Neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and mean platelet volume in Japanese patients with psoriasis and psoriatic arthritis: Response to therapy with biologics

J Dermatol. 2017 Oct;44(10):1112-1121. doi: 10.1111/1346-8138.13875. Epub 2017 May 11.

Abstract

Recent studies indicate the presence of systemic inflammation in psoriatic patients, and this inflammatory status is significantly associated with a range of comorbidities. The aim of this study was to evaluate the clinical significance of novel inflammatory biomarkers, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and mean platelet volume (MPV) in Japanese patients with plaque-type psoriasis (PsV) and psoriatic arthritis (PsA). One hundred and eighty-six patients with PsV and 50 patients with PsA treated with biologics, including infliximab, adalimumab and ustekinumab, were retrospectively analyzed before and after treatment. At baseline, NLR and PLR, as well as C-reactive protein (CRP), were significantly higher in PsA patients than those in PsV patients, and a significant correlation was found between NLR and PLR. In PsV patients, the NLR-high and PLR-high subgroups exhibited significantly higher Psoriasis Area and Severity Index scores compared with the NLR-low and PLR-low subgroups, respectively, and the NLR-high subgroup also showed higher CRP levels. MPV value was negatively associated with the presence of arthritis, but its association with inflammation was less clear than that of NLR or PLR. After treatment of the patients with biologics for up to 12 months, NLR and PLR decreased promptly in parallel with a decrease of CRP, irrespective of the type of biologics used. Altogether, these results indicate that both NLR and PLR may be useful markers to evaluate systemic inflammation in psoriatic patients. They may serve as simple, convenient and cost-effective biomarkers to monitor the disease course after systemic therapy.

Keywords: biologics; mean platelet volume; neutrophil-lymphocyte ratio; platelet-lymphocyte ratio; psoriasis.

MeSH terms

  • Adalimumab / therapeutic use
  • Adult
  • Age Factors
  • Aged
  • Biological Products / therapeutic use*
  • Biomarkers / blood
  • Blood Platelets*
  • C-Reactive Protein / analysis
  • Dermatologic Agents / therapeutic use*
  • Female
  • Humans
  • Infliximab / therapeutic use
  • Lymphocyte Count
  • Lymphocytes*
  • Male
  • Mean Platelet Volume
  • Middle Aged
  • Neutrophils*
  • Platelet Count
  • Psoriasis / blood
  • Psoriasis / drug therapy*
  • Retrospective Studies
  • Sex Factors
  • Time Factors
  • Treatment Outcome
  • Ustekinumab / therapeutic use

Substances

  • Biological Products
  • Biomarkers
  • Dermatologic Agents
  • C-Reactive Protein
  • Infliximab
  • Ustekinumab
  • Adalimumab