriasis as a systemic inflammation: Implications for disease management. J Eur Acad Dermatol Venereol. 2012;26(Suppl 2):3–11. doi: 10.1111/j.1468-3083.2011.04410.x
  2. Golden JB, McCormick TS,∙Ward NL. IL-17 in psoriasis: Implications for therapy and cardiovascular co-morbidities. Cytokine. 2013;62(2):195–201. doi: 10.1016/j.cyto.2013.03.013
  3. Späh F. Inflammation in atherosclerosis and psoriasis: Common pathogenic mechanisms and the potential for an integrated treatment approach. Br J Dermatol. 2008;159(Suppl 2):10–17. doi: 10.1111/j.1365-2133.2008.08780.x
  4. Armstrong AW, Voyles SV, Armstrong EJ, et al. A tale of two plaques: convergent mechanisms of T-cell-mediated inflammation in psoriasis and atherosclerosis. Exp Dermatol. 2011;20(7):544–549. doi: 10.1111/j.1600-0625.2011.01308.x
  5. Gerdes S, Rostami-Yazdi M, Mrowietz U. Adipokines and psoriasis. Exp Dermatol. 2011;20(2):81–87. doi: 10.1111/j.1600-0625.2010.01210.x
  6. Lockshin B, Balagula Y, Merola JF. Interleukin 17, inflammation, and cardiovascular risk in patients with psoriasis. J Am Acad Dermatol. 2018;79(2):345–352. doi: 10.1016/j.jaad.2018.02.040
  7. Ridker PM. Psoriasis, inflammation, and vascular risk: A problem more than skin deep? Eur Heart J. 2010;31(8):902–904. doi: 10.1093/eurheartj/ehq042
  8. Ferrucci PF, Gandini S, Battaglia A, et al. Baseline neutrophil-to-lymphocyte ratio is associated with outcome of ipilimumab treated metastatic melanoma patients. Br J Cancer. 2015;112(12):1904–1910. doi: 10.1038/bjc.2015.180
  9. Kabbani MS, Shchegoleva LS, Shashkova EYu. Ratio of immune indices in women of the semi-arid region. Russian journal of immunology. 2024;27(2):287–292. doi: 10.46235/1028-7221-16809-ROI EDN: MFGZEQ
  10. Buonacera A, Stancanelli B, Colaci M, Malatino L. Neutrophil to lymphocyte ratio: An emerging marker of the relationships between the immune system and diseases. Int J Mol Sci. 2022;23(7):3636. doi: 10.3390/ijms23073636
  11. Stavchikov EL, Zinovkin IV, Marochkov AV. Assessment of hematological relations in patients with diabetic foot syndrome. J Grodno State Medical University. 2023;21(1):52–57. doi: 10.25298/2221-8785-2023-21-1-52-57 EDN: SVFERS
  12. Clinical guidelines. Psoriasis. 2023-2024-2025 (10.02.2023). Approved by the Ministry of Health of Russia. Available at: http://disuria.ru/_ld/12/1261_kr23L40MZ.pdf. Accessed: 15.07.2024.
  13. Shvarts VA, Talibova SM, Sokolskaya MA, et al. Association of novel biomarkers of systemic inflammation with atherosclerosis and its severity. Russian Journal of Cardiology. 2024;29(8):6025. doi: 10.15829/1560-4071-2024-6025. EDN: FIDYSH
  14. Wang H, Li C, Yang R, et al. Prognostic value of the platelet-to-lymphocyte ratio in lung cancer patients receiving immunotherapy: A systematic review and meta-analysis. PLoS One. 2022;17(5):e0268288. doi: 10.1371/journal.pone.0268288
  15. Lebedeva OK, Ermakov AI, Gaikovaya LB, et al. Monocytic and lymphocytic inflammatory reaction during myocardial infarction complicated with acute heart failure in patients with type 2 diabetes mellitus. Translational Medicine. 2021;8(4):5–16. doi: 10.18705/2311-4495-2021-8-4-5-17 EDN: JNWGWF
  16. Wheeler JG, Mussolino ME, Gillum RF, et al. Associations between differential leucocyte count and incident coronary heart disease: 1764 incident cases from seven prospective studies of 30,374 individuals. Eur Heart J. 2004;25(15):1287–1292. doi: 10.1016/j.ehj.2004.05.002
  17. Joshi A, Bhambhani A, Barure R, et al. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as markers of stable ischemic heart disease in diabetic patients: An observational study. Medicine. 2023;102(5):e32735. doi: 10.1097/MD.0000000000032735
  18. Ding Q, Li X, Lin L, et al. Association between systemic immunity-inflammation index and psoriasis among outpatient US adults. Front Immunol. 2024;15:1368727. doi: 10.3389/fimmu.2024.1368727
  19. Liu YC, Chuang SH, Chen YP, Shih YH. Associations of novel complete blood count-derived inflammatory markers with psoriasis: A systematic review and meta-analysis. Arch Dermatol Res. 2024;316(6):228. doi: 10.1007/s00403-024-02994-2
  20. Tiucă OM, Morariu SH, Mariean CR, et al. Impact of blood-count-derived inflammatory markers in psoriatic disease progression. Life (Basel). 2024;14(1):114. doi: 10.3390/life14010114
  21. Zhang Y, Qian H, Kuang YH, et al. Evaluation of the inflammatory parameters as potential biomarkers of systemic inflammation extent and the disease severity in psoriasis patients. Arch Dermatol Res. 2024;316(6):229. doi: 10.1007/s00403-024-02972-8

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. Distribution of patients (n=77) depending on the severity of the skin process. Пс, psoriasis; ПсА, psoriatic arthritis. Source: Batkaeva NV et al., 2025.

Download (102KB)
Indexing metadata
3. Fig. 2. Distribution of body mass index in patients with psoriasis depending on age (n=77). Пс, psoriasis; ПсА, psoriatic arthritis. Source: Batkaeva NV et al., 2025.

Download (362KB)
Indexing metadata
4. Fig. 3. Distribution of body mass index values in patients with various forms of psoriasis depending on the severity of the skin process (n=77). Пс, psoriasis; ПсА, psoriatic arthritis. Source: Batkaeva NV et al., 2025.

Download (105KB)
Indexing metadata
5. Fig. 4. Correlation of body mass index values in psoriasis patients with PASI scores (n=77). Пс, psoriasis; ПсА, psoriatic arthritis. Source: Batkaeva NV et al., 2025.

Download (341KB)
Indexing metadata
6. Fig. 5. MLR results in psoriasis patients depending on the lesion of the scalp (n=77). Пс, psoriasis; ПсА, psoriatic arthritis. Source: Batkaeva NV et al., 2025.

Download (111KB)
Indexing metadata
7. Fig. 6. SII values in the study group depending on nail damage (n=58; p=0.005). Source: Batkaeva NV et al., 2025.

Download (159KB)
Indexing metadata
8. Fig. 7. NLR values in the study group depending on nail damage (n=58; p=0.053). Source: Batkaeva NV et al., 2025.

Download (124KB)
Indexing metadata
9. Fig. 8. PLR values in the study group depending on nail damage (n=58; p=0.037). Source: Batkaeva NV et al., 2025.

Download (153KB)
Indexing metadata
10. Fig. 9. Values of the SII, PLR and AISI indices in patients with onychodystrophy in the psoriasis and psoriatic arthritis (n=32). Пс, psoriasis; ПсА, psoriatic arthritis. Source: Batkaeva NV et al., 2025.

Download (87KB)
Indexing metadata
11. Fig. 10. Values of the SIRI, MLR и NLR indices in patients with onychodystrophy in the psoriasis and psoriatic arthritis (n=32). Пс, psoriasis; ПсА, psoriatic arthritis. Source: Batkaeva NV et al., 2025.

Download (70KB)
Indexing metadata
12. Fig. 11. Values of biomarkers of systemic inflammation in psoriasis and psoriatic arthritis depending on the severity of the skin process (n=77). Пс, psoriasis; ПсА, psoriatic arthritis. Source: Batkaeva NV et al., 2025.

Download (143KB)
Indexing metadata

Copyright (c) 2025 Eco-Vector

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
 


Согласие на обработку персональных данных

 

Используя сайт https://journals.rcsi.science, я (далее – «Пользователь» или «Субъект персональных данных») даю согласие на обработку персональных данных на этом сайте (текст Согласия) и на обработку персональных данных с помощью сервиса «Яндекс.Метрика» (текст Согласия).