The Relationship of Hematological Parameters and C-reactive Protein (CRP) With Disease Presence, Severity, and Response to Systemic Therapy in Patients With Psoriasis

Abstract

Objectives: Systemic inflammation has an important role in psoriasis, which is a chronic disease with an increasing prevalence and is associated with comorbidity. Our aim is to investigate the relationship of hematological parameters and C-reactive protein (CRP) with the presence and severity of the disease in patients with psoriasis. It is also to investigate whether it can be used as a biomarker in monitoring the response to systemic treatment. Materials and methods: This retrospective study was conducted with the participation of 139 psoriasis patients receiving biological therapy (BT) and conventional therapy (CT) and 140 healthy controls. Demographic, clinical, and laboratory data of patients and controls were examined and all parameters were compared with the psoriasis area severity index (PASI) score. In addition, the changes in these parameters before the treatment and in the third month of the treatment were examined in the patient groups who received BT and CT. Results: White blood cell (WBC), neutrophil, monocytes, platelet (PLT), plateletcrit, red blood cell, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) monocyte-lymphocyte ratio (MLR), red cell distribution width (RDW), CRP and erythrocytesedimentation (ESR) levels were higher compared to the healthy control group in psoriasis patients (p<0.05). Baseline PASI values were positively correlated with WBC, neutrophils, monocytes, NLR, MLR, and CRP. WBC, neutrophil, NLR, CRP, and ESR levels decreased in all patients in the third month of treatment (p<0.05). WBC, PLT, neutrophil, and NLR in patients receiving BT; while WBC, neutrophil, NLR, CRP, and ESR levels decreased in patients receiving CT, RDW levels increased (p<0.05). Adalimumab; NLR and basophil, methotrexate; WBC, NLR, neutrophil, and ESR levels caused a significant decrease (p<0.05). Conclusion: The fact that increased WBC, neutrophils, monocytes, NLR, MLR, and CRP levels are associated with the severity of psoriasis indicates that these parameters reflect systemic inflammation in psoriasis. In addition, the decrease in these parameters after BT and CT suggests that they can be considered simple and reliable markers that can be used as a complement to the PASI score in assessing disease severity and response to treatment.

Platelet Reactivity in the Exacerbation of Psoriasis

“…CRP is one of the most commonly used markers of inflammation. It has been shown to correspond to the severity of psoriasis [45,46]. In our study, it was positively correlated with a higher platelet reactivity in patients with an exacerbation of psoriasis.…”

The association between the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio and systemic sclerosis and its complications: a systematic review and meta-analysis

“…These cell types, particularly neutrophils, platelets, lymphocytes, and monocytes, have been shown to play an important role in the pathophysiology of SSc in experimental and clinical studies (18-27). A relatively higher neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-tolymphocyte ratio (MLR) have been shown to successfully discriminate between the presence and the absence of specific autoimmune conditions as well as the presence and absence of active disease in those affected, e.g., rheumatoid arthritis (28)(29)(30), psoriasis (31,32), and systemic lupus erythematosus (33)(34)(35)). However, the potential diagnostic role of the NLR, PLR, and MLR in SSc and relevant complications has not been critically appraised.…”