Neutrophil-lymphocyte and platelet-lymphocyte ratios in rheumatoid arthritis patients: Relation to disease activity

Aim of the work: To assess the neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) in rheumatoid arthritis (RA) patients and compare between active cases and those in remission. Patients and methods: The study included 50 RA patients and 20 matched control. Patients were enrolled into 2 equally divided groups; group A (active) with a disease activity score (DAS-28) ≥2.6 and group B (remission) <2.6. Laboratory investigations included the calculation of the NLR and PLR for all subjects. Results: The mean age of patients was 40.7 ± 10.1 years and the mean of disease duration was 5.9 ± 3.4 years. The DAS-28 was 3.9 ± 0.9 in active patients and 2.1 ± 0.3 in those in remission (p = .001). NLR was 2.8 ± 2.1 in the patients and 2.1 ± 0.59 in the control (p = .15). PLR was 1.7 ± 0.9 in the patients and 1.27 ± 0.46 in the control (p = .09). Active patients had an NLR of 3.27 ± 2.81 and PLR of 1.8 ± 1.2 while they were 2.3 ± 0.84 and PLR 1.5 ± 0.59 in patients in remission (p = .05 and p = .18 respectively). There was a significant difference regarding NLR and PLR between active patients and control (2.1 ± 0.59 and 1.27 ± 0.46; p = .03 and p = .04 respectively). In active patients, the NLR and PLR significantly correlated with the patients age (p = .02 and p = .006) and with the DAS-28 (p = .001 and p = .03 respectively). Conclusion: NLR and PLR are 2 emerging inflammatory biomarkers which could be used to evaluate disease activity in active RA patients. A larger scale longitudinal study is recommended to confirm the present results and further demonstrate the relation to medications received and disease outcome. Keywords: Rheumatoid arthritis, DAS-28, Neutrophil-lymphocyte ratio, Platelet-lymphocyte rati

Urinary and tissue monocyte chemoattractant protein1 (MCP1) in lupus nephritis patients

Aim of the work: To assess the role of urinary and tissue monocyte chemoattractant protein-1 (MCP-1) in active lupus nephritis (LN) and to correlate the levels with disease activity and renal status. Patients and methods: Urinary and tissue MCP-1 were determined in 42 systemic lupus erythematosus (SLE) patients with LN. 20 matched controls were considered. SLE disease activity index (SLEDAI) was recorded in all patients. Urinary and renal tissue MCP-1 was evaluated. Renal biopsy was performed in active LN patients for histopathological classification and correlation. Results: 22 active LN patients (22.8 ± 4.7 years old) and 20 inactive (24.6 ± 4.3 years old) were studied. They were 39 female and 3 males (F:M 13:1). The urinary MCP-1 was significantly higher in active LN patients (1072.8 ± 658.4 pg/mg creatinine) compared to the inactive group (151.3 ± 103.5 pg/mg creatinine) and both were significantly higher than the level in the controls (19 ± 17.8 pg/mg creatinine) (p < 0.001). A significant correlation was present in the active LN patients between urinary MCP-1 level and proteinuria, anti-dsDNA, renal SLEDAI and biopsy activity index and negatively with C3 and C4. There was a significant correlation of the glomerular MCP-1 renal tissue expression score with the renal SLEDAI, anti-dsDNA, biopsy activity index and urinary MCP-1 and negatively with C3. Tubulointerstitial MCP-1 score significantly correlated with urinary MCP-1. Urinary, glomerular and tubular MCP-1 showed a sensitivity of 97%, 64% and 4% and specificity of 100%, 95% and 20% respectively in detecting LN. Conclusion: MCP-1 could be a valuable marker for LN and disease activity