Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are positively correlated with disease activity of bullous pemphigoid.
Bullous Pemphigoid Disease Area Index
Bullous pemphigoid
Neutrophil-to-lymphocyte ratio
Platelet-to-lymphocyte ratio
Untreated patients
Journal
Archives of dermatological research
ISSN: 1432-069X
Titre abrégé: Arch Dermatol Res
Pays: Germany
ID NLM: 8000462
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
received:
15
11
2022
accepted:
09
05
2023
revised:
21
02
2023
medline:
29
8
2023
pubmed:
19
5
2023
entrez:
19
5
2023
Statut:
ppublish
Résumé
Bullous pemphigoid (BP) is a complex inflammatory process with elevated levels of autoantibodies, eosinophils, neutrophils, and various cytokines. Hematological inflammatory biomarkers can reflect inflammatory state in various diseases. Up to now, the correlations of hematological inflammatory biomarkers and disease activity of BP remain unknown. The purpose of this study was to clarify the associations between hematological inflammatory biomarkers and disease activity of BP. The levels of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), platelet-to-neutrophil ratio (PNR) and mean platelet volume (MPV) of 36 untreated BP patients and 45 age and gender matched healthy controls were detected by routine blood tests. The correlations between hematological inflammatory markers and clinical characteristics of BP were statistically analyzed. The Bullous Pemphigoid Disease Area Index (BPDAI) was used to measure disease activity of BP. The mean levels of NLR, PLR, PNR and MPV in 36 untreated BP patients were 3.9, 157.9, 45.7 and 9.4 fl, respectively. Increased NLR (p < 0.001), PLR (p < 0.01), and MPV (p < 0.001) but decreased PNR (p < 0.001) were observed in BP patients when compared with healthy controls. In BP patients, the levels of NLR were positively correlated to BPDAI Erosion/Blister Scores (p < 0.01); and the levels of NLR and PLR were both positively correlated to BPDAI without Damage Score (both p < 0.05) and BPDAI Total Score (both p < 0.05). No correlation was found in other statistical analyses between hematological inflammatory markers and clinical characteristics in BP patients involved in the present study. Therefore, NLR and PLR are positively correlated with disease activity of BP.
Identifiants
pubmed: 37204459
doi: 10.1007/s00403-023-02639-w
pii: 10.1007/s00403-023-02639-w
doi:
Substances chimiques
Biomarkers
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2383-2391Subventions
Organisme : the Scientific Research Project of Jiangsu Provincial Health Commission
ID : Grant No. ZD2021035
Organisme : the CAMS Innovation Fund for Medical Sciences
ID : Grant No. CIFMS-2021-I2M-1-059
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Nishie W (2014) Update on the pathogenesis of bullous pemphigoid: an autoantibody-mediated blistering disease targeting collagen XVII. J Dermatol Sci 73(3):179–186
pubmed: 24434029
doi: 10.1016/j.jdermsci.2013.12.001
Kasperkiewicz M, Zillikens D (2007) The pathophysiology of bullous pemphigoid. Clin Rev Allergy Immunol 33(1–2):67–77
pubmed: 18094948
doi: 10.1007/s12016-007-0030-y
Goletz S, Zillikens D, Schmidt E (2017) Structural proteins of the dermal-epidermal junction targeted by autoantibodies in pemphigoid diseases. Exp Dermatol 26(12):1154–1162
pubmed: 28887824
doi: 10.1111/exd.13446
Dopp R, Schmidt E, Chimanovitch I, Leverkus M, Brocker EB, Zillikens D (2000) IgG4 and IgE are the major immunoglobulins targeting the NC16A domain of BP180 in Bullous pemphigoid: serum levels of these immunoglobulins reflect disease activity. J Am Acad Dermatol 42(4):577–583
pubmed: 10727301
Daneshpazhooh M, Ghiasi M, Lajevardi V, Nasiri N, Balighi K, Teimourpour A et al (2018) BPDAI and ABSIS correlate with serum anti-BP180 NC16A IgG but not with anti-BP230 IgG in patients with bullous pemphigoid. Arch Dermatol Res 310(3):255–259
pubmed: 29423547
doi: 10.1007/s00403-018-1817-9
Ishiura N, Fujimoto M, Watanabe R, Nakashima H, Kuwano Y, Yazawa N et al (2008) Serum levels of IgE anti-BP180 and anti-BP230 autoantibodies in patients with bullous pemphigoid. J Dermatol Sci 49(2):153–161
pubmed: 17920818
doi: 10.1016/j.jdermsci.2007.08.008
Muhammed N, Korgaonkar S, Pradhan V, Khopkar US (2021) A Cross-sectional study to correlate disease severity in bullous pemphigoid patients with serum levels of autoantibodies against BP180 and BP230. Indian Dermatol Online J 12(5):696–700
pubmed: 34667755
pmcid: 8456256
doi: 10.4103/idoj.IDOJ_813_20
Lee EH, Kim YH, Kim S, Kim SE, Kim SC (2012) Usefulness of enzyme-linked immunosorbent assay using recombinant BP180 and BP230 for serodiagnosis and monitoring disease activity of bullous pemphigoid. Ann Dermatol 24(1):45–55
pubmed: 22363155
pmcid: 3283850
doi: 10.5021/ad.2012.24.1.45
Cai SC, Lim YL, Li W, Allen JC, Chua SH, Tan SH et al (2015) Anti-BP180 NC16A IgG titres as an indicator of disease activity and outcome in Asian patients with bullous pemphigoid. Ann Acad Med Singap 44(4):119–126
pubmed: 26041635
doi: 10.47102/annals-acadmedsg.V44N4p119
Tsuji-Abe Y, Akiyama M, Yamanaka Y, Kikuchi T, Sato-Matsumura KC, Shimizu H (2005) Correlation of clinical severity and ELISA indices for the NC16A domain of BP180 measured using BP180 ELISA kit in bullous pemphigoid. J Dermatol Sci 37(3):145–149
pubmed: 15734283
doi: 10.1016/j.jdermsci.2004.10.007
Feng S, Wu Q, Jin P, Lin L, Zhou W, Sang H et al (2008) Serum levels of autoantibodies to BP180 correlate with disease activity in patients with bullous pemphigoid. Int J Dermatol 47(3):225–228
pubmed: 18289320
doi: 10.1111/j.1365-4632.2008.03473.x
Patsatsi A, Kyriakou A, Pavlitou-Tsiontsi A, Giannakou A, Sotiriadis D (2012) Association of autoantibodies to BP180 with disease activity in Greek patients with bullous pemphigoid. Clin Dev Immunol 2012:854795
pubmed: 23227089
pmcid: 3514843
doi: 10.1155/2012/854795
Hashimoto T, Ohzono A, Teye K, Numata S, Hiroyasu S, Tsuruta D et al (2017) Detection of IgE autoantibodies to BP180 and BP230 and their relationship to clinical features in bullous pemphigoid. Br J Dermatol 177(1):141–151
pubmed: 27716903
doi: 10.1111/bjd.15114
van Beek N, Luttmann N, Huebner F, Recke A, Karl I, Schulze FS et al (2017) Correlation of serum levels of IgE autoantibodies against BP180 with bullous pemphigoid disease activity. JAMA Dermatol 153(1):30–38
pubmed: 27829102
doi: 10.1001/jamadermatol.2016.3357
Schmidt E, Obe K, Brocker EB, Zillikens D (2000) Serum levels of autoantibodies to BP180 correlate with disease activity in patients with bullous pemphigoid. Arch Dermatol 136(2):174–178
pubmed: 10677092
doi: 10.1001/archderm.136.2.174
Amo Y, Ohkawa T, Tatsuta M, Hamada Y, Fujimura T, Katsuoka K et al (2001) Clinical significance of enzyme-linked immunosorbent assay for the detection of circulating anti-BP180 autoantibodies in patients with bullous pemphigoid. J Dermatol Sci 26(1):14–18
pubmed: 11323216
doi: 10.1016/S0923-1811(00)00149-3
Marzano AV, Tedeschi A, Fanoni D, Bonanni E, Venegoni L, Berti E et al (2009) Activation of blood coagulation in bullous pemphigoid: role of eosinophils, and local and systemic implications. Br J Dermatol 160(2):266–272
pubmed: 18945300
doi: 10.1111/j.1365-2133.2008.08880.x
Fang H, Shao S, Xue K, Yuan X, Qiao P, Zhang J et al (2021) Neutrophil extracellular traps contribute to immune dysregulation in bullous pemphigoid via inducing B-cell differentiation and antibody production. FASEB J 35(7):e21746
pubmed: 34151465
doi: 10.1096/fj.202100145R
Park SH, Lee SH, Kim JH, Kim SC (2018) Circulating eosinophil and neutrophil counts correlate with disease severity in bullous pemphigoid. Ann Dermatol 30(5):544–549
pubmed: 33911476
pmcid: 7992477
doi: 10.5021/ad.2018.30.5.544
de Graauw E, Sitaru C, Horn M, Borradori L, Yousefi S, Simon HU et al (2017) Evidence for a role of eosinophils in blister formation in bullous pemphigoid. Allergy 72(7):1105–1113
pubmed: 28135772
doi: 10.1111/all.13131
Liu Z, Giudice GJ, Zhou X, Swartz SJ, Troy JL, Fairley JA et al (1997) A major role for neutrophils in experimental bullous pemphigoid. J Clin Investig 100(5):1256–1263
pubmed: 9276744
pmcid: 508303
doi: 10.1172/JCI119639
Liu Z, Shapiro SD, Zhou X, Twining SS, Senior RM, Giudice GJ et al (2000) A critical role for neutrophil elastase in experimental bullous pemphigoid. J Clin Investig 105(1):113–123
pubmed: 10619867
pmcid: 382581
doi: 10.1172/JCI3693
Chiriac MT, Roesler J, Sindrilaru A, Scharffetter-Kochanek K, Zillikens D, Sitaru C (2007) NADPH oxidase is required for neutrophil-dependent autoantibody-induced tissue damage. J Pathol 212(1):56–65
pubmed: 17380558
doi: 10.1002/path.2157
Liu Z, Sui W, Zhao M, Li Z, Li N, Thresher R et al (2008) Subepidermal blistering induced by human autoantibodies to BP180 requires innate immune players in a humanized bullous pemphigoid mouse model. J Autoimmun 31(4):331–338
pubmed: 18922680
pmcid: 2642586
doi: 10.1016/j.jaut.2008.08.009
Briand C, Gourier G, Poizeau F, Jelti L, Bachelerie M, Quereux G et al (2020) Characteristics of pruritus in bullous pemphigoid and impact on quality of life: a prospective cohort study. Acta Derm Venereol 100(18):adv00320
pubmed: 33135772
Lyakhovitsky A, Dascalu J, Drousiotis T, Barzilai A, Baum S (2021) Hematological inflammatory markers in patients with pemphigus vulgaris. Dermatology 237(6):912–920
pubmed: 33472194
doi: 10.1159/000512916
Akturk S, Buyukavci R (2017) Evaluation of blood neutrophil-lymphocyte ratio and platelet distribution width as inflammatory markers in patients with fibromyalgia. Clin Rheumatol 36(8):1885–1889
pubmed: 28466420
doi: 10.1007/s10067-017-3647-0
Gasparyan AY, Ayvazyan L, Mukanova U, Yessirkepov M, Kitas GD (2019) The platelet-to-lymphocyte ratio as an inflammatory marker in rheumatic diseases. Ann Lab Med 39(4):345–357
pubmed: 30809980
pmcid: 6400713
doi: 10.3343/alm.2019.39.4.345
Gasparyan AY, Ayvazyan L, Pretorius E, Kitas GD (2014) Platelets in rheumatic diseases: friend or foe? Curr Pharm Des 20(4):552–566
pubmed: 23565634
doi: 10.2174/138161282004140213143843
Kato A, Hamada T, Miyake T, Morizane S, Hirai Y, Yamasaki O et al (2018) Clinical and laboratory markers associated with relapse in cutaneous polyarteritis nodosa. JAMA Dermatol 154(8):922–926
pubmed: 29955757
pmcid: 6143022
doi: 10.1001/jamadermatol.2018.1601
Lee YH, Song GG (2018) Neutrophil-to-lymphocyte ratio, mean platelet volume and platelet-to-lymphocyte ratio in Behcet’s disease and their correlation with disease activity: a meta-analysis. Int J Rheum Dis 21(12):2180–2187
pubmed: 30417545
doi: 10.1111/1756-185X.13404
Jaszczura M, Gora A, Grzywna-Rozenek E, Barc-Czarnecka M, Machura E (2019) Analysis of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and mean platelet volume to platelet count ratio in children with acute stage of immunoglobulin A vasculitis and assessment of their suitability for predicting the course of the disease. Rheumatol Int 39(5):869–878
pubmed: 30868223
doi: 10.1007/s00296-019-04274-z
Atas H, Cemil BC, Kurmus GI, Gonul M (2016) Assessment of systemic inflammation with neutrophil-lymphocyte ratio in lichen planus. Postepy Dermatol Alergol 33(3):188–192
pubmed: 27512353
pmcid: 4969409
doi: 10.5114/pdia.2016.56930
Wang WM, Jin HZ (2020) Role of neutrophils in psoriasis. J Immunol Res 2020:3709749
pubmed: 32587871
pmcid: 7293746
doi: 10.1155/2020/3709749
Polat M, Bugdayci G, Kaya H, Oguzman H (2017) Evaluation of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in Turkish patients with chronic plaque psoriasis. Acta Dermatovenerol Alp Pannonica Adriat 26(4):97–100
pubmed: 29264899
Qin B, Ma N, Tang Q, Wei T, Yang M, Fu H et al (2016) Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol 26(3):372–376
pubmed: 26403379
doi: 10.3109/14397595.2015.1091136
Murrell DF, Daniel BS, Joly P, Borradori L, Amagai M, Hashimoto T et al (2012) Definitions and outcome measures for bullous pemphigoid: recommendations by an international panel of experts. J Am Acad Dermatol 66(3):479–485
pubmed: 22056920
doi: 10.1016/j.jaad.2011.06.032
Rifaioglu EN, Sen BB, Ekiz O, Dogramaci AC (2014) Mean platelet volume and eosinophilia relationship in patients with bullous pemphigoid. Platelets 25(4):264–267
pubmed: 23574380
doi: 10.3109/09537104.2013.784735
Ozer I, Balevi S, Ataseven A (2018) Can neutrophil/lymphocyte ratio be used as a marker in the diagnosis of bullous pemphigoid? Selcuk Med J 34(2):65–69
Sereflican B, Parlak AH (2019) Clinical, demographical features, accompanying diseases and neutrophil to lymphocyte ratioplatelet to lymphocyte ratio in patients with bullous pemphigoid. Cumhur Med J 41(1):88–93
Baxter JD (1976) Glucocorticoid hormone action. Pharmacol Ther B 2(3):605–669
pubmed: 790403
Baxter JD, Rousseau GG (1979) Glucocorticoid hormone action: an overview. Monogr Endocrinol 12:1–24
pubmed: 386083
doi: 10.1007/978-3-642-81265-1_1
Daneshpazhooh M, Shahdi M, Aghaeepoor M, Hasiri G, Chams C (2004) A comparative study of antibody titers of blister fluid and serum in patients with subepidermal immunobullous diseases. Int J Dermatol 43(5):348–351
pubmed: 15117364
doi: 10.1111/j.1365-4632.2004.01902.x
Patsatsi A, Vyzantiadis TA, Devliotou-Panagiotidou D, Chrysomallis F, Sotiriadis D (2008) Detection of anti-BP180NC16a and anti-BP230 autoantibodies in blister fluid of patients with bullous pemphigoid: the first survey in Greece. Clin Exp Dermatol 33(2):183–185
pubmed: 18093242
doi: 10.1111/j.1365-2230.2007.02622.x
Sernicola A, Russo I, Saponeri A, Alaibac M (2019) Biochip detection of BP180 autoantibodies in blister fluid for the serodiagnosis of bullous pemphigoid: a pilot study. Medicine (Baltimore) 98(7):e14514
pubmed: 30762788
doi: 10.1097/MD.0000000000014514
de Graauw E, Sitaru C, Horn MP, Borradori L, Yousefi S, Simon D et al (2018) Monocytes enhance neutrophil-induced blister formation in an ex vivo model of bullous pemphigoid. Allergy 73(5):1119–1130
pubmed: 29222810
doi: 10.1111/all.13376