Value of hematological indices versus VEGF as biomarkers of activity in Behçet's disease

The aim of this study is to investigate the value of several hematological indices, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), red blood cell distribution width (RDW), and mean platelet volume (MPV), versus vascular endothelial growth factor (VEGF) as biomarkers of activity in Behçet's disease (BD).

This study included 96 adult BD patients recruited from the Rheumatology Outpatient Clinic, Kasr Al-Ainy Hospital, Cairo University, and 60 healthy subjects as controls. Assessment of BD activity was done using the Behçet's Disease Current Activity Form (BDCAF). The CBC was measured by COULTER LH 750 assay analyzer with special consideration to the NLR, PLR, MPV, and RDW. Serum VEGF level was measured by enzyme-linked immunosorbent assay (ELISA) technique.

The NLR, RDW, and PLR were significantly higher in BD patients when compared with healthy controls (p = 0.011, < 0.001, < 0.001, respectively), while there was no statistical difference in MPV or VEGF between patients and controls (p = 0.82, 0.46). NLR and PLR were significantly higher in BD patients with vascular activity (p = 0.03, 0.01). RDW was significantly higher, while MPV was significantly lower in patients with vascular manifestations (p = 0.04, 0.004). NLR and PLR were the most valuable predictors of vascular activity (p = 0.033, 0.018). PLR was more powerful as a predictor of vascular activity, but it had a lower specificity than NLR.

The NLR, PLR, and RDW are significantly higher in BD patients, suggesting their value as promising inflammatory biomarkers in BD. NLR and PLR are the most valuable predictors of vascular activity, while RDW and MPV were not valuable predictors of BD activity, rather implicated in the ongoing vascular inflammatory process in BD. The VEGF was neither a surrogate biomarker of BD activity nor reflecting the ongoing inflammatory process in BD.