Investigation of monocyte HDL ratio as an indicator of inflammation and complete blood count parameters in patients with acne vulgaris

Relationships Between Disease Severity and the C-reactive Protein/Albumin Ratio and Various Hematological Parameters in Patients With Acne Vulgaris

OBJECTIVE

Acne vulgaris, an inflammatory disease, was investigated in this study with the claim that the C-reactive protein (CRP)/albumin ratio and some hematological parameter ratios have the potential to be used as inflammatory markers to monitor disease severity and prognosis.

METHODS

A descriptive cross-sectional study was conducted with two groups of patients aged 18-65 years, 61 patients diagnosed with acne vulgaris and 35 healthy control patients, and routine hemogram and biochemical parameters were compared. The Global Acne Severity Index was used to determine the severity of acne vulgaris.

RESULTS

The median age of acne patients was 22.0 (IQR=5.0) and the median age of healthy volunteers was 30.0 (IQR=14.0). There were 75.4% (n=46) women in the acne group and 77.1% (n=27) women in the control group. Among the acne patients, 42.6% (n=26) had mild acne, and 41% (n=25) had moderate acne severity. A significant difference was found between the study groups in terms of CRP/albumin ratio, CRP, monocyte/lymphocyte ratio (MLR), lymphocyte/albumin ratio (LAR), and monocyte/CRP ratio (MCR) according to laboratory test results and calculated test ratios (p<0.05). The area under the curve (AUC) value of the CRP/albumin ratio in the receiver operating characteristic (ROC) analysis between the acne and control groups was 0.660, and its cut-off value was found to be 0.236 with 68.6% sensitivity and 68.9% specificity.

CONCLUSION

This study is the first to compare the CRP/albumin ratio with the severity of acne vulgaris in the literature. CRP/albumin ratio and MCR may serve as inflammatory markers that can be used to monitor the severity of acne vulgaris.

Hematological parameters in patients with acnes

OBJECTIVE

To compare complete blood count (CBC) parameters and inflammatory factors in the patients with different grade of acne vulgaris and healthy controls.

METHODS

A total of 20 patients were enrolled in this study. Patients were divided into mild group and moderate-to-severe group based on the acne severity, and compared to controls. Inflammatory factors (TNF-α, IL-6, IL-8, and IL1-α) detected by ELISA and complete blood count parameters (MPV, NLR, dNLR, PLR, LMR, and SII) obtained by routine blood tests were compared among the three group.

RESULTS

All CBC parameters were not significantly elevated in patients with acne compared to healthy controls. However, the present studies have found that the inflammatory factors in acne patients were significantly elevated relative to healthy controls, and increase with the acne grade.

CONCLUSIONS

Inflammatory factors are convenient parameters to show inflammatory response to acne vulgaris, and may be a new clinical method for judging the acne grades of objectively. Considering the use of antibiotic, we believe that this metric worth further study.

High Neutrophil-to-Lymphocyte Ratio Facilitates Cancer Growth-Currently Marketed Drugs Tadalafil, Isotretinoin, Colchicine, and Omega-3 to Reduce It: The TICO Regimen

Simple Summary

Several elements that are composed of, or related to, neutrophils, have been shown to inhibit strong immune responses to cancer and promote cancers’ growth. This paper presents the collected data showing these elements and how their coordinated actions as an ensemble facilitate growth in the common cancers. The paper goes on to present a drug regimen, TICO, designed to reduce the cancer growth enhancing effects of the neutrophil related elements. TICO uses four already marketed, readily available generic drugs, repurposed to inhibit neutrophil centered growth facilitation of cancer.

Abstract

This paper presents remarkably uniform data showing that higher NLR is a robust prognostic indicator of shorter overall survival across the common metastatic cancers. Myeloid derived suppressor cells, the NLRP3 inflammasome, neutrophil extracellular traps, and absolute neutrophil count tend to all be directly related to the NLR. They, individually and as an ensemble, contribute to cancer growth and metastasis. The multidrug regimen presented in this paper, TICO, was designed to decrease the NLR with potential to also reduce the other neutrophil related elements favoring malignant growth. TICO is comprised of already marketed generic drugs: the phosphodiesterase 5 inhibitor tadalafil, used to treat inadequate erections; isotretinoin, the retinoid used for acne treatment; colchicine, a standard gout (podagra) treatment; and the common fish oil supplement omega-3 polyunsaturated fatty acids. These individually impose low side effect burdens. The drugs of TICO are old, cheap, well known, and available worldwide. They all have evidence of lowering the NLR or the growth contributing elements related to the NLR when clinically used in general medicine as reviewed in this paper.

A Novel Inflammatory Marker in the Follow-up of Moderate-to-Severe Acne Vulgaris Administered Isotretinoin: Systemic Immune-Inflammation Index (SII)

BACKGROUND

Systemic immune-inflammation index (SII) is calculated by multiplying the neutrophil-lymphocyte ratio (NLR) and the platelet count. In this study, we aimed to investigate the difference of SII and other inflammatory markers in patients with acne vulgaris compared to healthy controls and themselves after Oral isotretinoin (ISO) treatment.

MATERIALS AND METHODS

In this study 190 patients with severe acne vulgaris who received at least 3 months of ISO treatment (0.5-1mg/kg/day) and 66 healthy individuals were evaluated. Hemoglobin, neutrophil, lymphocyte, monocyte, and platelet counts, mean platelet volume (MPV), Plateletcrit (PCT), NLR, platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), and SII were analyzed.

RESULTS

Before ISO treatment, patients with moderate-to-severe acne vulgaris had significantly higher neutrophil counts and SII levels than healthy controls (p=0.036, p=0.028; respectively). In the third month of ISO treatment, both neutrophil count and SII level were similar to healthy control (p=0.376, p=0.379; respectively). In the follow-up of patients using ISO, a significant decrease was observed especially in SII levels (p=0.037). Although the lymphocyte count was not significantly different from the control group before treatment, it increased significantly after ISO and was significantly higher than both the control and pretreatment period (p=0.134, P=0.026, p=0.017; respectively). Although NLR was not different from control in the pre- and post-treatment period, the change in neutrophil and lymphocyte counts after treatment caused a statistically significant decrease in NLR (p=0.682, p=0.289, p=0.043; respectively).

CONCLUSIONS

We believe that SII is a more useful parameter as an indicator of the anti-inflammatory effect of isotretinoin.