Prognostic value of systemic inflammation biomarkers in patients with psoriasis.

BACKGROUND: Standard markers of systemic inflammation such as high-sensitivity C-reactive protein, erythrocyte sedimentation rate, and white blood cell count are only moderately correlated with psoriasis severity. Therefore, new in vivo assessments of inflammation are particularly important for understanding the severity of systemic inflammation in psoriasis. Currently, there is very little data on the role of new integral indices of systemic inflammation such as SIRI, MLR, NLR, SII, PLR and AISI for monitoring psoriasis.

AIMS: study of the role of hematological biomarkers of systemic inflammation (SIRI, MLR, NLR, SII, PLR and AISI) in patients with various forms of psoriasis

MATERIALS AND METHODS: Systemic inflammation indices SIRI, MLR, NLR, SII, PLR and AISI were calculated for all patients included in the study. To assess the area and severity of psoriatic skin lesions, a standardized assessment method was used - determining the PASI index.

RESULTS: The main group consisted of 77 patients with psoriasis, of which 33 (42.9%) were women, 44 (57.1%) were men. The average age of the patients was 41.3 (±13.4) years. The mean PASI value was 10.8 (3.2, 15.3). There were 58 patients (75.4%) with only skin manifestations of psoriasis, 19 (24.6%) patients with psoriatic arthritis.

When analyzing the values ​​of SIRI, MLR, NLR, SII, PLR and AISI in patients with psoriasis and psoriatic arthritis, their different diagnostic significance was revealed. Thus, psoriatic onychodystrophy was associated with higher values ​​of the SII (p=0.005), NLR (p=0.053) and PLR (p=0.037) indices in the subgroup of patients with psoriasis.

Damage to the scalp was statistically significantly associated with higher values ​​of the MLR index (p=0.049). The average value of the systemic inflammatory response index (SIRI) was 2 times higher than the average statistical norm in patients with only skin manifestations of psoriasis.

The average value of the cumulative systemic inflammation index (AISI) was 1.5 times higher than the average statistical norm in patients with psoriasis and in patients with psoriatic arthritis. An analysis between the study groups revealed a significant increase in the AISI index in patients with severe PsA (PASI 20-30) compared with patients with severe psoriasis.

CONCLUSIONS: Based on the results of our study, we can conclude that integral hematological indices of systemic inflammation are a sensitive tool for assessing and predicting the severity of psoriasis.

Thus, high SIRI and AISI values ​​are prognostically important for the early diagnosis of psoriatic arthritis; an increase in SII, NLR and PLR significantly predisposes to the development of onychodystrophy, and MLR – to damage to the scalp.