Platelet count as a potential predictor in refractory Takayasu arteritis

Springer Science and Business Media LLC - 2023
Xuemei Shi1, Juan Du1, Taotao Li1, Lili Pan1
1Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China

Tóm tắt

Platelet parameters have been recognized as important markers for disease severity in various types of diseases. The aim of our study was to investigate whether platelet count could be used as a potential predictor of refractory Takayasu arteritis (TAK). In this retrospective study, fifty-seven patients were selected as development data group to identify the associated risk factors and potential predictors of refractory TAK. Ninety-two TAK patients were included in the validation data group to verify the predictive value of platelet count for refractory TAK. Refractory TAK patients had higher levels of platelet (PLT) than non-refractory TAK patients (305.5 vs. 272.0 × 109/L, P = 0.043). For PLT, the best cut-off value was 296.5 × 109/L to predict refractory TAK. Elevated PLT (> 296.5 × 109/L) was found to be statistically related to refractory TAK (OR [95%CI] 4.000 [1.233–12.974], p = 0.021). In the validation data group, the proportion of refractory TAK in patients with elevated PLT was significantly higher than that in patients with non-elevated PLT (55.6% vs. 32.2%, P = 0.037). The 1-, 3- and 5-year cumulative incidence of refractory TAK were 37.0%, 44.4% and 55.6% in patients with elevated PLT, respectively. Elevated PLT (p = 0.035, hazard ratio (HR) 2.106) was identified as a potential predictor of refractory TAK. Clinicians should pay close attention to platelet levels in patients with TAK. For TAK patients with PLT greater than 296.5 × 109/L, closer monitoring of the disease and comprehensive assessment of disease activity are recommended to be alert to the occurrence of refractory TAK.

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Tài liệu tham khảo

Abisror N, Mekinian A, Lavigne C et al (2013) Tocilizumab in refractory Takayasu arteritis: a case series and updated literature review. Autoimmun Rev 12:1143–1149

Yun S, Sim E, Goh R, Park J, Han J (2016) Platelet activation: the mechanisms and potential biomarkers. Biomed Res Int 2016:1–5

Iba T, Levy JH (2018) Inflammation and thrombosis: roles of neutrophils, platelets and endothelial cells and their interactions in thrombus formation during sepsis. J Thromb Haemost 16:231–241

Gasparyan AY, Ayvazyan L, Mukanova U, Yessirkepov M, Kitas GD (2019) The platelet-to-lymphocyte ratio as an inflammatory marker in rheumatic diseases. Ann Lab Med 39:345–357

Kaushansky K (2005) The molecular mechanisms that control thrombopoiesis. J Clin Investig 115:3339–3347

Schrottmaier WC, Mussbacher M, Salzmann M, Assinger A (2020) Platelet-leukocyte interplay during vascular disease. Atherosclerosis 307:109–20

Pan L, Du J, Li T, Liao H (2017) Platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio associated with disease activity in patients with Takayasu’s arteritis: a case-control study. BMJ Open 7:e14451

Wang X, Dang A, Lv N, Cheng N, Cheng X (2017) Inflammation is associated with platelet coagulation function rather than enzymatic coagulation function in patients with Takayasu arteritis. Int Heart J 58:589–592

Chen R, Ma L, Lv P et al (2021) Serum complement 3 is a potential biomarker for assessing disease activity in Takayasu arteritis. Arthritis Res Ther 23:63

Seringec Akkececi N, Yildirim Cetin G, Gogebakan H, Acipayam C (2019) The C-reactive protein/albumin ratio and complete blood count parameters as indicators of disease activity in patients with takayasu arteritis. Med Sci Monitor 25:1401–1409

Arend WP, Michel BA, Bloch DA et al (1990) The American college of rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum 33:1129–1134

Hata A, Noda M, Moriwaki R, Numano F (1996) Angiographic findings of Takayasu arteritis: new classification. Int J Cardiol 54:S155–S163

Gail Kerr MMS, Hallahan CWM, Joseph Giordano M et al (1994) Takayasu arteritis. Ann Intern Med 120:919–29

Misra R, Danda D, Rajappa SM et al (2013) Development and initial validation of the Indi (ITAS2010). Rheumatology 52:1795–1801

Misra R, Misra D, Danda D, Lawrence A, Bacon P (2013) ITAS.a suggests persistent disease activity in Takayasu aorto-arteritis (TA) after induction therapy. La Presse Méd 42:729–30

Hellmich B, Agueda A, Monti S et al (2019) 2018 Update of the EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis 79:19–30

Jiang L, Li D, Yan F, Dai X, Li Y, Ma L (2012) Evaluation of Takayasu arteritis activity by delayed contrast-enhanced magnetic resonance imaging. Int J Cardiol 155:262–267

Watanabe T, Kishi Y, Numano F, Isobe M (2001) Enhanced platelet sensitivity to prostacyclin in patients in an active stage of Takayasu arteritis. Thromb Res 104:77–83

El-Dairi MA, MLCM, Thomas J. Cummings MSSS (2015) Diagnostic algorithm for patients with suspected giant cell arteritis. J Neuro-Ophthalmol 35:246–53

Oh LJ, Wong E, Andrici J, McCluskey P, Smith JEH, Gill AJ (2018) Full blood count as an ancillary test to support the diagnosis of giant cell arteritis. Intern Med J 48:408–413

Bornstein G, Barshack I, Koren-Morag N, Ben-Zvi I, Furie N, Grossman C (2018) Negative temporal artery biopsy: predictive factors for giant cell arteritis diagnosis and alternate diagnoses of patients without arteritis. Clin Rheumatol 37:2819–2824

Walvick MD, Walvick MP (2011) Giant cell arteritis: laboratory predictors of a positive temporal artery biopsy. Ophthalmology 118:1201–1204

Zha Q, He Y, Lu Y, Lu A (2006) Relationship between platelet counts and cartilage erosion in 436 cases of rheumatoid arthritis. Clin Chim Acta 371:194–195

Maric LS, Knezovic I, Papic N et al (2015) Risk factors for coronary artery abnormalities in children with Kawasaki disease: a 10-year experience. Rheumatol Int 35:1053–1058

Chantasiriwan N, Silvilairat S, Makonkawkeyoon K, Pongprot Y, Sittiwangkul R (2018) Predictors of intravenous immunoglobulin resistance and coronary artery aneurysm in patients with Kawasaki disease. Paediatr Int Child H 38:209–212

Elmas AT, Tabel Y (2016) Platelet counts in children with henoch-schonlein purpura-relationship to renal involvement. J Clin Lab Anal 30:71–74

Margraf A, Zarbock A (2019) Platelets in inflammation and resolution. J Immunol 203:2357–2367

Lupia E, Goffi A, Bosco O, Montrucchio G (2012) Thrombopoietin as biomarker and mediator of cardiovascular damage in critical diseases. Mediat Inflamm 2012:1–12

Ramirez GA, Manfredi AA, Maugeri N (2019) Misunderstandings between platelets and neutrophils build in chronic inflammation. Front Immunol 10:2491

Liu O, Jia L, Liu X et al (2012) Clopidogrel, a platelet P2Y12 receptor inhibitor, reduces vascular inflammation and angiotensin II induced-abdominal aortic aneurysm progression. PLoS ONE 7:e51707

von Hundelshausen P, Schmitt MMN (2014) Platelets and their chemokines in atherosclerosis—clinical applications. Front Physiol 5:294

Hu H, Zhu L, Huang Z et al (2010) Platelets enhance lymphocyte adhesion and infiltration into arterial thrombus. Thromb Haemost 104:1184

Li N (2013) CD4+ T cells in atherosclerosis: regulation by platelets. Thromb Haemost 109:980

Rossaint J, Margraf A, Zarbock A (2018) Role of platelets in leukocyte recruitment and resolution of inflammation. Front Immunol 9:2712

Khandoga A, Hanschen M, Kessler JS, Krombach F (2006) CD4+ T cells contribute to postischemic liver injury in mice by interacting with sinusoidal endothelium and platelets. Hepatology 43:306–315

Bergmann CB, Hefele F, Unger M et al (2016) Platelets modulate the immune response following trauma by interaction with CD4+ T regulatory cells in a mouse model. Immunol Res 64:508–517

Gerdes N, Zhu L, Ersoy M et al (2011) Platelets regulate CD4(+) T-cell differentiation via multiple chemokines in humans. Thromb Haemost 106:353–362

Akinosoglou K, Alexopoulos D (2014) Use of antiplatelet agents in sepsis: a glimpse into the future. Thromb Res 133:131–138

de Souza AWS, Machado NP, Pereira VM et al (2010) Antiplatelet therapy for the prevention of arterial ischemic events in Takayasu arteritis. Circ J 74:1236–1241

Ueno M (2010) Antiplatelet therapy in the treatment of Takayasu arteritis. Circ J 74:1079–1080

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