Background and aims

Behçet’s disease (BD) is an auto-immune vasculitis, characterized by episodic inflammation of multiple organs. The neutrophil to lymphocyte ratio (NLR) is used as a marker of inflammation in several diseases nowadays. While nitric oxide (NO) seem to be involved in BD pathogenicity. Our study aims to investigate the NLR as an inflammatory marker of BD activity as well as to evaluate the relationship between the NO production and NLR in Algerian BD patients with different clinical manifestations before and under colchicine + corticosteroid treatment.

Methods

For this purpose, we evaluated the NLR as the ratio of neutrophil count to lymphocyte count in naïve and treated active BD patients with different clinical manifestations and in inactive ones. Furthermore, we assessed NO production by the Griess’ method in the same patients. Additionally, we evaluated in vivo interferon-γ (IFN-γ) and interleukin-4 (IL-4) levels using ELISA.

Results and discussion

Our results indicate that the NLR and nitrite levels were higher in naïve active BD patients. Interestingly, this high ratio and NO production differed according to the clinical manifestations and was associated with an increased risk of mucocutaneous and vascular involvement. Importantly, in treated BD patients NLR was higher in active patients especially in those with mucocutaneous involvement while increased nitrites levels were regardless of the clinical manifestations studied. Both NLR and NO production decreased in these treated active patients. In addition, IL-4 production differed according to the clinical manifestations studied contrary to the IFN-γ production.

Conclusion

Collectively our results suggest that the NLR is a potential marker of BD activity in Algerian patients, predicting the disease severity. Moreover, the positive relationship between the NLR and NO production is related to an increased risk of mucocutaneous lesions and vascular involvement. Thus, the application of these two accessible tools could be benefit for the clinical prognosis and treatment of BD.

中文翻译：

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秋水仙碱-糖皮质激素联合治疗对中性粒细胞/淋巴细胞比率的影响：Behçet疾病活动的预测指标。

背景和目标

白塞氏病（BD）是一种自身免疫性血管炎，其特征是多个器官的发作性炎症。嗜中性白细胞与淋巴细胞的比率（NLR）被用作当今几种疾病中炎症的标志物。一氧化氮（NO）似乎与BD的致病性有关。我们的研究旨在调查NLR作为BD活动的炎症指标，并评估秋水仙碱+皮质类固醇治疗前后不同临床表现的阿尔及利亚BD患者NO产生与NLR之间的关系。

方法

为了这个目的，我们评估了NLR为在不同临床表现和非活动表现的未治疗和治疗的活跃BD患者中嗜中性粒细胞计数与淋巴细胞计数的比率。此外，我们通过Griess方法评估了同一患者的NO生成量。此外，我们使用ELISA评估了体内干扰素-γ（IFN-γ）和白介素4（IL-4）的水平。

结果和讨论

我们的结果表明，初次活动的BD患者的NLR和亚硝酸盐水平较高。有趣的是，这种高比例和NO的产生根据临床表现而有所不同，并且与皮肤粘膜和血管受累的风险增加有关。重要的是，在接受治疗的BD患者中，活跃患者的NLR较高，尤其是在有皮肤粘膜受累的患者中，而亚硝酸盐水平升高与所研究的临床表现无关。在这些接受治疗的活跃患者中，NLR和NO生成均降低。另外，根据研究的临床表现，IL-4产生与IFN-γ产生相反。

结论

总体而言，我们的结果表明，NLR是阿尔及利亚患者BD活动的潜在标志，可预测疾病的严重程度。此外，NLR和NO产生之间的正相关与粘膜皮肤病变和血管受累的风险增加有关。因此，这两个可访问的工具的应用可能有益于BD的临床预后和治疗。