Inflammatory indices obtained from routine blood tests show an inflammatory state associated with disease progression in engineered stone silicosis patients

Abstract

Patients with silicosis caused by occupational exposure to engineered stone (ES) present a rapid progression from simple silicosis (SS) to progressive massive fibrosis (PMF). Patient classification follows international rules based on radiology and high-resolution computed tomography (HRCT), but limited studies, if any, have explored biomarkers from routine clinical tests that can be used as predictors of disease status. Our objective was thus to investigate circulating biomarker levels and systemic inflammatory indices in ES silicosis patients whose exposure to ES dust ended several years ago. Ninety-one adult men, ex-workers in the manufacturing of ES, 53 diagnosed with SS and 38 with PMF, and 22 healthy male volunteers (HC) as controls not exposed to ES dust, were recruited. The following circulating levels of biomarkers like lactate dehydrogenase (LDH), angiotensin-converting-enzyme (ACE), protein C reactive (PCR), rheumatoid factor, alkaline phosphatase and fibrinogen were obtained from clinical reports after being measured from blood samples. As biochemical markers, only LDH (HC = 262 ± 48.1; SS = 315.4 ± 65.4; PMF = 337.6 ± 79.3 U/L), ACE (HC = 43.1 ± 18.4; SS = 78.2 ± 27.2; PMF = 86.1 ± 23.7 U/L) and fibrinogen (HC = 182.3 ± 49.1; SS = 212.2 ± 43.5; PMF = 256 ± 77.3 U/L) levels showed a significant sequential increase, not been observed for the rest of biomarkers, in the HC → SS → PMF direction. Moreover, several systemic inflammation indices neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic inflammation response index (SIRI), systemic immune-inflammation index (SII), aggregate index of systemic inflammation (AISI) derived from whole blood cell counts showed significant differences between the HC, SS and PMF groups. All these biomarkers were analyzed using receiver operating characteristic (ROC) curves, and the results provided moderately high sensitivity and specificity for discriminating between ES silicosis patient groups and healthy controls. Our study reveals that some inflammatory biomarkers, easily available from routine blood analysis, are present in ES silicosis patients even several years after cessation of exposure to ES silica dust and they could help to know the progression of the disease.

The role of platelet-related parameters for the prediction of NAFLD in OSAHS patients

“…In recent years, the relation between platelet-related parameters and liver diseases has caught the interest of many scientists since platelet-related parameters can represent the inflammatory state of the body and even provide the advantages of simplicity, cost-effectiveness, non-invasiveness, etc. [ 11 – 13 ].…”

“…AUC area under curve, BMI body mass index, PLR platelet to lymphocyte ratio, WBC/MPV white blood cell count to mean platelet volume ratio, FLI fatty liver index, APRI AST platelet ratio index, ROC receiver operating characteristic recent years, the relation between platelet-related parameters and liver diseases has caught the interest of many scientists since platelet-related parameters can represent the inflammatory state of the body and even provide the advantages of simplicity, cost-effectiveness, non-invasiveness, etc. [11][12][13].…”

“…Platelet to lymphocyte count ratio (PLR) is a novel biomarker that has been initially proposed as an ideal indicator of systemic inflammation [11][12][13]. Recently, emerging evidence indicated strong link in between OSAHS, liver diseases (including HBV/HCV and HCC), and PLR [14][15][16][17].…”

Plasma Cytokine Profiling Reveals Differences between Silicotic Patients with Simple Silicosis and Those with Progressive Massive Fibrosis Caused by Engineered Stone

“…Cytokines are the main mediators of intercellular communication regulating a wide range of cellular processes, including activation, proliferation, differentiation, survival/apoptosis, inflammation, fibrosis, tissue repair and hematopoiesis, among others. Our previous studies suggest that ES silicosis patients maintain a systemic inflammatory condition even years after the cessation of exposure to silica dust [ 13 ]. To date, many groups have analyzed one or a few specific cytokines in serum, sputum, or bronchoalveolar lavages from groups of patients with silicosis due to different causes, but to date, no one has analyzed such a large and homogeneous group of patients or a broad panel of cytokines that may be involved in the development of silicosis caused by ES.…”

Has COVID-19 Modified the Weight of Known Systemic Inflammation Indexes and the New Ones (MCVL and IIC) in the Assessment as Predictive Factors of Complications and Mortality in Acute Pancreatitis?

“…For the past two decades, complete blood cell counts have routinely been performed, and they are relatively inexpensive and easy to perform. Neutrophils and monocytes are components of the innate immune system; lymphocytes are indicators of the adaptive immune response, and platelets, in addition to hemostasis, coagulation, and angiogenesis, are involved in the inflammatory reaction and innate immunity [ 15 ]. The hematological indices derived from the leukocyte count are: the neutrophil/lymphocyte ratio (NLR) based on the coexistence of leukocytosis and lymphopenia in the initial inflammatory response [ 16 ]; the derived neutrophil/lymphocyte ratio (dNLR); the monocyte/lymphocyte ratio (MLR), reflecting the body’s immune status, with a decrease indicating an immune dysfunction of the host; the platelet/lymphocyte ratio (PLR), which is an inflammatory marker of immune-mediated, metabolic, and prothrombotic diseases; the aggregate index of systemic inflammation (AISI), which is studied in lung diseases [ 17 ] and COVID-19 [ 18 ]; and the systemic inflammatory response index (SIRI) and the systemic inflammatory index (IIS), which are new inflammatory markers that are increasingly studied as biomarkers in several diseases, such as neoplastic [ 19 ], inflammatory, and infectious diseases such as acute pancreatitis [ 20 ] and COVID-19 [ 21 ].…”