2025, Number 3
<< Back Next >>
Rev Nefrol Dial Traspl 2025; 45 (3)
Predictive value of systemic immune inflammation index for the inflammatory status and prognosis in patients with antineutrophil cytoplasmic antibody associated vasculitis
Baran E, Ozdemir A, Yilmaz M
Language: English
References: 23
Page: 130-138
PDF size: 583.90 Kb.
ABSTRACT
Introduction: The systemic
immune-inflammation index (SII)
has been explored in a few studies involving
patients with antineutrophil cytoplasmic antibody
(ANCA)-associated vasculitis (AAV), yielding
conflicting results.
Objectives:We aimed to
evaluate the role of SII in differentiating and
predicting the inflammatory status and prognosis
of AAV patients.
Materials and methods:This
study included 39 AAV patients diagnosed
through renal biopsy and 39 age- and sex-matched
healthy controls. Patients were divided into
subgroups based on ANCA positivity and
glomerular filtration rate (GFR) at the time of
diagnosis. They were followed up until death,
progression to end-stage renal disease (ESRD), or
outcome. SII, platelet lymphocyte ratio (PLR),
and neutrophil-lymphocyte ratio (NLR) were
calculated. Receiver operating characteristic
curve (ROC) analysis was used to evaluate the
diagnostic value of SII. Spearman’s correlation
analysis was used to examine the relationship
between NLR, PLR, SII, and inflammatory
status.
Results: All indices were significantly
higher in the patient group (p‹0.05). Regarding
the area under the curve (AUC) values: SII was
0.904 (p=0.001); NLR was 0.940 (p=0.001), and
PLR was 0.757 (p=0.001). While ANCA-positive
patients had higher levels of SII compared to
ANCA-negative patients, we found no difference
between the patients with different eGFR levels
and among outcome groups. Moreover,
Spearman’s analysis showed no correlation
between SII and C-reactive protein (CRP), CRP/
albumin, and the percentage of the
crescent.
Conclusion: SII and NLR appear to be
valuable markers for predicting AAV.
Unfortunately, SII failed to demonstrate any
correlation with inflammatory status or prognosis.
Further prospective studies on this subject will
contribute to this area of research.
REFERENCES
Fonseca JA, Gameiro J, Duarte I, Jorge S,Lopes JA. The neutrophil-to-lymphocyte ratioas a marker of vasculitis activity, severeinfection, and mortality in ANCA-associatedvasculitis: A retrospective study. Nefrologia(Engl Ed). 2021;41(3):321-328.
Přikryl P, Hrušková Z, Konopásek P,Hladinová Z, Tesař V, Vokurka M. Serumhepcidin is increased in ANCA-associatedvasculitis and correlates with activity markers.Physiol Res. 2018;67(6):945-954.
Lyons PA, Rayner TF, Trivedi S, Holle JU,Watts RA, Jayne DRW. Genetically distinctsubsets within ANCA-associated vasculitis. NEngl J Med. 2012;367(3):214-223.
Lionaki S, Blyth ER, Hogan SL, Hu Y, SeniorBA, Jennette CE. Classification ofantineutrophil cytoplasmic autoantibodyvasculitides: the role of antineutrophilcytoplasmic autoantibody specificity formyeloperoxidase or proteinase 3 in diseaserecognition and prognosis. Arthritis Rheum.2012;64(10):3452-3462.
Jennette JC. Overview of the 2012 revisedInternational Chapel Hill ConsensusConference nomenclature of vasculitides.Clinical and experimental nephrology.2013;17(5):603-606.
Goodnow CC. Multistep pathogenesis ofautoimmune disease. Cell. 2007;130(1):25-35.
Hutton HL, Alikhan MA, Kitching AR.Inflammasomes in the Kidney. Exp Suppl.2018; 108:177-210.
Hutton HL, Holdsworth SR, Kitching AR.ANCA-Associated Vasculitis: Pathogenesis,Models, and Preclinical Testing. SeminNephrol. 2017;37(5):418-435.
Hu B, Yang XR, Xu Y, Sun YF, Sun C, GuoW. Systemic immune-inflammation indexpredicts prognosis of patients after curativeresection for hepatocellular carcinoma. ClinCancer Res. 2014;20(23):6212-6222.
Yan Q, Ertao Z, Zhimei Z, Weigang D,Jianjun P, Jianhui C. Systemic immuneinflammationindex (SII): A More PromisingInflammation-Based Prognostic Marker forPatients with synchronic colorectal peritonealcarcinomatosis. J Cancer. 2020;11(18):5264-5272.
Chen JB, Tang R, Zhong Y, Zhou YO, Zuo X,Luo H. Systemic immune-inflammation indexpredicts a reduced risk of end-stage renaldisease in Chinese patients withmyeloperoxidase-anti-neutrophil cytoplasmicantibody-associated vasculitis: A retrospectiveobservational study. Exp Ther Med.2021;22(3):989.
Ahn SS, Jung SM, Song JJ, Park YB, LeeSW. The neutrophil-to-lymphocyte ratio atdiagnosis can estimate vasculitis activity andpredict a poor prognosis in patients withANCA-associated vasculitis: a retrospectivestudy. BMC Nephrol. 2018;19(1):187.
Meeusen JW, Kasozi RN, Larson TS, LieskeJC. Clinical Impact of the Refit CKD-EPI2021 Creatinine-Based eGFR Equation.Clinical chemistry. 2021;68(4):534–539.
Nakazawa D, Shida H, Kusunoki Y, MiyoshiA, Nishio S, Tomaru U. The responses ofmacrophages in interaction with neutrophilsthat undergo NETosis. J Autoimmun. 2016;67:19-28.
Xiao H, Heeringa P, Liu Z, Huugen D, Hu P,Maeda N. The role of neutrophils in theinduction of glomerulonephritis by antimyeloperoxidase antibodies. Am J Pathol.2005;167(1):39-45.
Moon JS, Ahn SS, Park YB, Lee SK, LeeSW. C-Reactive Protein to Serum AlbuminRatio Is an Independent Predictor of All-Cause Mortality in Patients with ANCAAssociatedVasculitis. Yonsei Med J.2018;59(7):865-871.
Willeke P, Kümpers P, Schlüter B, Limani A,Becker H, Schotte H. Platelet counts as abiomarker in ANCA-associated vasculitis.Scand J Rheumatol. 2015;44(4):302-308.
Huang L, Shen C, Zhong Y, Ooi JD, ZhouYO, Chen JB. The association of neutrophilto-lymphocyte ratio with all-cause mortalityin Chinese patients with MPO-ANCAassociatedvasculitis. Clin Exp Med.2020;20(3):401-408.
Park HJ, Jung SM, Song JJ, Park YB, LeeSW. Platelet to lymphocyte ratio is associatedwith the current activity of ANCA-associatedvasculitis at diagnosis: a retrospectivemonocentric study. Rheumatol Int. 2018;38(10):1865-1871.
Gündüz OS, Toraman A. Prognostic Value ofHematological Parameters in Anti-NeutrophilCytoplasmic Antibody-Associated Vasculitis.Celal Bayar Üniversitesi Sağlık BilimleriEnstitüsü Dergisi. 2022;9 (1):143-150.
Ozdemir A, Baran E, Kutu M, Celik S,Yılmaz M. Could systemic immuneinflammation index be a new parameter fordiagnosis and disease activity assessment insystemic lupus erythematosus. Int UrolNephrol. 2023;55(1):211-216.
Kim Y, Choi H, Jung SM, Song JJ, Park YB,Lee SW. The systemic immune-inflammationindex can estimate the cross-sectional highactivity and poor outcomes inimmunosuppressive drug-naďve patients withantineutrophil cytoplasmic antibodyassociatedvasculitis. Nephrology (Carlton).2019;24(7):711-717.
Wang R, An D, Wu Y, Ma P, Guo Y, Tang L.Clinicopathological characteristics andoutcomes of antineutrophil cytoplasmicautoantibody-related renal vasculitis withhyperuricemia: a retrospective case-control.Rep. 2021;11(1):2002.