Neutrophil- and platelet-to-lymphocyte ratios (NLR&PLR) and their relation with disease activity in rheumatoid arthritis patients

Abstract

RA is the most common chronic inflammatory arthritis and is associated with progressive destruction of synovial joints and physical disability. It is a polygenic disease characterized by autoimmunity and systemic inflammation with progressive impairment of the joints, resulting in lifelong disability and increased mortality. The disease is usually assessed at baseline and during the treatment follow-up period based on the DAS_28 score. The DAS_28 is calculated based on the number of painful joints, the number of swollen joints, VAS, CRP levels and/or ESR. Elements of the immune system play a significant role in the assessment of various autoimmune and inflammatory diseases. Among the immune system elements, neutrophils, lymphocytes and platelets have been reported to play a role in the control of inflammation and are also associated with alterations in secondary to inflammation. Alterations in circulating blood cells usually accompany systemic inflammation as normochromic anemia, thrombocytosis, lymhopenia with elevated neutrophil count. Hence, components of circulating blood cells could be used for the evaluation of inflammatory activity.