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Search Results (1,427)

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13 pages, 1233 KB  
Article
The Clinical Role of Systemic Inflammation-Based Biomarkers in Predicting Mortality in Post-Pneumonectomy Bronchopleural Fistula: A Multicenter Retrospective Analysis
by Omer Topaloglu, Kubra Nur Kilic, Sami Karapolat, Elvan Senturk Topaloglu, Atila Turkyilmaz, Buket Kaytaz Alkas, Aziz Gumus, Hasan Turut and Celal Tekinbas
Diagnostics 2025, 15(22), 2902; https://doi.org/10.3390/diagnostics15222902 (registering DOI) - 16 Nov 2025
Abstract
Background: Post-pneumonectomy bronchopleural fistula (PPBPF), although infrequent, represents one of the most devastating complications after pneumonectomy, carrying high morbidity and mortality. Accurate risk stratification is essential for timely management. Systemic inflammation-based hematologic indices—such as neutrophil-to-lymphocyte ratio (NLR), C-reactive protein/albumin ratio (CAR), systemic inflammation [...] Read more.
Background: Post-pneumonectomy bronchopleural fistula (PPBPF), although infrequent, represents one of the most devastating complications after pneumonectomy, carrying high morbidity and mortality. Accurate risk stratification is essential for timely management. Systemic inflammation-based hematologic indices—such as neutrophil-to-lymphocyte ratio (NLR), C-reactive protein/albumin ratio (CAR), systemic inflammation response index (SIRI), systemic immune-inflammation index (SIII), prognostic immune-inflammation index (PIII), and platelet-to-lymphocyte ratio (PLR)—serve as accessible, low-cost biomarkers reflecting host immune status and inflammatory burden. This study aimed to evaluate their association with mortality risk in patients with PPBPF. Methods: A multicenter retrospective cohort of 33 PPBPF patients (2014–2023) was analyzed. Demographic, clinical, and laboratory data at diagnosis were retrieved. Inflammatory indices were calculated from hematologic parameters. Associations with mortality were assessed using receiver operating characteristic (ROC) curves and univariate logistic regression. Post hoc power analyses were performed for key biomarkers. Results: Nine patients (27.3%) died during follow-up. Non-survivors had significantly higher levels of all biomarkers (p < 0.05). ROC analysis identified NLR as the most powerful discriminatory marker (AUC: 0.862), while SIII, SIRI, and CAR also demonstrated high accuracy (AUC > 0.83). Optimal thresholds of NLR ≥ 12 and CAR ≥ 10 yielded 88.9% sensitivity, >80% specificity, and excellent negative predictive values (NLR: 94.4%; CAR: 94.7%). Post hoc power analysis demonstrated robust statistical power for SIRI (94.9%), CAR (87.2%), and SIII (84.5%). Conclusions: Systemic inflammation-based biomarkers, particularly NLR and CAR, show strong associations with mortality in PPBPF. Incorporating these indices into clinical practice may help identify patients at increased risk and facilitate tailored surveillance and management strategies. Full article
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16 pages, 1370 KB  
Article
Evaluation of Immune Response Dynamics: Analyzing the Parameters of Complete Blood Count (CBC) in Experimental Borreliosis
by Diana Mihaela Alexandru, Diana Larisa Ancuţa and Cristin Coman
Life 2025, 15(11), 1758; https://doi.org/10.3390/life15111758 (registering DOI) - 16 Nov 2025
Abstract
The spirochete Borrelia is responsible for Lyme disease, a multisystemic infection and growing public health concern. This study aimed to evaluate host response dynamics to Borrelia bavariensis by analyzing hematological parameters as potential immuno-inflammatory markers in a murine model. Forty C3He/HeNCrl mice were [...] Read more.
The spirochete Borrelia is responsible for Lyme disease, a multisystemic infection and growing public health concern. This study aimed to evaluate host response dynamics to Borrelia bavariensis by analyzing hematological parameters as potential immuno-inflammatory markers in a murine model. Forty C3He/HeNCrl mice were inoculated intradermally with B. bavariensis (5 × 105 spirochetes/100 µL/mouse) and monitored for 90 days. Samples were collected at defined intervals for microbiological examination, hematology, and qPCR. Microbiological and qPCR testing revealed infection between days 7–21; results were negative on days 28–42. At later stages (days 60 and 90), Borrelia was only detectable by qPCR, highlighting differences in diagnostic sensitivity. Hematological analysis showed that the neutrophil-to-lymphocyte ratio (NLR) and systemic immuno-inflammatory index (SII) peaked on day 7 (p < 0.0001), followed by gradual normalization until day 35. These markers reflected the intensity of the inflammatory response and defined three distinct phases of host reaction. Overall, results demonstrate the complexity of immune responses in B. bavariensis infection and underscore the value of monitoring hematological indices for understanding host–pathogen interactions. This approach supports the potential use of simple blood markers in diagnostic strategies with translational relevance for clinical practice. Full article
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20 pages, 848 KB  
Article
The COX Pathway Alters Hematopoiesis in Hashimoto’s Thyroiditis
by Karolina Wrońska, Maciej Ziętek, Magdalena Marciniak and Małgorzata Szczuko
Cells 2025, 14(22), 1796; https://doi.org/10.3390/cells14221796 (registering DOI) - 15 Nov 2025
Abstract
Introduction: There is limited data in the literature on the effect of prostaglandins (PG) and thromboxanes (TX) on the development and severity of Hashimoto’s Thyroiditis (HT). This article aimed to analyze the association between blood count and the cyclooxygenase (COX) pathway in 39 [...] Read more.
Introduction: There is limited data in the literature on the effect of prostaglandins (PG) and thromboxanes (TX) on the development and severity of Hashimoto’s Thyroiditis (HT). This article aimed to analyze the association between blood count and the cyclooxygenase (COX) pathway in 39 women with HT. Methods: Biochemical analysis of PGE2 and TXB2 was performed using liquid chromatography (HPLC). Results: Morphological abnormalities were found in the women studied, particularly with regard to white blood cell parameters. An increase in thyroid-stimulating hormone (TSH) was associated with significantly higher levels of monocytes (p = 0.041). Correlations were also noted between the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) with TXB2 and PGE2. Furthermore, a very strong correlation was demonstrated for the first time between antibodies against tissue transglutaminase (anti-tTG) and antibodies against thyroglobulin (ATG) (r = 0.781; p = 0.007). Correlations between blood count and eicosanoids were also demonstrated. Conclusions: The results suggest the involvement of COX products in the pathogenesis of HT and hematopoiesis; therefore, this study may contribute not only to advancing knowledge, but also to developing new guidelines for diagnosing and treating autoimmune diseases. Full article
(This article belongs to the Special Issue The Role of T Cells and Cellular Signalling in Immune Diseases)
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11 pages, 938 KB  
Article
Clinical Severity and Systemic Inflammatory Indices as Predictors of In-Hospital Mortality After Limb Amputation a Retrospective Cohort Study
by Alim Namitokov, Tarlan Bakhishev, Roman Vinogradov, Aslan Zakeryaev, Sultan Butaev, Eldar Urakov, Gerey Khangereev, Leonid Sakhno, Marina Pchegatluk and Dmitri Ignatenko
J. Clin. Med. 2025, 14(22), 8063; https://doi.org/10.3390/jcm14228063 - 14 Nov 2025
Viewed by 104
Abstract
Background/Objectives: Major limb amputation is associated with high short-term mortality, yet practical preoperative risk models remain limited. This study aimed to identify easily obtainable preoperative predictors of in-hospital mortality after limb amputation and to develop a compact predictive model. Methods: We [...] Read more.
Background/Objectives: Major limb amputation is associated with high short-term mortality, yet practical preoperative risk models remain limited. This study aimed to identify easily obtainable preoperative predictors of in-hospital mortality after limb amputation and to develop a compact predictive model. Methods: We retrospectively analyzed 184 adult patients undergoing major or minor limb amputation between January 2021 and July 2025 at a tertiary referral hospital. Preoperative variables included demographics, comorbidities, urgency of surgery, hemoglobin, and complete blood count-derived inflammatory indices: neutrophil-to-lymphocyte ratio (NLR), systemic inflammatory response index (SIRI), and monocyte-to-lymphocyte ratio (MLR). The primary outcome was in-hospital mortality. Multivariable logistic regression was used to construct a compact preoperative model. Model performance was assessed by area under the receiver operating characteristic curve (AUC) and calibration plots. Results: In-hospital mortality occurred in 36 patients (19.6%). Independent predictors in the multivariable model were emergency surgery (OR 4.39, 95% CI 1.83–10.55), age (per 1 SD; OR 1.73, 95% CI 1.16–2.59), SIRI (per 1 SD; OR 1.77, 95% CI 1.19–2.65), and hemoglobin (per 1 SD decrease; OR 0.63, 95% CI 0.43–0.91). The model demonstrated good discrimination (AUC = 0.80) and acceptable calibration. Although not included in the model, intensive care unit and total hospital length of stay were higher among non-survivors. Conclusions: A compact preoperative model incorporating age, urgency of surgery, hemoglobin, and SIRI provides reliable risk stratification for in-hospital mortality after limb amputation. These variables are readily available before surgery, making the model practical for bedside clinical use. Prospective multicenter validation is warranted. Full article
(This article belongs to the Section General Surgery)
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23 pages, 11782 KB  
Systematic Review
Evaluating Immune-Inflammatory Indices for Risk Stratification in Cardiovascular Disease: An Umbrella Review of Systematic Reviews and Meta-Analyses
by Hanxin Liu, Pingwu Wang, Lik Hang Wu, Fan Wu, Xinya Zhou, Yuhan Li, Hui Su, Jiayi Zang, Xinchen Ji, Xueling Xiao, Ya-Ke Wu, Leroy Sivappiragasam Pakkiri and Chester Lee Drum
Diagnostics 2025, 15(22), 2862; https://doi.org/10.3390/diagnostics15222862 - 12 Nov 2025
Viewed by 272
Abstract
Background/Objectives: Although systematic reviews and meta-analyses have examined immune-inflammatory indices in cardiovascular disease (CVD), the evidence remains scattered and inconsistent. This umbrella review aims to synthesize findings and evaluate the overall predictive value of these indices for clinical outcomes. Methods: We systematically [...] Read more.
Background/Objectives: Although systematic reviews and meta-analyses have examined immune-inflammatory indices in cardiovascular disease (CVD), the evidence remains scattered and inconsistent. This umbrella review aims to synthesize findings and evaluate the overall predictive value of these indices for clinical outcomes. Methods: We systematically searched PubMed, Cochrane Library, Web of Science, Embase, Scopus, and Medline for systematic reviews with meta-analyses assessing neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR), and systemic inflammation response index (SIRI) in patients with CVD. Study quality and certainty of evidence were appraised using AMSTAR-2 and GRADE, respectively. Results: A total of 35 meta-analyses covering 106 unique outcomes were included, of which 87 showed significant associations. Elevated NLR and SII were consistently linked to higher risks of CVD mortality, major adverse cardiovascular events, myocardial infarction, heart failure, and stroke. PLR and SIRI were primarily associated with poor recovery from stroke and increased mortality in ST-elevation myocardial infarction. Specifically, the methodological quality of the included reviews was generally moderate to high according to AMSTAR-2, whereas none of the associations reached high certainty based on GRADE, with most rated as low or very low and about one-quarter as moderate certainty. Conclusions: The overall certainty of evidence remains limited according to GRADE, alongside methodological heterogeneity, population variability, and inconsistent thresholds that further restrict the direct applicability of these findings in clinical practice. Nevertheless, available evidence indicates that elevated immune-inflammatory indices are likely associated with worse clinical outcomes in patients with CVD. Future research should prioritize establishing standardized cutoffs, improving methodological consistency, and validating these indices across diverse populations to support their integration into clinical risk-stratification frameworks. Full article
(This article belongs to the Special Issue Recent Advances in Biomarkers for Cardiovascular Disease)
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22 pages, 5173 KB  
Article
Inflammation-Based Hematologic Indices as Prognostic Markers in Pulmonary Arterial and Chronic Thromboembolic Pulmonary Hypertension: A Hypothesis-Generating Registry Study
by Dragos-Gabriel Iancu, Razvan Gheorghita Mares, Liviu Cristescu, Radu-Adrian Suteu, Andreea Varga and Ioan Tilea
Int. J. Mol. Sci. 2025, 26(22), 10940; https://doi.org/10.3390/ijms262210940 - 12 Nov 2025
Viewed by 123
Abstract
Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are characterized by high morbidity and mortality. We retrospectively analyzed 468 hospital admissions from 80 patients to evaluate the prognostic value of inflammation-based hematologic indices, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), [...] Read more.
Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are characterized by high morbidity and mortality. We retrospectively analyzed 468 hospital admissions from 80 patients to evaluate the prognostic value of inflammation-based hematologic indices, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), neutrophil-percentage-to-albumin ratio (NPAR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammation index (SII). All biomarker–outcome associations were specified a priori as exploratory in this hypothesis-generating design. In PAH, both NPAR and SII were associated with in-hospital mortality (odds ratio [OR] 1.129, 95% confidence interval [CI] 1.011–1.261, p = 0.031; OR 1.001, 95% CI 1.000–1.002, p = 0.002), post-discharge mortality (NPAR OR 1.181, 95% CI 1.062–1.313, p = 0.002), and poorer overall survival (log-rank p = 0.002 and p = 0.012, respectively). Higher LMR was associated with reduced in-hospital mortality (OR 0.291, 95% CI 0.108–0.790, p = 0.015), while NLR predicted increased in-hospital mortality. In CTEPH, NLR and LMR were the strongest predictors, correlating with worse survival (log-rank p = 0.007 and p = 0.044) and higher post-discharge mortality (NLR OR 1.289, 95% CI 1.029–1.615, p = 0.027). Receiver operating characteristic (ROC) analysis suggests the potential value of SII in PAH and the promising performance of NPAR in CTEPH. Inflammation-based hematologic indices, particularly NPAR, SII, and NLR, may provide valuable prognostic information and may serve as practical, non-invasive tools for predicting hospitalization duration and mortality in PAH and CTEPH. Full article
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14 pages, 348 KB  
Article
Prognostic Value of Fibrinogen-to-Albumin Ratio and Neutrophil-to-Lymphocyte Ratio in Patients on Peritoneal Dialysis
by Selena Gajić, Ana Bontić, Aleksandar Sič, Vidna Karadžić-Ristanović, Milorad Stojadinović, Kristina Filić, Jelena Pavlović, Jovana Gavrilović, Kristina Petrović, Sanja Stanković, Nikola Trnić, Filip Simović, Pavle Popović, Svetlana Jovičić-Pavlović, Aleksandra Kezić and Marko Baralić
Life 2025, 15(11), 1728; https://doi.org/10.3390/life15111728 - 9 Nov 2025
Viewed by 297
Abstract
Background and Objectives: Chronic inflammation (CIn) is common among peritoneal dialysis (PD) patients and contributes to adverse outcomes. However, the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and fibrinogen-to-albumin ratio (FAR) in PD remains uncertain. Methodology: In this prospective cohort study, 65 PD [...] Read more.
Background and Objectives: Chronic inflammation (CIn) is common among peritoneal dialysis (PD) patients and contributes to adverse outcomes. However, the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and fibrinogen-to-albumin ratio (FAR) in PD remains uncertain. Methodology: In this prospective cohort study, 65 PD patients were followed for 18 months. Baseline demographic, clinical and laboratory data were collected and inflammatory indices were calculated. The composite outcome was all-cause mortality or transfer to hemodialysis (HD). Logistic regression analyses were used to identify independent predictors of outcomes. Results: Over the 18-month follow-up, 23 patients (35.4%) died and 13 (20.0%) transferred to HD. Patients with adverse outcomes had higher baseline FAR, C-reactive protein (CRP) and serum glucose (Glc) levels and lower triglycerides (TG). In multivariate analysis, higher FAR (OR 5.28, 95% CI 1.16–24.12), CRP (OR 1.28, 95% CI 1.02–1.62) and PTH (OR 1.01, 95% CI 1.00–1.01) were independently associated with adverse outcomes, while NLR showed marginal significance. In the mortality-only model, FAR (OR 3.99, 95% CI 1.17–13.61) and PTH remained significant predictors. Conclusions: FAR demonstrated a significant prognostic association with mortality and composite adverse outcomes in PD patients, whereas NLR had limited predictive value. Albumin-based inflammatory indices such as FAR may complement established markers for risk stratification. Larger multicenter studies are warranted to validate these findings. Full article
(This article belongs to the Section Medical Research)
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9 pages, 613 KB  
Brief Report
The Dynamic Change in the Neutrophil–Lymphocyte Ratio and Systemic Inflammatory Response Index After Undergoing an Intensive Resistance-Based Exercise Program
by Timothy P. Dougherty, David J. Carpenter, Chris Peluso and Colin E. Champ
J. Funct. Morphol. Kinesiol. 2025, 10(4), 436; https://doi.org/10.3390/jfmk10040436 - 8 Nov 2025
Viewed by 292
Abstract
Background: The change over time of certain inflammatory markers, such as the neutrophil–lymphocyte ratio (NLR) and systemic inflammatory response index (SIRI), is a prognostic factor in many cancers, including breast cancer. This study retrospectively evaluated how a 12-week intensive exercise program might have [...] Read more.
Background: The change over time of certain inflammatory markers, such as the neutrophil–lymphocyte ratio (NLR) and systemic inflammatory response index (SIRI), is a prognostic factor in many cancers, including breast cancer. This study retrospectively evaluated how a 12-week intensive exercise program might have influenced both the NLR and SIRI in women with breast cancer. Methods: Two institutional review board-approved prospective clinical trials, EXERT-BC (NCT05747209, 2 November 2022) and EXERT-BCN (NCT05978960, 31 July 2023), were retrospectively assessed. Complete blood count (CBC) values performed before and after participation in a 12-week intensive resistance program were analyzed post hoc. Blood tests were ordered as part of routine clinical care and not pre-specified by either study protocol. Participants who had blood work more than four months from study intake or completion were excluded. Additionally, those undergoing active systemic therapy or with underlying inflammatory conditions were also excluded. The NLR and SIRI values were analyzed via the Mann–Whitney test, with pair-wise assessment of pre- and post-intervention values via the Wilcoxon signed-rank test. Results: Out of 84 participants, 21 people met the inclusion criteria. Roughly 70% had either ductal carcinoma in situ (DCIS) or early-stage breast cancer. The average blood draw was taken within two months of study intake and outtake. After the 12-week structured exercise program, there was an associated reduction in both the NLR (2.26 [IQR, 1.70–4.22] to 1.99 [1.44–2.62]; ΔNLR = −0.27, W = 47.0, p = 0.016) and SIRI (1.23 [0.82–1.64] to 0.80 [0.59–1.45]; ΔSIRI = −0.43, W = 48.0, p = 0.018). Of those who saw their inflammatory markers improve, roughly two thirds showed a clinically relevant improvement. Conclusions: Completion of a 12-week intensive resistance exercise program was associated with a statistically improved NLR and SIRI. The small sample size and retrospective nature limit the broader application of these findings. The results, however, provide a genesis for prospective validation examining the potential benefit exercise might have on the NLR and SIRI in women with breast cancer. Full article
(This article belongs to the Section Sports Medicine and Nutrition)
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15 pages, 1122 KB  
Case Report
Training, Immunity, and Health in Elite Kayaking: A Longitudinal Study Monitoring a World-Class Marathon Paddler with Exercise-Induced Bronchoconstriction
by José Augusto Rodrigues dos Santos, Tiago Rama, Liliana Carina Baptista, Ana Isabel Padrão and Rodrigo Zacca
Sports 2025, 13(11), 401; https://doi.org/10.3390/sports13110401 - 7 Nov 2025
Viewed by 300
Abstract
Background: Exercise-induced bronchoconstriction (EIB) is common in athletes, being more frequent in outdoor endurance-based/long-distance sports. We followed a World-Class marathon paddler’s season with recurrent episodes of EIB, which intensified during cold exposure workouts. This unique immunophenotype profile during the season and its variations [...] Read more.
Background: Exercise-induced bronchoconstriction (EIB) is common in athletes, being more frequent in outdoor endurance-based/long-distance sports. We followed a World-Class marathon paddler’s season with recurrent episodes of EIB, which intensified during cold exposure workouts. This unique immunophenotype profile during the season and its variations were reflected in acute and chronic inflammatory markers. Methods: A longitudinal case study was conducted with blood sampling obtained from a single paddler after overnight fasting at three timepoints: T1 (beginning of season, after 15-day rest period), T2 (post-Winter National Championship), and T3 (post-Summer National Championship). Complete blood counts and lymphocyte immunophenotyping were performed using automated hematology analysis and multiparametric flow cytometry. Results: The total numbers of leukocytes (T1: 6.3; T2: 5.0; T3: 5.5 × 109/L), neutrophils (3.1; 2.5; 2.8 × 109/L), and lymphocytes (2.4; 1.8; 2.2 × 109/L) declined between T1 and T2, followed by a partial recovery at T3. In contrast, monocyte counts exhibited the reverse pattern (0.41; 0.62; 0.31 × 109/L). The two T cell subsets (αβ and γδ) remained relatively stable, showing only minor seasonal fluctuations. CD19+ B cells, initially at very low levels, increased steadily as the season progressed (0.05; 0.07; 0.16 × 109/L). During T2, the proportion of memory lymphocytes (CD45RO+) rose, while naive cells (CD45RA+) declined; this trend was subsequently inverted at M3. Although the CD4+/CD8+ ratio varied over time, it consistently stayed below the normal reference range established for healthy controls (0.50; 0.83; 0.60 for T1, T2, and T3, respectively). Conclusions: The immune assessment of the World-Class marathon paddler revealed transient immunosuppression early in the season, marked by reduced neutrophils, a low CD4+/CD8+ ratio, and diminished CD19+ lymphocytes. Over time, immune parameters showed signs of recovery, indicating a temporary imbalance that did not impair the athlete’s physical performance. Conclusions: This case study of an elite marathon kayaker revealed transient immune fluctuations across a competitive season, including early immunosuppression (low neutrophils, CD4+/CD8+ ratio 0.50, and minimal CD19+ B cells) followed by partial recovery mid- and late-season. Despite persistently inverted CD4+/CD8+ ratios suggesting chronic immune dysregulation, the athlete maintained competitive performance, highlighting the temporary nature of these changes and emphasizing that regular immune monitoring can help optimize health and performance in elite athletes. Full article
(This article belongs to the Collection Human Physiology in Exercise, Health and Sports Performance)
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13 pages, 1340 KB  
Article
Neutrophil-to-Lymphocyte Ratio as Potential Marker of Outcome After Standard EVAR
by Adriana Toncelli, Federico Filippi, Francesco Andreoli, Giulia Colonna, Claudia Panzano, Roberto Silingardi, Claudio Desantis, Massimo Ruggiero, Maurizio Taurino and Pasqualino Sirignano
Diagnostics 2025, 15(21), 2807; https://doi.org/10.3390/diagnostics15212807 - 6 Nov 2025
Viewed by 305
Abstract
Introduction: The neutrophil–lymphocyte ratio (NLR) has proven to be an inexpensive and easily available inflammatory marker for cardiovascular disease. The aim of the present study is to evaluate a possible association between preoperative NLR value and endovascular aneurysm repair (EVAR) outcomes. Methods [...] Read more.
Introduction: The neutrophil–lymphocyte ratio (NLR) has proven to be an inexpensive and easily available inflammatory marker for cardiovascular disease. The aim of the present study is to evaluate a possible association between preoperative NLR value and endovascular aneurysm repair (EVAR) outcomes. Methods: A multicentric retrospective study of patients undergoing EVAR in elective setting between 2015 and 2023 was performed. Preoperative NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count, and a cut-off of 5 was used as threshold for the analysis. Primary outcomes (technical success, endograft occlusion, AAA-related reintervention, endoleaks, and mortality rates) were compared between the NLR < 5 and the NLR > 5 group. Kaplan–Meier survival analysis was employed to assess overall survival and the incidence of long-term complications. Results: The study initially considered 1360 patients. Eventually, 823 patients were included in the study, of whom 129 (15.7%) with NLR > 5. The latter group presented a higher AAA diameter (59.1 mm vs. 55, mm; p = 0.004). Technical success was obtained in 98,9% of all enrolled patients. NLR values were significantly associated with ASA class (p = 0.014), involvement of the iliac arteries (p = 0.023), duration of ICU stays (p < 0.001), and overall length of hospitalization (<0.001). At Kaplan–Meier analysis, patient with NLR > 5 showed a significant lower survival rates (p = 0.006), while no significant differences were found in terms of endograft occlusion (p = 0.45), AAA-related reintervention (p = 0.63), and endoleaks (p = 0.49). Conclusions: This study highlights the association between the NLR value and an elevated risk of long-term mortality, highlighting its role as an indicator of the patient’s overall clinical condition rather than immediate surgical outcomes. Focusing on this selected group of patients can improve postoperative care and reduce long-term complications. Full article
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17 pages, 432 KB  
Article
Blood-Count-Derived Inflammatory Biomarkers and Characterization of Super-Responder Profile in Psoriatic Patients Receiving Biological Treatment: A Single-Center Study
by Agnieszka Hołdrowicz, Radosław Zajdel and Agnieszka Żebrowska
Int. J. Mol. Sci. 2025, 26(21), 10770; https://doi.org/10.3390/ijms262110770 - 5 Nov 2025
Viewed by 243
Abstract
In recent years, monoclonal antibodies targeting key cytokines underlying the occurrence of psoriatic skin lesions and joint involvement, i.e., Tumor Necrosis Factor-alpha (TNF-α), Interleukin 17 (IL-17), Interleukin 12 (IL-12), and Interleukin 23 (IL-23), have become more commonly used in the therapy of psoriasis. [...] Read more.
In recent years, monoclonal antibodies targeting key cytokines underlying the occurrence of psoriatic skin lesions and joint involvement, i.e., Tumor Necrosis Factor-alpha (TNF-α), Interleukin 17 (IL-17), Interleukin 12 (IL-12), and Interleukin 23 (IL-23), have become more commonly used in the therapy of psoriasis. Due to the high effectiveness, a favorable safety profile, and growing availability of biological treatment methods, the number of patients receiving chronic monoclonal antibody therapy is increasing each year. However, the factors affecting the effectiveness of biological drugs are not fully recognized. The study aimed at analyzing the clinical profile of patients and non-specific inflammatory markers in terms of the response to the psoriasis treatment with IL-17, IL-23, IL-12/23, and TNF-α inhibitors. The analysis involved 185 patients receiving biological therapy in the Department of Dermatology and Venereology at the Medical University of Lodz, which resulted in a total of 222 treatment cycles (TC). The super-response was defined as 100% reduction in the Psoriasis Area and Severity Index (PASI 100), at week 16 (±4 weeks) of therapy. Our study indicates that the chance of achieving a super-response was higher among younger patients with no psoriatic lesions on palms and soles, not suffering from non-alcoholic fatty liver disease, previously treated with methotrexate, and characterized by a higher level of derived Neutrophil-to-Lymphocyte Ratio (dNLR) at the beginning of treatment. Full article
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13 pages, 1300 KB  
Article
Can Preoperative Blood Inflammatory Biomarkers Predict Early Dental Implant Outcomes in Systemically Healthy Patients?
by Elena-Raluca Baciu, Cezara Andreea Onică, Gabriela Luminița Gelețu, Neculai Onică, Bogdan Florin Toma, Alexandra Cornelia Teodorescu, Costin Iulian Lupu and Alice Murariu
Bioengineering 2025, 12(11), 1208; https://doi.org/10.3390/bioengineering12111208 - 5 Nov 2025
Viewed by 404
Abstract
The aim of this study was to assess whether baseline the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the systemic immune-inflammation index (SII), and C-reactive protein (CRP) could predict postoperative outcomes in systemically healthy patients receiving dental implants. A retrospective analysis of 116 [...] Read more.
The aim of this study was to assess whether baseline the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the systemic immune-inflammation index (SII), and C-reactive protein (CRP) could predict postoperative outcomes in systemically healthy patients receiving dental implants. A retrospective analysis of 116 systemically healthy adults receiving dental implants was conducted. To minimise confounding, individuals over 50 years old, smokers, and those with systemic diseases, stage III/IV periodontitis, or current medication use were excluded. Periodontal status was classified as clinically healthy or stable. Baseline CRP and complete blood count-derived indices (NLR, PLR, SII) were recorded preoperatively. The primary outcome was osseointegration (proper versus impaired). Implant success was 95.7% (n = 111), with early implant failure occurring in 4.3% (n = 5). Females exhibited higher PLR values than males (p = 0.041), and SII was higher in periodontally stable patients compared to clinically healthy ones (p = 0.036). In systemically healthy patients, routine preoperative screening based on NLR, PLR, and CRP did not improve prediction of early implant failure, whereas SII demonstrated good, statistically significant discrimination (p = 0.015). These findings emphasise the need for further research to clarify the predictive value of blood inflammatory biomarkers. Full article
(This article belongs to the Special Issue Advanced Restorative Dental Materials and Implant Technologies)
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19 pages, 351 KB  
Article
Comprehensive Oxidative Stress Profiling and Clinical Correlates in Spondyloarthritis: The Role of Glutathione Peroxidase and Modifiable Lifestyle Factors
by Rim Dhahri, Insaf Fenniche, Ismail Dergaa, Halil İbrahim Ceylan, Nicola Luigi Bragazzi, Lobna Ben Ammar, Hiba Ben Ayed, Ba Afif, Chakib Mazigh and Imène Gharsallah
J. Clin. Med. 2025, 14(21), 7747; https://doi.org/10.3390/jcm14217747 - 31 Oct 2025
Viewed by 413
Abstract
Background: Oxidative stress represents a key pathogenic factor in spondyloarthritis (SpA), yet its comprehensive assessment remains underutilized in routine clinical practice. Objectives: We evaluated oxidative stress biomarker profiles in SpA patients to determine associations with disease activity, systemic inflammation, structural damage, lifestyle factors, [...] Read more.
Background: Oxidative stress represents a key pathogenic factor in spondyloarthritis (SpA), yet its comprehensive assessment remains underutilized in routine clinical practice. Objectives: We evaluated oxidative stress biomarker profiles in SpA patients to determine associations with disease activity, systemic inflammation, structural damage, lifestyle factors, and therapeutic responses for practical clinical implementation. Methods: This cross-sectional study included 101 patients meeting the Assessment of SpondyloArthritis International Society (ASAS) 2009 criteria. Oxidative stress assessment utilized a validated biomarker panel: copper, zinc, glutathione peroxidase (GPx), ceruloplasmin (Cp), transferrin (TF), haptoglobin (Hp), bilirubin (BR), and uric acid (UA). Clinical, radiological, lifestyle, and therapeutic data underwent systematic analysis. Results: Glutathione peroxidase activity was elevated in 82.1% of patients, establishing it as the most sensitive oxidative stress marker. Copper levels increased in 30.7% and zinc deficiency occurred in 36.4% of cases. Oxidative stress markers correlated significantly with inflammatory parameters (erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], neutrophil-to-monocyte ratio [NMR], systemic immune-inflammation index [SII]) and disease activity scores (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Ankylosing Spondylitis Disease Activity Score based on CRP [ASDAS-CRP], Disease Activity Score 44 [DAS44-CRP]). Higher oxidative stress was associated with a poorer quality of life, as indicated by elevated Ankylosing Spondylitis Quality of Life (ASQoL) scores. Physical activity and adherence to a Mediterranean diet were independently associated with better antioxidant capacity. Smoking and nonsteroidal anti-inflammatory drug (NSAID) use correlated with increased oxidative burden. Anti-tumor necrosis factor alpha (anti-TNFα) therapy was associated with reduced levels of oxidative stress. Structural damage, particularly cervical spine involvement, correlated with heightened oxidative stress. Conclusions: This comprehensive evaluation reveals significant clinical correlations between oxidative stress and multiple disease domains in SpA. Modifiable lifestyle factors and therapeutic interventions have a significant impact on the redox balance. These findings establish practical targets for personalized management. The integration of oxidative stress assessment into routine practice could enhance disease monitoring and inform the development of antioxidant-based therapeutic strategies. Full article
(This article belongs to the Section Immunology & Rheumatology)
12 pages, 1317 KB  
Article
Predicting Pulmonary Exacerbations in Cystic Fibrosis Using Inflammation-Based Scoring Systems
by Raphael S. Reitmeier, Melanie Götschke, Julia Walter, Jeremias Götschke, Julian Schlatzer, Diego Kauffmann-Guerrero, Jürgen Behr, Amanda Tufman and Pontus Mertsch
Diagnostics 2025, 15(21), 2761; https://doi.org/10.3390/diagnostics15212761 - 31 Oct 2025
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Abstract
Background: The aim of this study is to identify people with cystic fibrosis (pwCF) at risk for future pulmonary exacerbations (PEx) based on established and unestablished markers of chronic inflammation. There is currently no universal definition of PEx in cystic fibrosis (CF), [...] Read more.
Background: The aim of this study is to identify people with cystic fibrosis (pwCF) at risk for future pulmonary exacerbations (PEx) based on established and unestablished markers of chronic inflammation. There is currently no universal definition of PEx in cystic fibrosis (CF), but it is commonly characterized by clinical deterioration and a drop in FEV1 ≥10% with or without elevations in systemic inflammatory markers. PEx negatively affect clinical outcomes in pwCF; therefore, predicting and preventing PEx is a crucial goal in the treatment of pwCF. Methods: We retrospectively examined pwCF ≥18 years who had ≥2 pulmonary function tests per year for a 3-year period. The first year was marked as the baseline. The follow-up period (FU) was defined as the following two-year period after baseline. PEx were defined as a need for intravenous antibiotic treatment due to clinical deterioration. Various scoring systems and ratios (neutrophil/lymphocyte (NLR), lymphocyte/monocyte (LMR), CRP, CRP/albumin, Glasgow Prognostic Score (GPS), high-sensitivity modified Glasgow Prognostic Score (hs-GPS)) were compared in pwCF with and without PEx during the FU. Logistic regression models were used to determine the best marker for predicting PEx, considering factors such as age, sex, PEx at baseline, BMI, homozygote F508del mutation, diabetes mellitus, chronic bacterial infection, and CFTR (cystic fibrosis transmembrane conductance regulator)-modulator therapy. The results are reported as odds ratios (ORs) with p-values. Results: Out of 283 pwCF, 131 were included in the study. In total, 43.5% were female, and the mean age was 34.0 years. A total of 75 pwCF (57.3%) had PEx during FU. In the multivariate analysis, the following markers at baseline were significantly associated with having a PEx during FU: CRP(log) (OR = 7.29, p = 0.01), CRP/albumin (OR = 1.08, p = 0.006), decreased LMR (OR = 0.51, p = 0.02), increased NLR (OR = 1.52, p = 0.02), and GPS of 1 vs. 0 (OR = 2.75, p = 0.04). The results indicate that the CRP/albumin ratio was the best model for predicting PEx in pwCF during the FU, outperforming other models. Conclusions: While several inflammation-based scoring systems can predict PEx in pwCF, the easily calculated CRP/albumin proved to reliably identify pwCF with an increased risk for PEx, making it a promising tool in clinical practice. Full article
(This article belongs to the Section Clinical Diagnosis and Prognosis)
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14 pages, 930 KB  
Article
The Relationship Between Composite Inflammatory Indices and Dry Eye in Hashimoto’s Disease-Induced Hypothyroid Patients
by Asli Kirmaci Kabakci, Derya Cepni Cakir and Arzu Taskiran Comez
Biomedicines 2025, 13(11), 2675; https://doi.org/10.3390/biomedicines13112675 - 30 Oct 2025
Viewed by 407
Abstract
Background/Objectives: Hashimoto’s thyroiditis-induced hypothyroidism (HT–HypoT) is frequently accompanied by ocular surface complaints, but the role of systemic inflammatory markers in dry eye disease (DED) among these patients remains unclear. This study aimed to evaluate the relationship between composite inflammatory indices and the [...] Read more.
Background/Objectives: Hashimoto’s thyroiditis-induced hypothyroidism (HT–HypoT) is frequently accompanied by ocular surface complaints, but the role of systemic inflammatory markers in dry eye disease (DED) among these patients remains unclear. This study aimed to evaluate the relationship between composite inflammatory indices and the presence and severity of DED in patients with HT–HypoT. Methods: This retrospective study included 86 HT–HypoT patients and 43 DED controls without systemic comorbidities. DED diagnosis and severity were assessed using the Ocular Surface Disease Index (OSDI) and objective ocular surface tests. Laboratory parameters and composite inflammatory indices—including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), C-reactive protein-to-albumin ratio (CAR), and prognostic nutritional index (PNI)—were compared between groups. Results: DED was present in 44% of HT–HypoT patients. SIRI and CAR were higher in HT–HypoT patients with DED and increased with severity. Both indices independently predicted the presence and severity of DED and exhibited higher diagnostic performance than other inflammatory indices. Conclusions: In patients with HT–HypoT, SIRI and CAR provide additional diagnostic value for identifying the presence and severity of DED beyond that offered by traditional markers. These findings highlight the potential utility of routine blood-derived indices as adjunctive biomarkers in thyroid-related DED. Full article
(This article belongs to the Special Issue Recent Research on Dry Eye)
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