C˗reaktivni protein je pouzdaniji pokazatelj od inflamacijskih indeksa izvedenih iz krvne slike u predviđanju teških komplikacija kod dece obolele od malih boginja
Sažetak
Uvod/Cilj. Male boginje (MB) su infektivno oboljenje koje u pojedinim slučajevima može dovesti do razvoja ozbiljnih komplkacija opasnih po život. Kao pouzdani pokazatelji kliničkog ishoda u mnogim inflamacijskim bolestima pokazali su se C-reaktivni protein (CRP) i indeksi inflamacije izvedeni iz krvne slike: odnos granulocita i limfocita (GLO), odnos trombocita i limfocita (TLO), odnos monocita i limfocita (MLO), odnos srednje zapremine trombocita (SZT) i broja trombocita (STO), varijacije u veličini u volumenu eritrocita (VVE) i SZT. Cilj rada bio je da se analiziraju vrednosti CRP-a, broja krvnih ćelija, GLO, TLO, MLO, STO, VVE, i SZT kod dece sa MB i uporede sa vrednostima kod zdrave dece, kao i da se ove vrednosti analiziraju i uporede između dece sa lakšim i teškim komplikacijama MB. Poseban cilj rada bio je da se proceni adekvatnost navedenih markera inflamacije za predviđanje težine MB. Metode. Ispitivanu grupu činilo je 55 dece obolele od MB, sa komplikacijama, a kontrolnu grupu činilo je 30 zdrave dece. U daljem istraživanju korišćen je prvi uzorak krvi, uzet prvog dana hospitalizacije (pre lečenja). Rezultati. Broj belih krvnih zrnaca, limfocita, monocita i trombocita bio je značajno niži, dok su vrednosti GLO, TLO, STO i CRP-a bile značajno više kod dece obolele od MB (p ˂ 0,05). Kod dece sa težim komplikacijama MB zabeležene su značajno više vrednosti granulocita, CRP-a, GLO, TLO i niže vrednosti limfocita (p ˂ 0,05). Metodom linearne regresije pokazano je da je vrednost CRP-a bila jedini pouzdan pokazatelj u prognozi nastanka teške forme MB. Zaključak. Broj krvnih ćelija i indeksi inflamacije izvedeni iz krvne slike ne bi trebalo da budu presudni u proceni ozbiljnosti kliničkog toka MB kod dece. CRP je pozdaniji pokazatelj u predviđanju razvoja težeg oblika bolesti kod dece obolele od MB.
Reference
World Health Organization. Measles. [Internet]. [updated 2020 Jan]. Available from: http://www.who.int/imunization/diseases/measles/en/
2. World Health Organization. Measles-European Region. [Inter-net]. [updated 2019 Sept]. Available from: https://www.who.int/csr/don/06-may-2019-measles-euro/en/
3. World Health Organization. Treating measles in children. Geneva: World Health Organization; 2004.
4. Perry RT, Halsey NA. The clinical significance of measles: a re-view. J Infect Dis 2004; 189 (Suppl 1): S4‒16.
5. Laksono BM, de Vries RD, Verburgh RJ, Visser EG, de Jong A, Fraaij PLA, et al. Studies into the mechanism of measles-associated immune suppression during a measles outbreak in the Netherlands. Nat Commun 2018; 9(1):
6. Griffin DE. Measles virus-induced suppression of immune re-sponses. Immunol Rev 2010; 236: 176‒89.
7. Kerdiles YM, Sellin CI, Druelle J, Horvat B. Immunosuppression caused by measles virus: role of viral proteins. Rev Med Virol 2006; 16(1): 49‒63.
8. de Vries RD, de Swart RL. Measles immune suppression: func-tional impairment or numbers game? PLoS Pathog 2014; 10(12): e1004482.
9. Ryon JJ, Moss WJ, Monze M, Griffin DE. Functional and pheno-typic changes in circulating lymphocytes from hospitalized zambian children with measles. Clin Diagn Lab Immunol 2002; 9(5): 994‒1003.
10. Jahandideh B, Derakhshani M, Abbaszadeh H, Akbar Movas-saghpour A, Mehdizadeh A, Talebi M, et al. The pro-inflammatory cytokines effects on mobilization, self-renewal and differentia-tion of hematopoietic stem cells. Hum Immunol 2020; 81(5): 206‒17.
11. Sproston NR, Ashworth JJ. Role of C-Reactive Protein at Sites of Inflammation and Infection. Front Immunol 2018; 9: 754.
12. Qi X, Dong Y, Lin X, Xin W. Value of Neutrophil to Lympho-cyte Ratio, Platelet to Lymphocyte Ratio, and Red Blood Cell Distribution Width in Evaluating the Prognosis of Children with Severe Pneumonia. Evid Based Complement Alternat Med 2021; 2021: 1818469.
13. Kamath S, Blann AD, Lip GY. Platelet activation: assessment and quantification. Eur Heart J 2001; 22(17): 1561‒71.
14. Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean platelet volume (MPV): new per-spectives for an old marker in the course and prognosis of in-flammatory conditions. Mediators Inflamm 2019; 2019: 9213074.
15. Salvagno GL, Sanchis-Gomar F, Picanza A, Lippi G. Red blood cell distribution width: A simple parameter with multiple clini-cal applications. Crit Rev Clin Lab Sci 2015; 52(2): 86‒105.
16. Angkananard T, Anothaisintawee T, McEvoy M, Attia J, Thakkin-stian A. Neutrophil lymphocyte ratio and cardiovascular dis-ease risk: a systematic review and meta-analysis. Biomed Res Int 2018; 2018: 2703518.
17. Bilgin S, Aktas G, Zahid Kocak M, Atak BM, Kurtkulagi O, Du-man TT, et al. Association between novel inflammatory mark-ers derived from hemogram indices and metabolic parameters in type 2 diabetic men. Aging Male 2020; 23(5): 923‒7.
18. Dezayee ZMI, Al-Nimer MSM. The Clinical Importance of Measurement of Hematological Indices in the Breast Cancer Survivals: A Comparison Between Premenopausal and Post-menopausal Women. World J Oncol 2016; 7(1): 1‒4.
19. Dursun A, Ozsoylu S, Akyildiz BN. Neutrophil-to-lymphocyte ratio and mean platelet volume can be useful markers to pre-dict sepsis in children. Pak J Med Sci 2018; 34(4): 918‒22.
20. Can E, Hamilcikan Ş, Can C. The value of neutrophil to lym-phocyte ratio and platelet to lymphocyte ratio for detecting
early-onset neonatal sepsis. J Pediatr Hematol Oncol 2018; 40(4): e229-32.
21. Meshaal MS, Nagi A, Eldamaty A, Elnaggar W, Gaber M, Rizk H. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as independent predictors of out-come in infective endocarditis (IE). Egypt Heart J 2019; 71(1): 13.
22. Li Y, Wang M, Wang W, Feng D, Deng H, Zhang Y, et al. Prog-nostic Value of Neutrophil-to-Lymphocyte Ratio in Predicting Death Risk in Patients with Severe Hand, Foot and Mouth Disease. Ther Clin Risk Manag 2020; 16: 1023‒9.
23. Mathews S, Rajan A, Soans ST. Prognostic value of rise in neu-trophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in predicting the mortality in pediatric intensive care. Int J Contemp Pediatr 2019; 6(3): 1052‒8.
24. Zhang C, Li G, Zhang H, Zhang H, Fei Y. Decreased Lympho-cyte to Monocyte Ratio and Increased Neutrophil to Lympho-cyte Ratio Observed in Rotavirus-Positive Acute Gastroenteri-tis in Children: A Retrospective Study. Ann Clin Lab Sci 2020; 50(4): 450‒6.
25. Liu Z, Li X, Zhang M, Huang X, Bai J, Pan Z, et al. The role of Mean Platelet Volume/platelet count Ratio and Neutrophil to Lymphocyte Ratio on the risk of Febrile Seizure. Sci Rep 2018; 8(1): 15123.
26. Yan JH, Chang LS, Lin YJ, Guo MM, Huang YH, Kuo HC. Clin-ical Characteristics for Differentiating Febrile Children With Suspected Kawasaki Disease Diagnosis. Front Pediatr 2020; 8: 221.
27. Almiş H, Bucak IH, Çelik V, Tekin M, Karakoç F, Konca Ç, et al. Mean platelet volume in hepatitis A. Eur Rev Med Pharmacol Sci 2016; 20(11): 2310‒4.
28. Yukkaldıran A, Erdoğan O, Kaplama ME. Neutro-phil‐lymphocyte and platelet‐lymphocyte ratios in otitis media with effusion in children: Diagnostic role and audiologic corre-lations. Int J Clin Pract 2021; 75(3): e13805.
29. Han SY, Lee IR, Park SJ, Kim JH, Shin JI. Usefulness of neu-trophil-lymphocyte ratio in young children with febrile urinary tract infection. Korean J Pediatr 2016; 59(3): 139‒44.
30. Tekin M, Konca C, Gulyuz A, Uckardes F, Turgut M. Is the mean platelet volume a predictive marker for the diagnosis of acute pyelonephritis in children? Clin Exp Nephrol 2015; 19(4): 688‒93.
31. Solmaz A, Demir A, Gümüş H, Aksoy M, Solmaz F. Neutro-phil/Lymphocyte Ratios, Platelet/Lymphocyte Ratios, and Mean Platelet Volume Values in Patients with Measles. Cureus 2020; 12(1): e6607.
32. Güzelçiçek A, Demir M. Hematological Parameters in Measles. J Pediatr Inf 2021; 15(1): e33‒7.
33. Rosales C, Lowell CA, Schnoor M, Uribe-Querol E. Neutrophils: Their Role in Innate and Adaptive Immunity 2017. J Immunol Res 2017; 2017: 9748345.
34. Helin E, Salmi AA, Vanharanta R, Vainionpää R. Measles virus replication in cells of myelomonocytic lineage is dependent on cellular differentiation stage. Virology 1999; 253(1): 35‒42.
35. de Vries RD, Mesman AW, Geijtenbeek TB, Duprex WP, de Swart RL. The pathogenesis of measles. Curr Opin Virol 2012; 2(3): 248‒55.
36. Jeon JS, Rheem I, Kim JK. C-Reactive Protein and Respiratory Viral Infection. Korean J Clin Lab Sci 2017; 49(1): 15‒21.
37. Slaats J, Ten Oever J, van de Veerdonk FL, Netea MG. IL-1β/IL-6/CRP and IL-18/ferritin: Distinct Inflammatory Programs in Infections. PLoS Pathog 2016; 12(12): e1005973.
38. Griffin DE, Hirsch RL, Johnson RT, De Soriano IL, Roedenbeck S, Vaisberg A. Changes in serum C-reactive protein during com-plicated and uncomplicated measles virus infections. Infect Immun 1983; 41(2): 861‒4.
39. Kim YJ, Kim SY, Kim YY, Kim JW, Lee JH, Han KJ, et al. Quan-tities of receptor molecules for colony stimulating factors on leukocytes in measles. Yonsei Med J 2002; 43(1): 43‒7.
40. Thomas MR, Storey RF. The role of platelets in inflammation. Thromb Haemost 2015; 114(3): 449‒58.
41. Assinger A. Platelets and infection - an emerging role of plate-lets in viral infection. Front Immunol 2014; 5: 649.
42. Garraud O. Platelets as immune cells in physiology and im-munopathology. Front Immunol 2015; 6: 274.
43. Hu ZD. Red blood cell distribution width: a promising index for estimating activity of autoimmune disease. J Lab Precis Med 2016; 1(2): 1‒6.
44. Lippi G, Targher G, Montagnana M, Salvagno GL, Zoppini G, Guidi GC. Relation between red blood cell distribution width and in-flammatory biomarkers in a large cohort of unselected outpa-tients. Arch Pathol Lab Med 2009; 133(4): 628‒32.
45. Jandial A, Kumar S, Bhalla A, Sharma N, Varma N, Varma S. Elevated red cell distribution width as a prognostic marker in severe sepsis: a prospective observational study. Indian J Crit Care Med 2017; 21(9): 552.