Skip to main content
SpringerLink
Log in

New inflammatory markers in early rheumatoid arthritis

Neue inflammatorische Marker für die frühe rheumatoide Arthritis

  • Originalien
  • Published:
Zeitschrift für Rheumatologie Aims and scope Submit manuscript

Abstract

Background

Rheumatoid arthritis (RA) is the most common chronic inflammatory disorder and is associated with progressive destruction of synovial joints and physical disability. Therapies with known benefits include disease-modifying antirheumatic drugs (DMARDs), such as methotrexate, as well as more recent biologic agents, such as tumor necrosis factor inhibitors (anti-TNF therapy).

Method

This was a retrospective study, which included 205 RA and 112 early RA (ERA) patients from the Rheumatology Clinic at Gaziantep University School of Medicine Research Center as well as 104 healthy controls.

Results

The mean neutrophil to lymphocyte ratio (NLR) was found to be 3.15 ± 2.64 in the patient group and 2.03 ± 0.94 in the control group. The mean platelet to lymphocyte ratio (PLR) was 162.39 ± 107.76 in the patient group and 131.23 ± 48.09 in the control group. There was a significant difference in both the NLR and PLR between the patient and control groups (both p < 0.01). There was a significant difference in both the NLR and PLR between patients with active disease and remission (both p < 0.001) in RA, including anti-TNF therapy and DMARDs groups. There was a significant difference in NLR (p = 0.001) but not in PLR (p = 0.051) between active disease and remission in ERA.

Conclusion

The results of the present study suggest that the NLR may be considered a useful marker of disease activity in RA and one that can aid the diagnosis of ERA. The PLR can be used in the assessment of disease activity in RA patients undergoing anti-TNF therapy but is not suitable for diagnosing ERA.

Zusammenfassung

Hintergrund

Rheumatoide Arthritis (RA) stellt die häufigste chronisch-entzündliche Erkrankung dar und ist mit einer fortschreitenden Zerstörung der Synovialgelenke und körperlicher Behinderung assoziiert. Therapien mit bekanntem Nutzen sind krankheitsmodifizierende antirheumatische Medikamente (DMARDs), wie z. B. Methotrexat, sowie neuere biologische Wirkstoffe, wie Tumornekrosefaktorinhibitoren (Anti-TNF-Therapie).

Methode

Es handelte sich um eine retrospektive Studie, in die 205 RA-Patienten und 112 Patienten mit früher RA (ERA) aus dem Forschungszentrum der Rheumatologischen Klinik der Gaziantep University School of Medicine sowie 104 gesunde Kontrollpersonen eingeschlossen wurden.

Ergebnisse

Das mittlere Neutrophilen-Lymphozyten-Verhältnis (NLR) betrug 3,15 ± 2,64 in der Patientengruppe und 2,03 ± 0,94 in der Kontrollgruppe. Das mittlere Thrombozyten-Lymphozyten-Verhältnis (PLR) lag bei 162,39 ± 107,76 in der Patientengruppe und bei 131,23 ± 48,09 in der Kontrollgruppe. Sowohl für NLR als auch für PLR gab es einen signifikanten Unterschied zwischen der Patienten- und der Kontrollgruppe (beide p-Werte < 0,01). Es gab einen signifikanten Unterschied sowohl für NLR als auch für PLR zwischen RA-Patienten mit aktiver Krankheit und RA-Patienten in Remission (beide p-Werte < 0,001), einschließlich der Gruppen, die eine Anti-TNF-Therapie und DMARDs erhielten. Einen signifikanten Unterschied für NLR (p = 0,001), aber nicht für PLR (p = 0,051) gab es zwischen ERA-Patienten mit aktiver Krankheit und ERA-Patienten in Remission.

Schlussfolgerung

Die Ergebnisse der vorliegenden Studie zeigen, dass NLR als ein nützlicher Marker für die Krankheitsaktivität bei RA und als Hilfe für die Diagnose einer ERA betrachtet werden kann. PLR kann bei der Untersuchung der Krankheitsaktivität bei RA-Patienten, die eine Anti-TNF-Therapie erhalten, verwendet werden, ist jedoch für die Diagnose einer ERA nicht geeignet.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Churov AV, Oleinik EK, Knip M (2015) MicroRNAs in rheumatoid arthritis: altered expression and diagnostic potential. Autoimmun Rev 14(11):1029–1037. doi:10.1016/j.autrev.2015.07.005

    Article  CAS  PubMed  Google Scholar 

  2. Tedesco A, D’Agostino D, Soriente I, Amato P, Piccoli R, Sabatini P (2009) A new strategy for the early diagnosis of rheumatoid arthritis: a combined approach. Autoimmun Rev 8(3):233–237. doi:10.1016/j.autrev.2008.07.031

    Article  CAS  PubMed  Google Scholar 

  3. van der Linden MP, Knevel R, Huizinga TW, van der Helm-van Mil AH (2011) Classification of rheumatoid arthritis: comparison of the 1987 American College of Rheumatology criteria and the 2010 American College of Rheumatology/European League Against Rheumatism criteria. Arthritis Rheum 63(1):37–42. doi:10.1002/art.30100

    Article  PubMed  Google Scholar 

  4. Berghen N, Teuwen LA, Westhovens R, Verschueren P (2015) Malignancies and anti-TNF therapy in rheumatoid arthritis:a single-center observational cohort study. Clin Rheumtol 34(10):1687–1695. doi:10.1007/s10067-015-3026-7

    Article  Google Scholar 

  5. Uslu AU, Küçük A, Şahin A, Ugan Y, Yılmaz R, Güngör T, Bağcacı S, Küçükşen S (2015) Two new inflammatory markers associated with Disease Activity Score-28 in patients with rheumatoid arthritis: neutrophil-lymphocyte ratio and platelet-lymphocyte ratio. Int J Rheum Dis 18(7):731–735. doi:10.1111/1756-185X.12582

    Article  PubMed  Google Scholar 

  6. Özer S, Yılmaz R, Sönmezgöz E, Karaaslan E, Taşkın S, Bütün İ, Demir O (2015) Simple markers for subclinical inflammation in patients with Familial Mediterranean Fever. Med Sci Monit 23(21):298–303. doi:10.12659/MSM.892289

    Google Scholar 

  7. Prajapati JH, Sahoo S, Nikam T, Shah KH, Maheriya B, Parmar M (2014) Association of high density lipoprotein with platelet to lymphocyte and neutrophil to lymphocyte ratios in coronary artery disease patients. J Lipids 2014:686791. doi:10.1155/2014/686791

    Article  PubMed  PubMed Central  Google Scholar 

  8. Makay B, Gücenmez ÖA, Duman M, Ünsal E (2014) The relationship of neutrophil-to-lymphocyte ratio with gastrointestinal bleeding in Henoch-Schonlein purpura. Rheumatol Int 34(9):1323–1327. doi:10.1007/s00296-014-2986-2

    Article  CAS  PubMed  Google Scholar 

  9. Hu ZD, Sun Y, Guo J, Huang YL, Qin BD, Gao Q, Qin Q, Deng AM, Zhong RQ (2014) Red blood cell distribution width and neutrophil/lymphocyte ratio are positively correlated with disease activity in primary Sjögren’s syndrome. Clin Biochem 47(18):287–290. doi:10.1016/j.clinbiochem.2014.08.022

    Article  CAS  PubMed  Google Scholar 

  10. Uluca Ü, Ece A, Şen V, Karabel D, Yel S, Güneş A, Tan I, Sabas M (2014) Usefulness of mean platelet volume and neutrophil-to-lymphocyte ratio for evaluation of children with Familial Mediterranean fever. Med Sci Monit 5(20):1578–1582. doi:10.12659/MSM.892139

    Google Scholar 

  11. Boyraz I, Koç B, Boyacı A, Tutoğlu A, Sarman H, Ozkan H (2014) Ratio of neutrophil/lymphocyte and platelet/lymphocyte in patient with ankylosing spondylitis that are treating with anti-TNF. Int J Clin Exp Med 7(9):2912–2915

    CAS  PubMed  PubMed Central  Google Scholar 

  12. Olumuyiwa-Akeredolu OO, Pretorius E (2015) Platelet and red blood cell interactions and their role in rheumatoid arthritis. Rheumatol Int 35(12):1955–1964. doi:10.1007/s00296-015-3300-7

    Article  CAS  PubMed  Google Scholar 

  13. Chandrashekara S, Rajendran A, Bai Jaganath A, Krishnamurthy R (2015) Neutrophil-lymphocyte ratio,pain perception, and disease activity score may serve as important predictive markers for sustained remission in rheumatoid arthritis. Reumatismo 67(3):109–115

    Article  CAS  PubMed  Google Scholar 

  14. Tekeoğlu İ, Gürol G, Harman H, Karakeçe E, Çiftçi İH (2015) Overlooked hematological markers of disease activity in rheumatoid arthritis. Int J Rheum Dis. doi:10.1111/1756-185X.12805

    PubMed  Google Scholar 

  15. Mercan R, Bitik B, Tufan A, Bozbulut UB, Atas N, Ozturk MA, Haznedaroglu S, Goker B (2015) The association between neutrophil/lymphocyte ratio and disease activity in rheumatoid arthritis and Ankylosing Spondylitis. J Clin Lab Anal. doi:10.1002/jcla.21908

    PubMed  Google Scholar 

  16. van Venrooij WJ, Zendman AJ, Pruijn GJ (2006) Autoantibodies to citrullinated antigens in (early) rheumatoid arthritis. Autoimmun Rev 6(1):37–41

    Article  PubMed  Google Scholar 

  17. Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd, Birnbaum NS, Burmester GR, Bykerk VP, Cohen MD, Combe B, Costenbader KH, Dougados M, Emery P, Ferraccioli G, Hazes JM, Hobbs K, Huizinga TW, Kavanaugh A, Kay J, Kvien TK, Laing T, Mease P, Ménard HA, Moreland LW, Naden RL, Pincus T, Smolen JS, Stanislawska-Biernat E, Symmons D, Tak PP, Upchurch KS, Vencovský J, Wolfe F, Hawker G (2010) Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum 62(9):2569–2581. doi:10.1002/art.27584

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Medicine, Department of Rheumatology, Gaziantep University, 27500, Gaziantep, Turkey

    O. Zengin MD, M. E. Onder, B. Kisacik & A. M. Onat

  2. School of Medicine, Department of Internal Medicine, Gaziantep University, 27500, Gaziantep, Turkey

    A. Kalem & M. Bilici

  3. School of Medicine, Department of Geriatrics, Gaziantep University, 27500, Gaziantep, Turkey

    I. H. Türkbeyler & Z. A. Ozturk

Authors
  1. O. Zengin MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. E. Onder
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. Kalem
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Bilici
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. I. H. Türkbeyler
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Z. A. Ozturk
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. B. Kisacik
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A. M. Onat
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to O. Zengin MD.

Ethics declarations

Conflict of interests

O. Zengin, M. E. Onder, A. Kalem, M. Bilici, I. H. Türkbeyler, Z. A. Ozturk, B. Kisacik and A. M. Onat state that they have no conflict of interests.

All studies on humans described in this manuscript were carried out with the approval of the responsible ethics committee and in accordance with national law and the Helsinki Declaration of 1975 (in its current revised form). Informed consent was obtained from all participants in the study.

Additional information

Redaktion

U. Müller-Ladner, Bad Nauheim

U. Lange, Bad Nauheim

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zengin, O., Onder, M.E., Kalem, A. et al. New inflammatory markers in early rheumatoid arthritis. Z Rheumatol 77, 144–150 (2018). https://doi.org/10.1007/s00393-016-0187-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00393-016-0187-y

Keywords

Schlüsselwörter

Search

Navigation