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Association Between Systemic Inflammatory Response Biomarkers and Disease Activity in Systemic Lupus Erythematosus: A
Tao Ma1, Jiale Zhang1, Jie Kong1
1Department of Rheumatology and Immunology, Affiliated Nantong Clinical College of Nantong University, Nantong First People's Hospital, Nantong 226001, China.
Routine complete blood count (CBC)-derived inflammatory biomarkers like monocyte-to-lymphocyte ratio (MLR) and systemic inflammation response index (SIRI) correlate with systemic lupus erythematosus (SLE) disease activity and neuropsychiatric risk. These accessible markers can aid in rapid clinical assessment for SLE patients.
Area of Science:
- Rheumatology and Immunology
- Hematology
- Clinical Diagnostics
Background:
- Systemic lupus erythematosus (SLE) is a complex autoimmune disease characterized by systemic inflammation.
- Assessing SLE disease activity and neuropsychiatric (NP) involvement often requires specialized tools.
- Routine complete blood count (CBC) parameters can be used to derive inflammatory biomarkers.
Purpose of the Study:
- To evaluate the association of CBC-derived inflammatory biomarkers—neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammation response index (SIRI)—with SLE disease activity.
- To explore the utility of these biomarkers in risk stratification for neuropsychiatric lupus erythematosus (NPSLE).
Main Methods:
- A multi-center retrospective study involving 579 SLE patients and 282 healthy controls (HCs).
- Calculation of NLR, MLR, PLR, and SIRI from routine CBC parameters.
- Assessment of disease activity using the SLE Disease Activity Index 2000 (SLEDAI-2K); NPSLE status was determined from available neuropsychiatric data.
Main Results:
- SLE patients showed significantly higher levels of SIRI, NLR, PLR, and MLR compared to HCs.
- MLR, NLR, PLR, and SIRI were positively associated with SLEDAI-2K scores; MLR demonstrated a significant association with higher SLEDAI-2K in multivariable analysis.
- MLR, NLR, and SIRI were elevated in patients with NPSLE compared to non-NPSLE patients; SIRI showed modest discriminatory ability for NPSLE risk stratification.
Conclusions:
- Routine CBC-derived inflammatory biomarkers, particularly MLR, NLR, and SIRI, are associated with SLE disease activity.
- These biomarkers may serve as accessible, low-cost adjunctive tools for rapid clinical assessment and NPSLE risk stratification.
- Further prospective studies are needed to validate their clinical utility as complementary tools, not replacements for established indices.