New Study Points to Inflammation-Based Biomarker Associated With HS Severity

New research is signaling that a simple and cost-effective biomarker may be used to monitor the severity of hidradenitis suppurativa (HS).

The retrospective study of patients with the condition showed that pan-immune-inflammation value (PIV), across a variety of biomarkers, had the strongest indications for HS severity. According to the researchers, whose findings appear in Journal of the European Academy of Dermatology and Venereology, the biomarker may be able to be used with clinical scores in treatment decisions or in clinical trials.

“In routine clinic evaluation of HS disease, severity based only on clinical features can be a challenge (eg, distinguishing Hurley II and Hurley III),” explained the researchers. “Hence, diagnostic and monitoring biomarkers for HS are needed. Data regarding the association of serum markers of inflammation with HS disease severity have recently been reported by our research group.”

Across the 142 patients with HS and 35 sex- and age-matched controls, the researchers saw a significant positive correlation between modified HS score (mHSS) and PIV (r = 0.32; P < .0001), in addition to neutrophil to lymphocyte ratio (NLR) (r = 0.17; P = .0415), monocyte to lymphocyte ratio (MLR) (r = 0.23; P = .0052), and systemic immune-inflammation index (SII) (r = 0.19; P = 0.0222). They also found that the platelet to neutrophil ratio (PNR) had a negative correlation with mHSS (r = –0.21; P = .0124).

Compared with the controls, patients with HS had significantly higher PIV and SII, although PIV—a combination of neutrophil, platelet, and monocyte counts—was the only biomarker significantly associated with severity based on the Youden index, with an index of 0.56.

PIV also showed an area under the curve (AUC) of 0.79 (95% CI, 0.71-0.85; P < .0001), with a sensitivity of 59.3 and a specificity of 96.5.

The platelet to lymphocyte ratio (PLR), MLR, and PNR were all significantly lower in these patients compared with the controls. Previous research has connected NLR and PLR with the severity of skin inflammatory diseases, although this correlation has not previously been studied in HS specifically.

“On the basis of our data, PLR does not appear to be a suitable biomarker for disease activity or severity,” described the researchers. “By contrast, NLR, MLR, PNR, SII, and PIV positively or negatively correlated with HS severity. However, the AUC values for Hurley stage and [Severity Assessment of Hidradenitis Suppurativa score] were relatively poor for NLR, MLR, PNR, and SII.”

Reference

Gambichler T, Hessam S, Cramer P, Rached NA, Bechara G. Complete blood collection-based systemic inflammation biomarkers for patients with hidradenitis suppurativa. J Eur Acad Dermatol Venereol. Published online April 24, 2022. doi:10.1111/jdv.18175