Relação neutrófilos-linfócitos e plaquetas-linfócitos e atividade do lúpus eritematoso sistêmico: um estudo transversal em pacientes brasileiros
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2024.200940Palavras-chave:
Lúpus eritematoso sistêmico, Neutrófilos, Plaquetas, Linfócitos, InflamaçãoResumo
Fundamento: Identificar a atividade da doença no Lúpus Eritematoso Sistêmico (LES) é importante para a escolha do tratamento correto. A relação neutrófilo/linfócito (N/L) e plaqueta/ linfócito (P/L) tem sido considerada como reflexo do estado inflamatório em diversas situações. Neste estudo, objetivamos avaliar a associação de N/L e P/L com a atividade da doença do LES. Métodos: Este é um estudo transversal de 189 pacientes com LES para atividade da doença para SLEDAI-2K (SLE Disease activity index), VHS (velocidade de hemossedimentação), PCR (proteína C reativa) e hemograma com N/L e P/L Razão. Resultados: A relação N/L demonstrou correlação com SLEDAI (rho=0,24; p=0,0009) VHS (rho=0,17; p=0,02) e PCR (rho=0,23; p=0,004); P/L correlacionado com SLEDAI (rho=0,21; p=0,003), PCR (rho=0,26; p=0,001), VHS (rho=0,23; p=0,003) e níveis de anti-dsDNA (rho=0,29; p= 0,02) e teve correlação negativa com a hemoglobina (rho=-0,27; p=0,0001). Um ponto de corte de 2,28 na relação N/L teve sensibilidade de 68,6% e especificidade de 68,2% para doença ativa; um ponto de corte de 124,1 na relação P/L teve sensibilidade de 82,9 e especificidade de 41,1% para LES ativo. Conclusões: As relações N/L e P/L são úteis na avaliação da atividade da doença do LES.
Downloads
Referências
Tsang-A-Sjoe MWP, Bultink IEM, Heslinga M, Voskuy AE. Both prolonged remission and lupus low disease activity state are associated with reduced damage accrual in systemic lupus erythematosus. Rheumatology (Oxford). 2017;56(1):121-8.
Apostolopoulos D, Morand EF. It hasn't gone away: the problem of glucocorticoid use in lupus remains. Rheumatology (Oxford). 2017;56 (suppl-1):i114-i22.
Buyon JP, Petri MA, Kim MY, Kalunian KC, Grossman J, Hahn BH, et al. The effect of combined estrogen and progesterone hormone replacement therapy on disease activity in systemic lupus erythematosus: a randomized trial. Ann Intern Med. 2005; 142:953–62.
- Gordon C, Sutcliffe N, Skan J, Stoll T, Isenberg DA. Definition and treatment of lupus flares measured by the BILAG index. Rheumatology. 2003;42:1372–9.
- Ward MM, Marx AS, Barry NN. Comparison of the validity and sensitivity to change of 5 activity indices in systemic lupus erythematosus. J Rheumatol. 2000;27(3):664-70.
- Qian G, Hongxia D, Jin LI. Neutrophil-lymphocyte ratio at 14th week predicts loss of response to 52-week infliximab therapy in patients with Crohn's disease. Nan Fang Yi Ke Da Xue Xue Bao. 2020;40:453-458
- Ruta VM, Man AM, Alexescu TG, Motoc NS, Tarmure S, Ungur RA, et al. Neutrophil-to-lymphocyte ratio and systemic immune-inflammation index-biomarkers in interstitial lung disease. Medicina (Kaunas). 2020;56(8):381.
- Chandrashekara S, Lingaraju DC, Renuka P, Anupama KR. Potential of neutrophil to lymphocyte ratio in predicting sustained remission in rheumatoid arthritis compared to other immune activation markers. Indian J Med Res. 2020;152:234-43.
-Targońska-Stępniak B, Zwolak R, Piotrowski M, Grzechnik K, Majdan M. The Relationship between hematological markers of systemic inflammation (neutrophil-to-lymphocyte, platelet-to-lymphocyte, lymphocyte-to-monocyte ratios) and ultrasound disease activity parameters in patients with rheumatoid arthritis. J Clin Med. 2020; 9:2760.
- Xu S, Ma Y, Wu M, Zhang X, Yang J, Deng J et al. Neutrophil lymphocyte ratio in patients with ankylosing spondylitis: A systematic review and meta-analysis. Mod Rheumatol. 2020;30:141-8.
- Kim A, Kim Y, Kim GT, Ahn E, So MW, Sohn DH, et al. Platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio as potential makers for digital ulcers and interstitial lung disease in patients with systemic sclerosis: cross-sectional analysis of data from a prospective cohort study. Rheumatol Int. 2020;40:1071-9.
- Paliogiannis P, Fois AG, Sotgia S, Mangoni AA, Zinellu E, Pietro Pirina P, et al. Neutrophil to lymphocyte ratio and clinical outcomes in COPD: recent evidence and future perspectives Eur Respir Rev. 2018;27(147):170113.
-Wang N, Li C, Yang Y, Guan Y, Wang F, Wang Y, et al. The Usage of Platelet/Lymphocyte Ratio, Carbohydrate Antigen 125 Combined with Magnetic Resonance Diffusion Weighted Imaging in Diagnosis of Recurrent Ovarian Cancer and Neuropathic Pain. World Neurosurg. 2020:S1878-8750(20)32502-X.
- Firizal AS, Sugianli AK, Hamijoyo L. Cut off point of neutrophil-to-lymphocyte ratio as a marker of active disease in systemic lupus erythematosus. Lupus. 2020;29:1566-70.
- Wu Y, Chen Y, Yang X, Chen L, Yang Y. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were associated with disease activity in patients with systemic lupus erythematosus. Int Immunopharmacol. 2016;36:94-9.
- Gasparyan AY, Ayvazyan L, Mukanova U, Yessirkepov M, Kitas GD. The platelet-to-lymphocyte ratio as an inflammatory marker in rheumatic diseases. Ann Lab Med. 2019;39:345-7.
- Kweon OJ, Lee MK, Kim HJ, Chung JW, Choi SH, Kim HR. Neutropenia and neutrophil: lymphocyte ratio in a healthy Korean population: race and sex should be considered. Int J Lab Hematol. 2016;38:308-18.
- Lewis MJ, Jawad AS. The effect of ethnicity and genetic ancestry on the epidemiology, clinical features and outcome of systemic lupus erythematosus Rheumatology (Oxford). 2017;56 (suppl-1):i67-i77.
- Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortin PR et al. Derivation and Validation of the Systemic Lupus International Collaborating Clinics Classification Criteria for Systemic Lupus Erythematosus. Arthritis & Rheumatism 2012;64:2677–86.
-Gladman DD, Ibanez D, Urowitz MB. Systemic Lupus Erythematosus Disease Activity Index 2000. J Rheumatol 2002;29: 288–91.
- Soliman WM, Sherif NM, Ghanima IM and EL-Badawy MA. Neutrophil to lymphocyte and platelet to lymphocyte ratios in systemic lupus erythematosus: relation with disease activity and lupus nephritis. Rheumatol Clin 2020;16: 255–61.
-Yee C-S, Farewell VT, Isenberg DA, Griffiths B, The L-S, Bruce IN et al. The use of systemic lupus erythematosus disease activity index-2000 to define active disease and minimal clinically meaningful change based on data from a large cohort of systemic lupus erythematosus patients. Rheumatology (Oxford) 2011;50: 982–8.
- Ma L, Zeng A, Chen B, Chen Y, Zhou R. Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in patients with systemic lupus erythematosus and their correlation with activity: A meta-analysis. Int Immunopharmacol. 2019;76:105949.
- Han BK, Wyham KD, Cain KC, Tyden H, Anders A Bengtsson AA, Lood C. Neutrophil and lymphocyte counts are associated with different immunopathological mechanisms in systemic lupus erythematosus Lupus Sci Med . 2020;7(1):e000382.
- Mekaj YH. The roles of platelets in inflammation, immunity, wound healing and malignancy. Int J Clin Exp Med. 2016;9:5347-58.
- Gerdes N, Zhu L, Ersoy M, Hermansson A, Hjemdahl P, Hu H, Hansson GK, Li N. Platelets regulate CD4+ T-cell differentiation via multiple chemokines in humans. Thromb Haemost. 2011; 106:353-62.
- Marques NP, Marques NCT, Lucena EHG, Martelli DRB, Oliveira EA, Martelli-Junior H. The continuous increase in the number of systemic lupus erythematosus cases in Brazil in the COVID-19 era. Braz Oral Res. 2023;37:e066.
Downloads
Publicado
Edição
Seção
Licença
Copyright (c) 2024 Jady Elen Pontes, Thiago Alberto Fernando Gomes dos Santos, Renato Mitsunori Nisihara, Thelma Larocca Skare quando publicados
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
