Abstract
References
- Smolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet.2016;388:2023-38.
- Tobón GJ, Youinou P, Saraux A. The environment, geo‐epidemiology, and autoimmune disease: rheumatoid arthritis. J Autoimmun. 2010; 35:10‐14.
- Lin YJ, Anzaghe M, Schulke S. Update on the pathomechanism, diagnosis, and treatment options for rheumatoid arthritis. Cells. 2020; 9(4): 880.
- Smolen JS, Breedveld FC, Burmester GR, et al. Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force. Ann Rheum Dis. 2016; 75(1): 3- 15.
- Orr CK, Najm A, Young F, et al. The utility and limitations of CRP, ESR and DAS28-CRP in appraising disease activity in rheumatoid arthritis. Front Med. 2018; 5: 185.
- Rossaint J, Margraf A, Zarbock A. Role of platelets in leukocyte recruitment and resolution of inflammation. Front Immunol. 2018; 9: 2712.
- Li S, Zou J, Liu C, et al. Baseline derived neutrophil-to-lymphocyte ratio as a prognostic biomarker for non-colorectal gastrointestinal cancer patients treated with immune checkpoint blockade. Clin Immunol. 2020; 212:108345.
- Azab B, Bhatt V, Phookan J,Murukutla S,Kohn N,Terjanian T,Widmann W. Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting Short-and Long –Term Mortalty in Breast Cancer Patients.Official Journal of the Society of Surgıcal Onkology 2012;19:217-224.
- Halazun KJ, Hardy MA, Rana AA, Woodland DC 4th, Luyten EJ, Mahadev S, et al. Negative impact of neutrophil-lymphocyte ratio on outcome after liver transplantation for hepatocellular carcinoma. Ann Surg. 2009; 250:141–51.
- Tousoulis D, Antoniades C, Koumallos N, Stefanadis C. Proinflammatory cytokines in acute coronary syndromes: from bench to bedside. Cytokine Growth FactorRev 2006; 17:225-33.
- Tamhane UU, Aneja S, Montgomery D, et al. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 2008; 102:653-7.
- Pourafkari L, Choi C, Garajehdaghi R, Tajlil A, Dosluoglu HH, Nader ND. Neutrophil-lymphocyte ratio is a marker of survival and cardiac complications rather than patency following revascularization of lower extremities. Vasc Med. 2018; 23(5): 437- 444.
- Lee HN, Kim YK, Kim GT, et al. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio as predictors of 12-week treatment response and drug persistence of anti-tumor necrosis factor-alpha agents in patients with rheumatoid arthritis: a retrospective chart review analysis. Rheumatol Int. 2019; 39(5): 859- 868.
- Fu H, Qin B, Hu Z, et al. Neutrophil‐ and platelet‐to‐lymphocyte ratios are correlated with disease activity in rheumatoid arthritis. Clin Lab. 2015;61: 269‐273.
- Yang Z, Zhang Z, Lin F, et al. Comparisons of neutrophil‐, monocyte‐, eosinophil‐, and basophil‐ lymphocyte ratios among various systemic autoimmune rheumatic diseases. APMIS. 2017; 125:863‐871.
- Abd-Elazeem MI, Mohamed RA. Neutrophil‐lymphocyte and pla- telet‐lymphocyte ratios in rheumatoid arthritis patients: relation to disease activity. Egypt Rheumatol. 2018; 40:227‐231.
- Zengin O, Onder ME, Kalem A, et al. New inflammatory markers in early rheumatoid arthritis. Z Rheumatol 77, 144–150 (2018)
- Mercan R, Bitik B, Tufan A, et al. The association between neu- trophil/lymphocyte ratio and disease activity in rheumatoid arthritis and ankylosing spondylitis. J Clin Lab Anal. 2016; 30:597‐601.
- Gençay Can A, Günendi Z. Prognostic Factors in Rheumatoid Arthritis Rheumatism 2008; 23: 60-2 of rheumatoid arthritis. Clinic Chest Med.1998;19:667-85.
- Young Ho Lee. Association between the Neutrophil-to-lymphocyte Ratio, and Platelet-to-lymphocyte Ratio and Rheumatoid Arthritis and their Correlations with the Disease Activity: A Meta-analysis. J Rheum Dis 2018;25(3):169-178.
The Relationship of Neutrophil Lymphocyte Ratio With Prognosis And Disease Activity In Patients With Rheumatoid Arthritis
Abstract
Background: Rheumatoid arthritis (RA) is an autoimmune disease associated with systemic inflammation. Laboratory parameters such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and various disease evaluation indexes (such as DAS 28; HAQ score, SF-36) are used as indicators of the severity of inflammatory activity. Neutrophil-to-lymphocyte ratio (NLR); It has attracted attention in recent years as a non-specific inflammatory marker. In our study, it was aimed to investigate the possible role of peripheral blood NLR, which is easy and inexpensive to measure, in demonstrating disease activity and prognosis in patients with RA.
Materials and Methods: Forty-three patients who were diagnosed with RA according to the criteria of the American Rheumatology Association and who had not received prior specific treatment for RA were included in the study. Laboratory parameters such as ESR, CRP, and disease assessment indices (DAS 28; HAQ score) were compared with the NLR at the time of diagnosis and at the time of enrollment after treatment.
Results: There were no significant correlation found between the mean NLR and DAS 28, HAQ which provide information about the prognosis of the disease. When the relationship between NLR, ESR and CRP was examined in order to evaluate the relatonship between the disease activity and inflamation during the diagnosis instead of a composite index such as DAS 28, moderately weak relationship between NLR and CRP level was found (p=0.033, r=0,343) while the tendency between NLR and the average ESR was found to be also moderately weak (p=0.056, r=0.301).
Conclusions: Moderate to weak correlation between mean NLR and mean CRP levels (p=0.033, r=0.343); between the mean ESR level, a moderate-weak correlation was found (p=0.056, r=0.301). The association with baseline CRP and the trend towards association with ESR suggest that NLR may be associated with inflammation. It was thought that the loss of this relationship during the study, that is, after the treatment, may be due to the fact that other factors such as medication affect this rate.
References
- Smolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet.2016;388:2023-38.
- Tobón GJ, Youinou P, Saraux A. The environment, geo‐epidemiology, and autoimmune disease: rheumatoid arthritis. J Autoimmun. 2010; 35:10‐14.
- Lin YJ, Anzaghe M, Schulke S. Update on the pathomechanism, diagnosis, and treatment options for rheumatoid arthritis. Cells. 2020; 9(4): 880.
- Smolen JS, Breedveld FC, Burmester GR, et al. Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force. Ann Rheum Dis. 2016; 75(1): 3- 15.
- Orr CK, Najm A, Young F, et al. The utility and limitations of CRP, ESR and DAS28-CRP in appraising disease activity in rheumatoid arthritis. Front Med. 2018; 5: 185.
- Rossaint J, Margraf A, Zarbock A. Role of platelets in leukocyte recruitment and resolution of inflammation. Front Immunol. 2018; 9: 2712.
- Li S, Zou J, Liu C, et al. Baseline derived neutrophil-to-lymphocyte ratio as a prognostic biomarker for non-colorectal gastrointestinal cancer patients treated with immune checkpoint blockade. Clin Immunol. 2020; 212:108345.
- Azab B, Bhatt V, Phookan J,Murukutla S,Kohn N,Terjanian T,Widmann W. Usefulness of the Neutrophil-to-Lymphocyte Ratio in Predicting Short-and Long –Term Mortalty in Breast Cancer Patients.Official Journal of the Society of Surgıcal Onkology 2012;19:217-224.
- Halazun KJ, Hardy MA, Rana AA, Woodland DC 4th, Luyten EJ, Mahadev S, et al. Negative impact of neutrophil-lymphocyte ratio on outcome after liver transplantation for hepatocellular carcinoma. Ann Surg. 2009; 250:141–51.
- Tousoulis D, Antoniades C, Koumallos N, Stefanadis C. Proinflammatory cytokines in acute coronary syndromes: from bench to bedside. Cytokine Growth FactorRev 2006; 17:225-33.
- Tamhane UU, Aneja S, Montgomery D, et al. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol 2008; 102:653-7.
- Pourafkari L, Choi C, Garajehdaghi R, Tajlil A, Dosluoglu HH, Nader ND. Neutrophil-lymphocyte ratio is a marker of survival and cardiac complications rather than patency following revascularization of lower extremities. Vasc Med. 2018; 23(5): 437- 444.
- Lee HN, Kim YK, Kim GT, et al. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio as predictors of 12-week treatment response and drug persistence of anti-tumor necrosis factor-alpha agents in patients with rheumatoid arthritis: a retrospective chart review analysis. Rheumatol Int. 2019; 39(5): 859- 868.
- Fu H, Qin B, Hu Z, et al. Neutrophil‐ and platelet‐to‐lymphocyte ratios are correlated with disease activity in rheumatoid arthritis. Clin Lab. 2015;61: 269‐273.
- Yang Z, Zhang Z, Lin F, et al. Comparisons of neutrophil‐, monocyte‐, eosinophil‐, and basophil‐ lymphocyte ratios among various systemic autoimmune rheumatic diseases. APMIS. 2017; 125:863‐871.
- Abd-Elazeem MI, Mohamed RA. Neutrophil‐lymphocyte and pla- telet‐lymphocyte ratios in rheumatoid arthritis patients: relation to disease activity. Egypt Rheumatol. 2018; 40:227‐231.
- Zengin O, Onder ME, Kalem A, et al. New inflammatory markers in early rheumatoid arthritis. Z Rheumatol 77, 144–150 (2018)
- Mercan R, Bitik B, Tufan A, et al. The association between neu- trophil/lymphocyte ratio and disease activity in rheumatoid arthritis and ankylosing spondylitis. J Clin Lab Anal. 2016; 30:597‐601.
- Gençay Can A, Günendi Z. Prognostic Factors in Rheumatoid Arthritis Rheumatism 2008; 23: 60-2 of rheumatoid arthritis. Clinic Chest Med.1998;19:667-85.
- Young Ho Lee. Association between the Neutrophil-to-lymphocyte Ratio, and Platelet-to-lymphocyte Ratio and Rheumatoid Arthritis and their Correlations with the Disease Activity: A Meta-analysis. J Rheum Dis 2018;25(3):169-178.
Details
| Primary Language | English |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Medical Science Research Articles |
| Authors | |
| Publication Date | December 31, 2022 |
| Acceptance Date | December 30, 2022 |
| Published in Issue | Year 2022Volume: 44 Issue: 4 |