The platelet functions in patients with ankylosing spondylitis: Anti-TNF-αtherapy decreases the mean platelet volume and platelet mass

Abstract

The present study was designed to investigate the interaction between platelet indices (mean platelet volume (MPV), platelet count (PLC) and platelet mass (PLM)), inflammatory markers and disease activity in ankylosing spondylitis (AS) subjects. The effects of anti-TNF-alpha therapy and conventional treatment on platelet indices were also compared. We studied 68 patients with AS (group I, 46 men, age: 36.4 +/- 6.9 years) and as control group 34 age and sex-matched healty subjects. All patients received conventional therapy (CT) at the beginning (Group I). The patients were reevaluated after 3 months according to Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score. Group II consisted of 35 subjects who responded to the CT and continued to take the same therapy for 3 months additionally. Group III consisted of 33 subjects who had a high disease activity score (BASDAI > 4) after 3 months and were accepted refractory to the CT therapy. In Group III the treatment was switched to infliximab and continued for 3 months at the standard intravenous dose. Significantly higher baseline MPV, PLC and PLM was reported as compared to controls decreased by therapy (9.12 +/- 1.20 vs. 8.35 +/- 0.94 fl, p < 0.001, 340 +/- 69 vs. 251 +/- 56 (x 10(3)/ microL) p < 0.0001, 3096 +/- 736 vs. 2110 +/- 384; p < 0.0001, respectively). In the same way, they were substantially lowered by both treatments in group II and group III. PLC and PLM were positively correlated with WBC and ESR (r : 0.44; p < 0.0001, r : 0.41; p = 0.001, r : 0.52; p < 0.0001, r : 0.41; p = 0.001), respectively) in AS patients. Additionally, MPV and PLM were positively correlated with BASDAI score (r : 0.41; p < 0.001, r = 0.29; p < 0.001 respectively). We have found that increased platelet activity reduced by therapy in AS patients. Additionally, it was correlated with inflammatory markers and disease activity. According to these results, it can be suggested that both anti-TNF-alpha and conventional therapy might contribute to a decrease in the risk of cardiovascular morbidity and mortality in AS patients.

May Neutrophil-Lymphocyte and Platelet-Lymphocyte Ratios Indicate Disease Activity in Ankylosing Spondylitis?

“…In the same way, we investigated if there were relationships between PLR and MPV values and disease activity in AS or not. Inconsistently with previous studies about several chronic inflammatory diseases including chronic obstructive pulmonary disease, 15 inflammatory bowel disease, 18 RA and AS, [19][20][21] we found that MPV did not reflect disease activity in AS since its levels were similar in healthy controls as well as patients with mild and moderate to severe disease activity. Similar to the present results, no significantly different levels of MPV were reported in patients of hemodialysis, renal transplanted, peritoneal dialysis and chronic renal failure patients when compared to each other 34 as well as in patients with advanced stage endometriosis.…”

“…33 Moreover, significantly decreased levels of MPV were reported after anti-TNF-a therapy in patients with AS. 20 Recently, MPV that was investigated in inflammatory bowel disease, 18 chronic obstructive pulmonary disease, 15 RA and AS [19][20][21] and PLR which was evaluated in some cancers like gastric, 14 colon, 22 and non-small cell lung cancers 23 have become to be prominent markers to indicate inflammatory status and prognosis of several diseases, but there is no cut-off level reported before for PLR and MPV as well as NLR. In the same way, we investigated if there were relationships between PLR and MPV values and disease activity in AS or not.…”

“…17 In addition, mean platelet volume (MPV) was reported to have a predictive value of inflammation in chronic obstructive pulmonary disease, 15 inflammatory bowel disease, 18 rheumatoid arthritis (RA) and AS. [19][20][21] On the other hand, platelet-lymphocyte ratio (PLR) was also suggested to be an inflammatory marker, and shown to be a valuable prognostic marker in several malignancies such as gastric, 14 colon, 22 and non-small cell lung cancers. 23 However, the relationships between NLR, MPV and disease activity in AS have not been fully understood yet and the associations between PLR and disease activity of AS was not investigated before.…”

Does varicocele correction lead to normalization of preoperatively elevated mean platelet volume levels?

“…24 Similarly, MPV values decreased after treatment of active disease in patients with ankylosing spondylitis. 25 Furthermore, higher MPV values were shown in patients with severe obstructive sleep apnea leading to cardiovas� cular complications compared to a control group in a study with 95 subjects. 26 A significant decrease was found in MPV after continuous positive airway pressure (CPAP) treatment for 6 months in a similar group of patients.…”

Neutrophil to Lymphocyte Ratio and Mean Platelet Volume as Inflammatory Indicators in Systemic Lupus Erythematosus Nephritis

“…[11][12][13] MPV has been evaluated in chronic inflammatory diseases such as rheumatoid arthritis, ankylosing spondylitis, and Behçet's disease. [14][15][16] Due to their inflammatory roles, MPV and NLR may be used as inflammatory markers in LN, which is known as a systemic, autoimmune complication of SLE. Yavuz and Ece 17 have suggested MPV as a disease activation indicator for juvenile SLE nephritis patients.…”