İnaktif Behçet Hastalığı'nda İnflamatuar Belirteçler

Year 2022, Volume: 1 Issue: 1, 24 - 28, 25.06.2022

Ozlem Yagiz Aghayarov , Aydın Keskinrüzgar , Ayşe Sevgi Karadağ , Aynur Aliyeva , Demet Işık Bayraktar , İbrahim Çukurova

Abstract

Amaç: Behçet hastalığı kronik multisistem tulumlu inflamatuar bir hastalıktır ve hastalık aktivitesinin tanı ve takibinde birçok sitokin ve biyobelirteç tanımlanmıştır. Nötrofil-lenfosit oranı (NLR) ve trombosit-lenfosit oranı (PLR), otoimmün hastalıklarda hastalık şiddetini değerlendirmek için yeni inflamatuar biyobelirteçler olarak kullanılmaktadır. Çalışmanın amacı, inaktif dönemdeki Behçet hastalarında NLR ve PLR değerlerini incelemektir. Gereç ve Yöntemler: Dahiliye kliniği tarafından detaylı sistemik muayenesi yapılan, çalışmaya dahil edilme kriterlerine uyan ve hastalık aktivitesi değerlendirildikten sonra inaktif olarak kabul edilen hastalar çalışmada yer alan diğer kliniklerce (kulak burun boğaz hastalıkları, göz hastalıkları ve diş hekimliği) olası inflamatur ve malign hastalıklar yönünden değerlendirildi. NLR yüksekliği yapabilecek diğer nedenler ekarte edildikten sonra 40 Behçet hastası ve 45 sağlıklı kontrol çalışmaya dahil edildi. Bu iki grubun NLR ve PLR değerleri karşılaştırıldı. Bulgular: Hasta grubunun NLR değerleri kontrol grubuna oranla istatistiksel olarak daha yüksekti. Hasta grubunda PLR değerleri daha yüksekti ancak istatistiksel olarak anlamlı fark yoktu. Sonuç: Çalışmadaki hastalarda NLR yüksekliğine neden olabilecek diğer durumlar tüm branşlar tarafından değerlendirildikten sonra ve hastalar inaktif evrede oldukları halde NLR yüksek bulunmuştur. Bu durum Behçet hastalığında hastada klinik bulgu olmasa ve hasta inaktif evrede olsa dahi altta yatan bir inflamatuar durumu desteklemektedir.

Keywords

Behçet hastalğı, Nötrofil-lenfosit oranı, Trombosit-lenfosit oranı;, Hastalık aktivitesi, Trombosit-lenfosit oranı

References

• 1. Cho SB, Cho S, Bang D. New insights in the clinical understanding of Behçet's disease. Yonsei Med J. 2012;53:35-42.
• 2. Greco A, De Virgilio A, Ralli M, Ciofalo A, Mancini P, Attanasio G et al. Behçet's disease: new insights into pathophysiology, clinical features and treatment options. Autoimmun Rev. 2018;17:567-75.
• 3. Park JS, Kang MI, Ha YJ, Song JJ, Park YB, Lee SK et al. Serum anti‐lysozyme is associated with disease activity of Behçet's disease. Int J Rheum Dis. 2017;20: 261-8.
• 4. Kul A, Ateş O, Melikoğlu MA, Uğur M, Öztürk N, Erkayhan G et. al. Endocan measurement for active Behçet disease. Arch Rheumatol. 2017; 32: 197- 202.
• 5. Sarıyıldız MA, Yazmalar L, Batmaz İ, Alpaycı M, Burkan YK, Sula B et.al. Serum GDF-15 level in Behçet's disease: relationships between disease activity and clinical parameters. Int J Dermatol. 2016; 55:1289-94.
• 6. Yazmalar L, Batmaz I, Sula B, Alpaycı M, Aydın F, Turkcu F et al. Serum levels of alpha-1 acid glycoprotein and pentraxin 3 in patients with Behçet's disease and relationship with disease activity. Int J Dermatol. 2015;54:e394-400.
• 7. Durmazlar SP, Ulkar GB, Eskioglu F, Tatlican S, Mert A, Akgul A. Significance of serum interleukin-8 levels in patients with Behcet's disease: high levels may indicate vascular involvement. Int J Dermatol. 2009; 48:259-64.
• 8. Ha YJ, Park JS, Kang MI, Lee SK, Park YB, Lee SW. Increased serum interleukin-32 levels in patients with Behçet's disease. Int J Rheum Dis. 2018;21: 2167- 74.
• 9. Djaballah-Ider F, Chaib S, Belguendouz H, Talbi D, Touil-Boukoffa C. T cells activation and interferon-γ/nitric oxide production during Behçet disease: a study in Algerian patients. Ocul Immunol Inflamm. 2012;20:215-7.
• 10. Enecik ME, Mavi B, Yucel Ç, Keskin G, Yildiz M. The importance of serum interleukin-20 levels in patients with Behçet's disease. Adv Clin Exp Med. 2018;27:1391-5.
• 11. Lopalco G, Lucherini OM, Lopalco A, Venerito V, Fabiani C, Frediani B et al. Cytokine signatures in mucocutaneous and ocular Behçet's disease. Front Immunol. 2017;8:200.
• 13.Ozan N, Alpaycı M, Aslan M, Cankaya H, Kıroglu AF, Turan M et al. Mean platelet volume, red cell distribution width, platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios in patients with ankylosing spondylitis and their relationships with high-frequency hearing thresholds. Eur Arch Otorhinolaryngol. 2016;273:3663-72.
• 12. Mercan R, Bitik B, Tufan A, Bozbulut UB, Atas N, Ozturk MA et.al. The association between neutrophil/lymphocyte ratio and disease activity in rheumatoid arthritis and ankylosing spondylitis. J Clin Lab Anal. 2016;30:597-601.
• 14. Yolbas S, Yildirim A, Gozel N, Uz B, Koca SS. Hematological indices may be useful in the diagnosis of systemic lupus erythematosus and in determining disease activity in Behçet's disease. Med Princ Pract. 2016;25:510-6.
• 15. Kim DS, Shin D, Lee MS, Kim HJ, Kim DY, Kim SM et al. Assessments of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in Korean patients with psoriasis vulgaris and psoriatic arthritis. J Dermatol. 2016;43:305-10.
• 16. Balkarli A, Kucuk A, Babur H, Erbasan F. Neutrophil/lymphocyte ratio and mean platelet volume in Behçet's disease. Eur Rev Med Pharmacol Sci. 2016;20:3045-50.
• 17. Bhat T, Teli S, Rijal J, Bhat H, Raza M, Khoueiry G et al. Neutrophil to lymphocyte ratio and cardiovascular diseases: a review. Expert Rev Cardiovasc Ther. 2013;11:55-9.
• 18. Koseoglu HI, Altunkas F, Kanbay A, Doruk S, Etikan I, Demir O. Platelet-lymphocyte ratio is an independent predictor for cardiovascular disease in obstructive sleep apnea syndrome. J Thromb Thrombolysis. 2015;39:179-85.
• 19. Koiwa M, Goto S, Takahashi K, Kamada T, Takai S, Nakamura H. Neutrophil/lymphocyte ratio in patients with rheumatoid arthritis treated with biological agents. J Nippon Med Sch. 2016;83:118-24.
• 20. 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.
• 21. Li X, Chen ZH, Xing YF, Wang TT, Wu DH, Wen JY et al. Platelet-to-lymphocyte ratio acts as a prognostic factor for patients with advanced hepatocellular carcinoma. Tumour Biol. 2015;36:2263-9.
• 22. Racz JM, Cleghorn MC, Jimenez M, Atenafu EG, Jackson TD, Okrainec A et al. Predictive ability of blood neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in gastrointestinal stromal tumors. Ann Surg Oncol. 2015;22:2343-50.
• 23. Ozturk C, Balta S, Balta I, Demirkol S, Celik T, Turker T et al. Neutrophil–lymphocyte ratio and carotid–intima media thickness in patients with Behcet disease without cardiovascular involvement. Angiology. 2015;66:291-6.
• 24. Alan S, Tuna S, Turkoglu EB. The relation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and mean platelet volume with the presence and severity of Behçet's syndrome. Kaohsiung J Med Sci. 2015;3:626-31.
• 25.Davatchi F, Assaad-Khalil S, Calamia KT, Crook JE, Sadeghi-Abdollahi B, Schirmer M et al. International team for the revision of the international criteria for Behçet’s disease (ITR-ICBD). The international criteria for Behçet’s disease (ICBD): a collaborative study of 27 countries on the sensitivity and specificity of the new criteria. J Eur Acad Dermatol Venereol. 2014;28:338- 47.
• 26. Bhakta BB, Brennan P, James TE, Chamberlain MA, Noble BA, Silman AJ. Behcet's disease: Evaluation of a new instrument to measure clinical activity. Rheumatology. 1999;38:728-33.
• 27. Neves FDS, Caldas CAM, Medeiros DMD, Moraes JCBD, Gonçalves CR. Cross-cultural adaptation of simplified version(s) of Behçet's Disease Current Activity Form (BDCAF) and comparison between two different instruments with Brazilian versions for evaluating Behçet's Disease activity: BR-BDCAF and BR-BDCAF(s). R
• 28.Neves FS, Spiller F. Possible mechanisms of neutrophil activation in Behçet's disease. International Immunopharmacology. 2013;17:1206- 10.
• 29. Janeway Jr, CA Travers P, Walport M, Shlomchik MJ. Autoimmune responses are directed against self antigens. In: Immunobiology: The Immune System in Health and Disease. 5th edition. Garland Science, 2001.
• 30. Hammad M, Shehata OZ, Abdel-Latif SM, El-Din AMM. Neutrophil/lymphocyte ratio and platelet/ lymphocyte ratio in Behçet's disease: which and when to use? Clin Rheumatol. 2018;37:2811-7.
• 31. Gheita TA, Sakr BR, Rabea RE, Abd ElHamid SM. Value of hematological indices versus VEGF as biomarkers of activity in Behçet's disease. Clin Rheumatol. 2019;38:2201-10.
• 32. Vayá A, Rivera L, Todolí J, Hernandez JL, Laiz B, Ricart JM. Haematological, biochemical and inflammatory parameters in inactive Behçet's disease. Its association with red blood cell distribution width. Clin Hemorheol Microcirc. 2014; 56:319-24.
• 33. Uluyol S, Kilicaslan S. Diagnostic value of neutrophil-lymphocyte ratios and mean platelet volumes in the activation of recurrent aphthous stomatitis. Indian J Otolaryngol Head Neck Surg. 2019;71:120-3.
• 34. Lee YH, Song GG. Neutrophil-to-lymphocyte ratio, mean platelet volume and platelet-tolymphocyte ratio in Behçet's disease and their correlation with disease activity: A meta-analysis. Int J Rheum Dis. 2018;21:2180-7.