The Assessment of Red Blood Cell Distribution Width, Platelet Parameters and Inflammatory Markers in Patients on Antıpsoriasis Therapy

Objective: Psoriasis is an inflammatory skin disease with several comorbid-ities. We aimed to evaluate red blood cell distribution width (RDW), platelet parameters and inflammatory markers in patients on antipsoriasis therapies. Materials and Methods: 94 psoriasis patients and 74 healthy controls were prospectively analyzed. Before and after 8 weeks of different therapies (cal-cipotriol+clobetasol propionate; narrow-band UVB; combined narrow-band UVB and acitretin; infliximab and adalimumab), red blood cell distribution width, platelet parameters, high sensitivity C reactive protein, and erythro-cyte sedimentation rate levels were measured. Lipid profile and fasting blood glucose tests were also performed prior the treatment. Psoriasis severity and area index and body mass index were calculated for each patient. Results: red blood cell distribution width, high sensitivity C reactive protein, triglyceride, total cholesterol levels and body mass index were higher in pa-tients than in controls (p0.05, for all). Red blood cell distribution width was not cor-related with psoriasis severity and area index (p>0.05). The limitations of our study are the relatively small samples of therapy groups and short duration of follow-up.Conclusion: The role of antipsoriasis therapies on inflammatory markers should be elucidated via additional larger-scale studies. Red blood cell dis-tribution width and high sensitivity C reactive protein might be useful to de-tect systemic inflammation in psoriasis.

Kaynakça

Davidovici BB, Sattar N, Prinz J, et al. Psoriasis and sys-temic inflammatory diseases: potential mechanistic linksbetween skin disease and comorbid conditions. J InvestDermatol 2010; 130: 1785-96.

Srikanthan K, Feyh A, Visweshwar H, et al. SystematicReview of Metabolic Syndrome Biomarkers: A Panel forEarly Detection, Management, and Risk Stratificationin the West Virginian Population. Int J Med Sci. 2016; 13:25-38.

Esser N, Paquot N, Scheen AJ. Inflammatory markers andcardiometabolic diseases. Acta Clin Belg. 2015; 70: 193-9.

Dagistan Y, Dagistan E, Citisli V. Evaluation of simple blood counts as inflammation markers for brain tumor patients.Neurol Neurochir Pol. 2016; 50: 231-5.

Al-Najjar Y, Goode KM, Zhang J, et al. Red cell distributionwidth: an inexpensive and powerful prognostic marker inheart failure. Eur J Heart Fail. 2009; 11: 1155-62.

Cakal B, Akoz AG, Ustundag Y, et al. Red cell distributionwidth for assessment of activity of inflammatory boweldisease. Dig Dis Sci. 2009; 54: 842-7.

Clarke K, Sagunarthy R, Kansal S. RDW as an additionalmarker in inflammatory bowel disease/undifferentiatedcolitis. Dig Dis Sci. 2008; 53: 2521-3.

Hampole CV, Mehrotra AK, Thenappan T, et al. Usefulnessof red cell distribution width as a prognostic marker inpulmonary hypertension. Am J Cardiol. 2009; 104: 868-72.

Lappé JM, Horne BD, Shah SH, et al. Red cell distributionwidth, C-reactive protein, the complete blood count, andmortality in patients with coronary disease and a normalcomparison population. Clin Chim Acta. 2011; 412: 2094-9.

Lee WS, Kim TY. Relation between red blood cell distribu-tion width and inflammatory biomarkers in rheumatoidarthritis. Arch Pathol Lab Med. 2010; 134: 505-6.

Lippi G, Targher G, Montagnana M, et al. Relation between red blood cell distribution width and inflammatory bio-markers in a large cohort of unselected outpatients. ArchPathol Lab Med. 2009; 133: 628-32.

Molnar T, Farkas K, Szepes Z, et al. RDW can be a useful ad-ditional marker in diagnosing Crohn’s disease and ulcer-ative colitis. Dig Dis Sci. 2008; 53: 2828–9.

Patel KV, Semba RD, Ferrucci L, et al. Red cell distributionwidth and mortality in older adults: a meta-analysis. JGerontol A Biol Sci Med Sci. 2010; 65: 258-65.

Pan Y, Muheremu A, Wu X, et al. Relationship betweenplatelet parameters and hepatic pathology in patientswith chronic hepatitis B infection - a retrospective cohortstudy of 677 patients. J Int Med Res. 2016; 44: 779-86.

Matowicka-Karna J. Markers of inflammation, activation of blood platelets and coagulation disorders in inflammato-ry bowel diseases. Postepy Hig Med Dosw (Online). 2016;70: 305-12.

Makhlouf HA, Sadek SH, Nafady AA. Platelet function indiabetic and non-diabetic patients with chronic obstruc-tive pulmonary disease: A case control study. Clin Respir J. 2 016 . d o i : 10 .1111/c r j .12 47 7

Deng Y, Chang C, Lu Q. The Inflammatory Response inPsoriasis: A Comprehensive Review. Clin Rev AllergyImmunol. 2016; 50: 377-89.

Dreiher J, Weitzman D, Davidovici B, et al. Psoriasis anddyslipidaemia: a population-based study. Acta DermVenereol. 2008; 88: 561-5

Farías MM, Serrano V, de la Cruz C. Psoriasis and obe-sity: a review and practical recommendations. ActasDermosifiliogr 2011; 102: 505-9.

Shapiro J, Cohen AD, David M, et al. The association be-tween psoriasis, diabetes mellitus, and atherosclerosis inIsrael: a case-control study. J Am Acad Dermatol. 2007; 56: 629–34.

Späh F. Inflammation in atherosclerosis and psoriasis:common pathogenic mechanisms and the potential foran integrated treatment approach. Br J Dermatol. 2008;159: 2: 10-7.

Ucak S, Ekmekci TR, Basat O, et al. Comparison of variousinsulin sensitivity indices in psoriatic patients and theirrelationship with type of psoriasis. J Eur Acad DermatolVenereol. 2006; 20: 517-22.

De Simone C, Carbone A, Caldarola G. Etanercept thera-py for psoriasis in a patient with numerous comorbidities. Am J Clin Dermatol. 2010; 11: 49–50.

Prens EP, Benne K, van Damme J, et al. Interleukin-1 andinterleukin-6 in psoriasis. J Invest Dermatol. 1990; 95:121S -124S

Fitch E, Harper E, Skorcheva A, et al. Pathophysiology ofpsoriasis: recent advances on IL-23 and Th17 cytokines.Curr Rheumatol Rep. 2007; 9: 461-7.

Ghazizadeh R, Shimizu H, Tosa M, et al. Pathogenic mech-anisms shared between psoriasis and cardiovascular dis-ease. Int J Med Sci. 2010; 7: 284-9.

Gerdes S, Osadtschy S, Rostami-Yazdi M, et al. Leptin, ad-iponectin, visfatin and retinol-binding protein-4 - me-diators of comorbidities in patients with psoriasis? ExpDermatol. 2012; 21: 43-7.

Coimbra S, Oliveira H, Reis F, et al. Circulating levels ofadiponectin, oxidized LDL and C-reactive protein inPortuguese patients with psoriasis vulgaris, according tobody mass index, severity and duration of the disease. JDermatol Sci. 2009; 55(3): 202–4.

Pietrzak A, Kadzielewski J, Janowski K, et al. Lipoprotein(a) in patients with psoriasis: associations with lipid pro-files and disease severity. Int J Dermatol. 2009; 48: 379-87.

Coimbra S, Oliveira H, Reis F, et al. C-reactive protein andleucocyte activation in psoriasis vulgaris according to se-verity and therapy. J Eur Acad Dermatol Venereol. 2010;24: 789-96.

Dogan S, Atakan N. Is serum amyloid A protein a better in-dicator of inflammation in severe psoriasis? Br J Dermatol. 2010; 163: 895–6.

Sategna Guidetti C, Scaglione N, Martini S. Red cell distri-bution width as a marker of coeliac disease: a prospective study. Eur J Gastroenterol Hepatol. 2002; 14: 177–81.

Sánchez-Chaparro MA, Calvo-Bonacho E, González-Quintela A, et al. Higher red blood cell distribution widthis associated with the metabolic syndrome: results of theIbermutuamur Cardiovascular Risk assessment study.Diabetes care 2010; 33: e40.

Bujak K, Wasilewski J, Osadnik T, et al. The Prognostic Role of Red Blood Cell Distribution Width in Coronary ArteryDisease: A Review of the Pathophysiology. Dis Markers.2015; 2015: 824 624 .

Kim DS, Shin D, Jee H, et al. Red blood cell distributionwidth is increased in patients with psoriasis vulgaris: Aretrospective study on 261 patients. J Dermatol. 2015; 42:5 6 7.

Doğan S, Atakan N. Red blood cell distribution width is areliable marker of inflammation in plaque psoriasis. ActaDermatovenerol Croat. 2017; 25: 26-31.

Balevi A, Olmuşçelik O, Ustuner P, et al. Is there anyCorrelation between Red Cell Distribution Width, MeanPlatelet Volume Neutrophil Count, Lymphocyte Count,and Psoriasis Area Severity Index in Patients UnderTreatment for Psoriasis? Acta Dermatovenerol Croat. 2018; 26: 199-205.

Vadakayil AR, Dandekeri S, Kambil SM, et al. Role ofC-reactive protein as a marker of disease severity and car-diovascular risk in patients with psoriasis. Indian Dermatol Online J. 2015; 6: 322-5.

Takahashi H, Iinuma S, Honma M, et al. Increased serumC-reactive protein level in Japanese patients of psoria-sis with cardio- and cerebrovascular disease. J Dermatol.2014; 41: 981-5.

Ni C, Chiu MW. Psoriasis and comorbidities: links and risks. Clin Cosmet Investig Dermatol. 2014; 7: 119-32.

Ferguson LD, Brown R, Celis-Morales C, et al. Associationof central adiposity with psoriasis, psoriatic arthritisand rheumatoid arthritis: a cross-sectional study of theUK Biobank. Rheumatology (Oxford). 2019 May 25 (doi:10.1093/rheumatology/kez192).

Han JH, Lee JH, Han KD, et al. Increased risk of psoria-sis in subjects with abdominal obesity: A nationwidepopulation-based study. J Dermatol. 2019 May 31 (doi:10 .1111/ 13 4 6 - 813 8 .14 9 3 9 ) .

Fleming P, Kraft J, Gulliver WP, et al. The Relationshipof Obesity with the Severity of Psoriasis: A SystematicReview. J Cutan Med Surg. 2015; 19: 450-6.

Coban M, Tasli L, Turgut S, et al. Association of Adipokines, Insulin Resistance, Hypertension and Dyslipidemia inPatients with Psoriasis Vulgaris. Ann Dermatol. 2016; 28:74 - 9.[

Pereira RR, Amladi ST, Varthakavi PK. A study of the prev-alence of diabetes, insulin resistance, lipid abnormalities,and cardiovascular risk factors in patients with chronicplaque psoriasis. Indian J Dermatol. 2011; 56: 520-6.

Kaynak Göster