Clinical Significance of Immature Neutrophils in Relation to Disease Activity in Psoriatic Arthritis Patients

Abstract

Background: Psoriatic arthritis (PsA) is a complex type of progressive inflammatory arthritis associated with psoriasis. Prevalence of PsA has been reported 5.8–40.9% among patients suffering from psoriasis. A recent meta-analysis indicated that there is no gender predilection in patients with PsA. It shares genetic and clinical features with other forms of spondyloarthritis and affects different structures of the musculoskeletal system in addition to the skin and the nail. Neutrophils are crucial responders of the innate immune response, but the role played by neutrophils in psoriasis has not been well characterized. This thesis discussed the current understanding of the role and potential mechanisms of immature neutrophils in psoriatic arthritis. Objective: To study the relation between immature neutrophils in blood and disease activity in psoriatic arthritis patients. Methods: This randomized control trial, done on 50 PsA patients from Physical medicine, Rheumatology and Rehabilitation and Dermatology outpatient clinics of Ain Shams University hospital, included by CASPAR criteria, subjected to full medical history taking and thorough clinical examination with calculation of SPARCC,ASDAS and PASI scores.laboratory evaluation include CBC with differential white blood cell count for Immature Neutrophils percentage,ESR,CRP and Rheumatoid factor.CBC was compared with 20 age and sex matched healthy controls. Results: The Immature Neutrophils mean ± SD(%) was found to be 5.99±1.57 in patients and was statistically significantly higher in them than in controls 2.25±1.16(P<0.037) and it was statistically significantly correlated with disease activity according to ASDAS score, SPARCC,PASI score ,ESR,CRP,RBCS,WBCS,Platelets,Enthesitis,Dactylitis ,skin and nail affection . Conclusion: This study highlighted the role of immature neutrophils as a novel biomarker for disease activity in psoriatic arthritis.