Hematological Inflammatory Markers Research Articles

Evaluating Hematological Inflammatory Markers as Predictors of Preeclampsia

Evaluating Hematological Inflammatory Markers as Predictors of Preeclampsia

The predictive impact of hematological inflammatory markers in detecting prostate cancer in patients with PI-RADS 3 lesions on multiparametric magnetic resonance imaging.

The diagnostic accuracy of suspicious lesions that are classified as PI-RADS 3 in multiparametric prostate magnetic-resonance imaging (mpMRI) is controversial. This study aims to assess the predictive capacity of hematological inflammatory markers such as neutrophil-lymphocyte ratio (NLR), pan-immune-inflammation value (PIV), and systemic immune-response index (SIRI) in detecting prostate cancer in PI-RADS 3 lesions. 276 patients who underwent mpMRI and subsequent prostate biopsy after PI-RADS 3 lesion detection were included in the study. According to the biopsy results, the patients were distributed to two groups as prostate cancer (PCa) and no cancer (non-PCa). Data concerning age, PSA, prostate volume, PSA density, PI-RADS 3 lesion size, prostate biopsy results, monocyte counts (109/L), lymphocyte counts (109/L), platelet counts (109/L), neutrophils count (109/L) were recorded from the complete blood count. From these data; PIV value is obtained by monocyte × neutrophil × platelet/lymphocyte, NLR by neutrophil/lymphocyte, and SIRI by monocyte number × NLR. Significant variations in neutrophil, lymphocyte, and monocyte levels between PCa and non-PCa patient groups were detected (p = 0.009, p = 0.001, p = 0.005 respectively, p < 0.05). NLR, PIV, and SIRI exhibited significant differences, with higher values in PCa patients (p = 0.004, p = 0.001, p < 0.001 respectively, p < 0.05). The area under curve of SIRI was 0.729, with a cut-off value of 1.20 and with a sensitivity 57.70%, and a specificity of 68.70%. SIRI outperformed NLR and PIV in detecting PCa in PI-RADS 3 lesions, showcasing its potential as a valuable biomarker. Implementation of this parameter to possible future nomograms has the potential to individualize and risk-stratify the patients in prostate biopsy decision.

Letter to editor:"the predictive role of hematological inflammatory markers on the prognosis of kidney injury".

Letter to editor:"the predictive role of hematological inflammatory markers on the prognosis of kidney injury".

The impact of inflammatory biomarkers on amputation rates in patients with diabetic foot ulcers.

Diabetic Foot Ulcers (DFUs) are a major complication of diabetes, often leading to amputation. Understanding the relationship between haematological inflammatory markers and the incidence of amputation in DFU patients with infectious complications is crucial for improving management and outcomes. This retrospective study, conducted from May 2020 to October 2022, involved 109 patients with DFUs, categorised into amputation (AM) and non-amputation (NAM) groups. Patients were evaluated for various factors, including demographic data, DFU duration, and blood parameters such as haemoglobin A1c (HbA1c), haemoglobin (Hb), albumin (ALB), white blood cell count (WBC), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), C-reactive protein (CRP), platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and lymphocyte-to-monocyte ratio (LMR). Statistical analyses were performed using independent sample t-tests, Mann-Whitney U test and logistic regression. The univariate analysis showed no significant difference in BMI, DM duration or DFU duration between groups. However, significant differences were noted in PCT, Hb, ESR, ALB, HbA1c and WBC levels, and in inflammatory ratios (NLR, PLR and LMR). Multivariate logistic regression identified CRP, NLR and PLR as independent risk factors for amputation. The study highlights CRP, PLR and NLR as key independent risk factors for amputation in patients with DFUs. These easily obtainable markers from routine blood tests can effectively aid in predicting the risk of osteomyelitis and amputation, enhancing clinical decision making and patient care strategies.

The role of preoperative hematological inflammatory markers as a predictor of meningioma grade: A systematic review and meta-analysis.

Inflammatory processes play an important role in the aggressiveness of a tumor. However, the relationship between inflammatory markers in meningioma grade is not well known. Knowledge of preoperative meningioma grade plays an important role in the prognosis and treatment of this tumor. This study aims to assess preoperative hematological inflammatory markers as a predictor of the pathological grade of meningioma. To ensure comprehensive retrieval of relevant studies, we searched the following key databases, PubMed, Science Direct, and Biomed Central, with evidence related to preoperative hematological inflammatory markers among meningioma up to September 2023. The studies involved were selected based on established eligibility criteria. The analysis in this study uses Review Manager 5.4. Six studies were obtained from the search results. The total number of patients 2789 (469 high-grade meningioma and 2320 low-grade meningioma) analysis shows elevated neutrophil-to-lymphocyte ratio (NLR) (mean difference [MD]: 0.29; 95% confidence interval [CI] 0.13-0.45; P = 0.0004), monocyte-to-lymphocyte ratio (MLR) (MD: 0.02; 95% CI 0.00-0.04; P = 0.003), and low lymphocyte-to-monocyte ratio (LMR) (MD: -0.82; 95% CI -1.46--0.18; P = 0.005) significantly associated with high-grade meningioma compared to low-grade meningioma. No significant correlation between high-grade and low-grade meningioma based on platelet-lymphocyte ratio value is observed. The parameters of NLR, MLR, and LMR have been found to be cost-effective preoperative methods that demonstrate potential value in the prediction of meningioma grade. To enhance the reliability of the findings, it is imperative to do further prospective study.

Hematological profile, inflammatory markers and serum liver enzymes in COVID 19 positive children vs. COVID 19 negative ones-a comparative study.

Complete blood count, C-reactive protein and transaminases are routine laboratory parameters investigated in children with infections, including COVID 19. We aimed to evaluate the diagnostic accuracy of these parameters in children diagnosed with COVID 19. At the time of admission, children with COVID 19 suggestive symptoms were tested RT-PCR for SARS CoV-2 and were allocated to either the study group (RT-PCR SARS CoV-2 positive) or control group (RT-PCR SARS CoV-2 negative). All children were evaluated by complete blood count, CRP, and transaminases. When comparing the two groups, we identified significantly lower values for leukocytes (p < 0.001), neutrophils (p < 0.001), lymphocytes (p < 0.001) and thrombocytes (p = 0.014), but no significantly different values for CRP (p = 0.916) and monocytes (p = 0.082). A diagnostic score for COVID-19 was compiled using the abovementioned parameters-presence of fever, number of lymphocytes and aspartate-aminotransferase. Performance was tested, showing a positive discrimination value (AUC of 0.703)-81.5% sensitivity, 50.6% specificity. The leukocytes, neutrophils and lymphocytes have significantly lower values in COVID-19 children. The proposed score based on the presence of fever the values of lymphocytes and AST has a good sensitivity in predicting COVID-19 infection.

Inflammation indexes and machine-learning algorithm in predicting urethroplasty success.

To assess the predictive capability of hematological inflammatory markers for urethral stricture recurrence after primary urethroplasty and to compare traditional statistical methods with a machine-learning-based artificial intelligence algorithm. Two hundred eighty-seven patients who underwent primary urethroplasty were scanned. Ages, smoking status, comorbidities, hematological inflammatory parameters (neutrophil-lymphocyte ratios, platelet-lymphocyte ratios [PLR], systemic immune-inflammation indexes [SII], and pan-immune-inflammation values [PIV]), stricture characteristics, history of previous direct-visual internal urethrotomy, urethroplasty techniques, and grafts/flaps placements were collected. Patients were followed up for one year for recurrence and grouped accordingly. Univariate and multivariate logistic regression analyses were conducted to create a predictive model. Additionally, a machine-learning-based logistic regression analysis was implemented to compare predictive performances. p<0.05 was considered statistically significant. Comparative analysis between the groups revealed statistically significant differences in stricture length (p=0.003), localization (p=0.027), lymphocyte counts (p=0.008), PLR (p=0.003), SII (p=0.003), and PIV (p=0.001). In multivariate analysis, stricture length (odds ratio [OR] 1.230, 95% confidence interval [CI] 1.142-1.539, p<0.0001) and PIV (OR 1.002, 95% CI 1.000-1.003, p=0.039) were identified as significant predictors of recurrence. Classical logistic regression model exhibited a sensitivity of 0.76, specificity of 0.43 with an area under curve (AUC) of 0.65. However, the machine-learning algorithm outperformed traditional methods achieving a sensitivity of 0.80, specificity of 0.76 with a higher AUC of 0.82. PIV and machine-learning algorithms shows promise on predicting urethroplasty outcomes, potentially leading to develop possible nomograms. Evolving machine-learning algorithms will contribute to more personalized and accurate approaches in managing urethral stricture.

The association of hematological inflammatory markers and psychological function in COVID-19 patients: A cross-sectional study.

Mental health disorders are linked to systemic inflammation. Due to high inflammation and mental health disorders in COVID-19 patients, we aimed to investigate the relationship between blood inflammatory markers such as red cell distribution width to platelet ratio (RPR), platelet-lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR), red cell distribution width (RDW), white blood cell (WBC), and psychological function in COVID-19 patients. In the current cross-sectional study, neuro-psychological function, and a complete blood count (CBC) were measured on 120 COVID-19 patients aged >30 years from the Imam Reza Hospital in Mashhad, Iran. Our results showed that anxiety related to MCHC (mean ± SD: 32.71 ± 1.68, p < 0.05), WBC (mean ± SD: 12.23 ± 5.43, p < 0.05), and PLR (median (IQR): 28.72 (15.88-41.31), p < 0.05) significantly. In the stress subgroup, only RPR was associated with stress (p < 0.05). Linear regression between hematological parameters and psychological score indicated that RDW and PLR had a significantly positive association with depression (β = 0.086; p = 0.045 and β = 1.326; p = 0.016, respectively) and anxiety scores (β = 0.100; p = 0.038 and β = 1.356; p = 0.010, respectively). Moreover, a positive correlation was found between PLR and stress (β = 1.102; p = 0.012). This study showed a positive association between depression/anxiety/stress symptoms and levels of hematological inflammatory markers including PLR and RDW. The findings of this study provide novel insights into mental health and physiological markers, underscoring the potential influence of inflammation on mood disorders. Our findings offer exciting prospects for future research and may lead to innovative approaches in the management and treatment of depression, anxiety, and stress.

Electroconvulsive therapy improves hematological inflammatory markers in bipolar disorder.

Immune dysfunction and inflammation participate in the pathophysiology of bipolar disorder (BD). Abnormal levels of inflammatory markers, namely, red cell distribution width (RDW) and platelet distribution width (PDW), were detected in BD. Electroconvulsive therapy (ECT) for various mental disorders including BD was linked to changes in these inflammatory mediators. Hence, we aimed to assess the impact of ECT on PDW and RDW in patients with BD. Seventy-two patients aged ≥ 16 were enrolled in the current prospective cohort study over 6 months, diagnosed as BD based on DSM-IV and indicated for ECT and complete blood count (CBC) drawn pre-ECT and after four ECT sessions. By the end of the ECT sessions, we noticed a significant elevation in PDW with lowering in RDW levels. However, no significant differences were detected before and after ECT regarding platelet (PLTs) count, mean platelet volume (MPV), and Plateletcrit (PCT). ECT seems to improve the CBC-derived inflammatory markers (RDW and PDW) subsequently, improving the underlying inflammatory process in BD without disturbing PLT homeostasis which support its anti-inflammatory role in BD.

PSVI-1 Elucidating the Effects of the CXCL12/CXCR4 Axis Through Hematological Changes in Sheep During Gestation

Abstract The placenta, an organ that develops during pregnancy, is essential for transporting nutrients and oxygen to the developing offspring. Formation of the placenta is characterized by many physiological and hematological changes necessary for a healthy gestation. Improper placentation causes placental insufficiency which increases fetal mortality and poor postnatal health and performance. Causes of placental insufficiency are poorly understood, however evidence indicates immune factors including the chemokine ligand 12 (CXCL12) and its receptor (CXCR4) regulate several processes central to placentation and white blood cells (WBC) have essential roles by promoting trophoblast invasion and supporting artery remodeling. We previously demonstrated suppressing CXCL12/CXCR4 signaling at the fetal-maternal interface during implantation diminishes placental vascularization, reduces trophoblast invasion, and creates an excessively inflammatory placental environment. Building on these studies, we hypothesized the negative impacts early in gestation would result in compromised placental development and altered hematological parameters during gestation. Identifying key hematological changes or inflammatory markers in a complete blood count analysis during pregnancy might provide diagnostic clues to placental insufficiency at early stages of pregnancy. Our objective was to determine if disrupting the CXCL12/CXCR4 axis during implantation results in an altered hematological profile or serum progesterone (P4) concentrations. Using an in-vivo sheep model osmotic pumps were surgically installed to deliver treatments into the uterine lumen on day 12 of gestation. Pumps delivered either CXCR4 inhibitor (AMD3100) at (1X, 1.5X, or 3X dose), CXCL12 at (low or high dose), or PBS (control) into the uterus over the course of 14 days. Blood samples were collected via jugular venipuncture daily from days 11 to 16 of gestation, every two days from days 18 to 30, and weekly from day 35 to 135 and analyzed within 2 h of collection for a complete blood count using the Abaxis VetScan HM5. Serum was also collected and P4 concentrations were quantified by radioimmunoassay. Manipulating the CXCL12/CXCR4 axis during early gestation did not affect (P = 0.98) systemic circulating progesterone values during days tested, but neutrophils, lymphocytes, WBCs, and platelets increased indicated systemic inflammation. Of the hematological parameters tested, WBC counts were increased (P &amp;lt; 0.05) in the 3X AMD3100 treatment group and neutrophils and lymphocytes tended (P &amp;lt; 0.1) to increase compared with control. Our results reveal that suppressing CXCL12/CXCR4 signaling during early gestation creates an inflammatory response reflected in circulation. A greater understanding of hematological changes and endometrial interactions involved in placentation in sheep is necessary to elucidate the causes of placental insufficiency and recurrent pregnancy loss. Future research will investigate if circulating markers indicative of placental dysfunction exist which may lead to methods to improve fertility, pregnancy outcomes, and fetal health.

Evaluation of hematologic inflammatory markers in Graves’ disease

Introduction: The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and the systemic immune-inflammation index (SII) have been used as new inflammatory markers in certain autoimmune diseases to assess the severity of inflammation. The current study aimed to evaluate the changes in neutrophil and lymphocyte series in hyperthyroid patients and to investigate whether NLR, PLR, and SII may be markers of inflammation. Methods: This cross-sectional study was conducted with 207 Graves’ patients and 120 healthy controls between 2018-2022 years. Hematologic parameters, thyroid function tests, age and gender were recorded. The NLR, PLR and SII values of all subjects were calculated. Firstly, groups were composed as Graves' group and participants without thyroid disorder as control group. Secondly, Graves' patients composed as two groups before treatment and after antithyroid treatment. These groups were compared with each other in terms of descriptive data and hematological parameters. Results: The patient and control groups were similar in terms of gender (p=0.522) and age (p=0.051). Graves’ patients had a significantly lower NLR than the control group (p=0.004). There was no significant difference between the groups in terms of PLR (p=0.120) and SII (p=0.577). Patients’ baseline TSH-receptor antibodies (TRAb) levels had a significant positive correlation with fT3 (r:0.283, p&amp;lt;0.001), fT4 (r:0.252, p&amp;lt;0.001) and Thyroid stimulating immunoglobulin (TSI) (r:0.673, p&amp;lt;0.001). There was no significant correlation between TRAb and TSI levels, inflammatory markers, and hematological parameters. Conclusions: Graves’ patients had lower NLR compared to the control group. The patient and control groups did not have a significant difference with regard to PLR and SII. Thyroid autoantibody levels and inflammatory markers did not have a significant correlation. Keywords: Hyperthyroidism, inflammation, neutrophils, lymphocytes

The predictive value of hematological inflammatory markers for acute kidney injury and mortality in adults with hemophagocytic Lymphohistiocytosis: A retrospective analysis of 585 patients.

Hemophagocytic lymphohistiocytosis (HLH) is a rare immunological hyperactivation-related disease with a high mortality rate. The purpose of this study was to examine the relationship between complete blood count parameters and the occurrence of acute kidney injury (AKI) and mortality in patients with HLH. We included 585 adult patients with HLH. Logistic regression models for AKI and 28-day mortality were developed. Multivariate logistic regression models revealed that hemoglobin (HB)≤7.3g/dl (adjusted OR, 1.651; 95% CI, 1.044-2.612), hemoglobin-to-red blood cell distribution width ratio (HRR)<0.49 (adjusted OR, 1.692), neutrophil-to-lymphocyte ratio (NLR)≥3.15 (adjusted OR, 1.697), and neutrophil-to-lymphocyte-platelet ratio (NLPR)≥11.0 (adjusted OR, 1.608) were independent risk factors for the development of AKI. Moreover, lower platelet levels (31×109/L<platelets<84×109/L, adjusted OR, 2.133; platelets≤31×109/L, adjusted OR, 3.545) and higher red blood cell distribution width-to-platelet ratio (RPR) levels (0.20<RPR<0.54, adjusted OR, 2.595; RPR≥0.54, adjusted OR, 4.307), lymphocytes≤0.34×109/L (adjusted OR, 1.793), NLPR≥11.0 (adjusted OR, 2.898), and the aggregate index of systemic inflammation (AISI)≤7 (adjusted OR,1.778) were also independent risk factors for 28-day mortality. Furthermore, patients with AKI had a worse prognosis than those without AKI (P<0.05). In patients with HLH, hematological parameters are of great value for the early identification of patients at high risk of AKI and 28-day mortality.

Utility of baseline D-dimer and neutrophil-to-lymphocyte ratio (NLR) in predicting the severity among COVID-19 patients in an Indian cohort during the first wave of the pandemic

Introduction and Aim: COVID-19 outbreak was declared as pandemic by WHO Director-General on 11th March 2020 in his opening remarks at the media briefing. The global population infected by Corona virus appeared to be responding at different levels in the first wave which warranted WHO to categorise the disease as mild, moderate, and severe. Haematological, biochemical, and radiological parameters played a crucial role in critically triaging and following-up disease progression. Amongst various laboratory parameters, this work aimed to identify the most specific marker in predicting disease severity. Materials and Methods: Blood samples from study population of 510 laboratory confirmed COVID-19 cases admitted in our hospital were selected. The patients who were classified as having mild, moderate, and severe disease were analysed for biochemical and haematological inflammatory markers. Results were analysed by ANOVA and post-hoc tests. ROC curves were derived to determine the cut-off values between severe and non-severe groups. Correlation between D-dimer and NLR was done by Pearson’s correlation. Results: Patients with co-morbidities were likely to develop severe complications which could lead to poor outcome. From ROC curves, we determine that NLR, with highest area under curve, is the best marker of disease severity. A significant positive correlation was found between D-dimer and NLR (p=0.000) across groups. Baseline cut-off values for D-dimer and NLR based to differentiate between severe and non-severe cases were 0.5 and 4.875 respectively. Conclusion: We conclude that baseline NLR is a simple and most useful tool that would assist clinicians in designing treatment strategies for a COVID-19 infected patient.

Hematologic and biochemical inflammatory markers increase with body mass and positively correlate in adolescents.

Atherosclerosis is a chronic inflammatory disease that has its origins in childhood. The goal of this study was to explore the relationships of hematologic inflammatory markers to body mass, biochemical inflammatory markers and cardiometabolic risk factors. Healthy, white, non-Hispanic identifying adolescents (n = 75, age 12 to 18 years) were enrolled. Measures studied included body mass index percentile (BMI%), neutrophil and platelet to lymphocyte ratio (NLR, PLR), pan immune inflammation value (PIV), lipids, augmentation index, reactive hyperemia, inflammatory markers (interleukin 6: IL6, c-reactive protein: CRP), complement (C3, C3a, C4, C4a, C5a) insulin secretion and insulin sensitivity (oral glucose tolerance test: Matusda index, and disposition index (DI)). NLR (rS = 0.31, p < 0.01), PLR (rS = 0.32, p < 0.01), PIV (rS = 0.32, p < 0.01) and CRP (rS = 0.51, p < 0.001) all positively correlated with BMI% but IL-6 did not. NLR, PLR and PIV all positively correlated with each other. NLR correlated with the reactive hyperemia response (rS = 0.29, p < 0.02) but this relationship was lost when BMI% was included. NLR positively correlated with C3a, C4, CRP and IL6 even when BMI% was included. In healthy adolescents hematologic markers of inflammation increase with increasing body mass and neutrocyte to lymphocyte ratio is associated with increased complement and inflammatory markers independent of obesity. Hematologic and biochemical markers of inflammation increase with increased body mass in healthy adolescents. Hematologic and biochemical markers of inflammation are positively related independent of body mass in healthy adolescents. Hematologic inflammatory markers are not relatedto markers of cardiometabolic risk in healthy adolescents.

Monocyte anisocytosis corresponds with increasing severity of COVID-19 in children.

Although SARS-CoV-2 infection can lead to severe COVID-19 in children, the role of biomarkers for assessing the risk of progression to severe disease is not well established in the pediatric population. Given the differences in monocyte signatures associated with worsening COVID-19 in adults, we aimed to determine whether monocyte anisocytosis early in the infectious course would correspond with increasing severity of COVID-19 in children. We performed a multicenter retrospective study of 215 children with SARS-CoV-2 infection, Multisystem Inflammatory Syndrome in Children (MIS-C), convalescent COVID-19, and healthy age-matched controls to determine whether monocyte anisocytosis, quantified by monocyte distribution width (MDW) on complete blood count, was associated with increasing severity of COVID-19. We performed exploratory analyses to identify other hematologic parameters in the inflammatory signature of pediatric SARS-CoV-2 infection and determine the most effective combination of markers for assessing COVID-19 severity in children. Monocyte anisocytosis increases with COVID-19 severity and need for hospitalization. Although other inflammatory markers such as lymphocyte count, neutrophil/lymphocyte ratio, C-reactive protein, and cytokines correlate with disease severity, these parameters were not as sensitive as MDW for identifying severe disease in children. An MDW threshold of 23 offers a sensitive marker for severe pediatric COVID-19, with improved accuracy when assessed in combination with other hematologic parameters. Monocyte anisocytosis corresponds with shifting hematologic profiles and inflammatory markers in children with COVID-19, and MDW serves as a clinically accessible biomarker for severe COVID-19 in children.

Association Between Inflammatory Biomarkers and Contrast-induced Acute Kidney Injury in ACS Patients Undergoing Percutaneous Coronary Intervention: A Cross-sectional Study.

The present study aimed to evaluate the predictive role of inflammatory biomarkers in the development of contrast-induced acute kidney injury (CI-AKI) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). The inflammatory biomarkers assessed were: platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), neutrophil-to-lymphocyte*platelet ratio (NLPR), systemic inflammatory index (SII), and systemic inflammation response index (SIRI). Overall, 950 patients undergoing PCI were enrolled. The frequency of CI-AKI was 15.2% (n = 144). The levels of NLR, MLR, NLPR, SII, and SIRI were higher in the CI-AKI group than in the Non-CI-AKI group (P < .05). The addition of NLR ≥2.96, dNLR ≥2.08, NLPR ≥.012, SII ≥558.04, and SIRI ≥1.13 to the Mehran score model significantly increased the area under the curve (P < .05). Multivariable logistic regression analyses indicated that inflammatory biomarkers were significantly associated with CI-AKI, including NLR ≥2.96 (OR = 1.588, P = .017), dNLR ≥2.08 (OR = 1.686, P = .007), SII ≥558.04 (OR = 1.521, P = .030), and SIRI ≥1.13 (OR = 1.601, P = .017). Therefore, inflammation is associated with the development of CI-AKI, and preoperative hematological inflammatory markers could predict the risk of CI-AKI in ACS patients undergoing PCI.

Protective effect of vitamin C against ethanol induced oxidative stress in Wistar rats

Inflammation is a natural immune response to harmful agents. This study aimed to explore the protective effect of vitamin C against alcohol-induced toxicity on hematological inflammatory markers. Forty healthy adult male Wistar rats were acclimatized and divided into eight groups. Group A served as the control, while Group B received alcohol. Groups C, D, and E were given varying doses of vitamin C, and Groups F, G, and H received alcohol followed by vitamin C treatments. After twenty-one days, blood samples were collected and analyzed for various markers. Rats receiving alcohol only showed increased white blood cell count (WBC), platelet count (PLT), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR), along with decreased antioxidant enzyme activity. However, rats receiving vitamin C alone or in combination with alcohol exhibited reduced inflammatory markers and increased antioxidant activity compared to the alcohol-only group. The study demonstrated that commercial-grade vitamin C at doses of 100 mg/kg, 200 mg/kg, and 300 mg/kg effectively reduced chronic low-grade inflammation. Overall, the findings suggest that vitamin C supplementation may mitigate the inflammatory effects of alcohol consumption.

Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are positively correlated with disease activity of bullous pemphigoid.

Bullous pemphigoid (BP) is a complex inflammatory process with elevated levels of autoantibodies, eosinophils, neutrophils, and various cytokines. Hematological inflammatory biomarkers can reflect inflammatory state in various diseases. Up to now, the correlations of hematological inflammatory biomarkers and disease activity of BP remain unknown. The purpose of this study was to clarify the associations between hematological inflammatory biomarkers and disease activity of BP. The levels of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), platelet-to-neutrophil ratio (PNR) and mean platelet volume (MPV) of 36 untreated BP patients and 45 age and gender matched healthy controls were detected by routine blood tests. The correlations between hematological inflammatory markers and clinical characteristics of BP were statistically analyzed. The Bullous Pemphigoid Disease Area Index (BPDAI) was used to measure disease activity of BP. The mean levels of NLR, PLR, PNR and MPV in 36 untreated BP patients were 3.9, 157.9, 45.7 and 9.4fl, respectively. Increased NLR (p < 0.001), PLR (p < 0.01), and MPV (p < 0.001) but decreased PNR (p < 0.001) were observed in BP patients when compared with healthy controls. In BP patients, the levels of NLR were positively correlated to BPDAI Erosion/Blister Scores (p < 0.01); and the levels of NLR and PLR were both positively correlated to BPDAI without Damage Score (both p < 0.05) and BPDAI Total Score (both p < 0.05). No correlation was found in other statistical analyses between hematological inflammatory markers and clinical characteristics in BP patients involved in the present study. Therefore, NLR and PLR are positively correlated with disease activity of BP.

The Use of New Hematological Markers in the Diagnosis of Alopecia Areata.

Alopecia areata (AA) is a non-cicatricial inflammatory and autoimmune hair loss disease. In recent studies, it has been reported that hematological parameters can be used as oxidative stress markers in the diagnosis of many inflammatory diseases due to their low cost and widespread use. In this study, it was aimed to reveal the significant cut-off points of hematological inflammatory markers in AA that can guide clinicians in clinical practice and determine how many times they increase the risk of disease. The present study is retrospective case-control type. Seventy patients with AA and seventy healthy controls were included in the study. The hematological parameters in both groups were evaluated retrospectively. Hemoglobulin, monocyte, platelet, monocyte high-density lipoprotein cholesterol (HDL-C) ratio (MHR), monocyte lymphocyte ratio (MLR), platelet lymphocyte ratio (PLR) were high in patients with AA, while the number of lymphocytes was low. In ROC analysis, the optimal cut-off values for the diagnosis of AA were as follows: MLR 0.216, MHR 0.010, and PLR 111.715. In regression analysis, being above the following values of MLR 0.216, MHR 0.010, and PLR 111.715 increased the risk of developing AA by 6.3, 3.8, and 2.7 times, respectively. It was seen that MHR and PLR, especially MLR, can significantly increase the risk of developing the disease in AA and can also be used as diagnostic markers.

Hematological Markers: Testing a new diagnostic modality for Intrahepatic Cholestasis of pregnancy

Background: Intrahepatic Cholestasis of pregnancy (ICP) is the most common pregnancy specific liver disorder presenting usually in the 3rd trimester with unexplained pruritis, elevated serum bile acids and/or raised liver enzymes. ICP is associated with adverse perinatal outcomes. Serum total bile acids (TBA) are considered as a gold standard for diagnosis of ICP but are time consuming, expensive and not readily available everywhere. Neutrophil to Lymphocyte ratio (NLR), Mean Platelet Volume (MPV) and Red cell Distribution Width (RDW) are haematological inflammatory markers and are routinely available on a simple complete blood count test when asked for. Aims: To study the role of haematological inflammatory markers in Intrahepatic Cholestasis of Pregnancy (ICP) and their association with the severity of the disease. Methods: This prospective case-control study was done in a tertiary care setting in New Delhi, from January 2021- August 2022(20 months) wherein 82 women with ICP were recruited after a written and informed consent. NLR, MPV, RDW and TBA levels were done. 82 healthy women with uncomplicated pregnancies served as the control group. Results: Both cases &amp; controls were comparable in terms of sociodemographic characteristics. Mean TBA levels were 22.85+/-7.82 in mild cases(60 subjects) &amp; 66.20+/-26.97 (22 severe cases). Cases delivered earlier between 37–38 weeks. Majority of women delivered vaginally &amp; was statistically significant. Cases developed more fetal distress(42.7% vs 9.8%) NLR and MPV were significantly raised (p&lt;0.05) while RDW was lower in cases. The cut off for NLR &amp; MPV were statistically significant. Conclusion: MPV can serve as a good screening tool, a high sensitivity (95.1%) while NLR can serve as a confirmatory test as it has high specificity (96.3%) to make diagnosis of ICP, although further exploration with larger multicentric studies is required.