Diagnostic Potential of New Systemic Inflammation Markers (MLR, SIRI, CAR, dNLR, ALB/dNLR) in Predicting the Severity of Pathogenic Signs of Rheumatoid Arthritis

The aim of the study was to histologically validate the diagnostic potential of new systemic inflammation biomarkers (MLR, SIRI, CAR, dNLR, ALB/dNLR) in assessing the severity of rheumatoid arthritis (RA) induced in warm-blooded animals with genetically determined resistance to hypoxia.

Materials and Methods. An autoimmune RA model (experimental groups) was induced by subcutaneous injection of complete Freund’s adjuvant into the right hind limbs of 8-month-old male rats of strains with high (HR/SmY) and low (LR/SmY) resistance to hypoxia. Rats in the control groups received only the solvent. After 35 days, blood was collected from the hearts of all the rats. To calculate the new inflammation biomarkers — CAR, ALB/dNLR, SIRI, dNLR, NC/LC, and MLR — the following laboratory parameters were used: ALB (albumin), CRP (C-reactive protein), MC (monocytes), LC (lymphocytes), and NC (neutrophils). The effectiveness of disease severity assessment using these biomarkers was determined based on histological examination of plantar sections of the tarsal and metatarsophalangeal joints of control and experimental rats.

Results. Genetically determined resistance to hypoxia is an important factor in the onset of the pathogenetic RA mechanisms. Low hypoxia resistance was associated with more severe connective tissue pathology compared to high resistance: LR/HR — 164 points/113 points, p≤0.05. The severity of pathomorphological RA changes (considering the organism’s resistance to hypoxia), identified histologically (cartilage degeneration: LR/HR — 29 points/18 points, p≤0.01; general joint inflammation: LR/HR — 37 points/26 points, p≤0.01; osteolysis: LR/HR — 6 points/0 points, p≤0.01), was most effectively reflected by the following integral inflammation indices: CAR (LR/HR — 11.55·10^–6 units/12.73·10^–6 units), ALB/dNLR (LR/HR — 86.93 units/78.51 units), and SIRI (LR/HR — 0.14 units/ 0.19 units).

Conclusion. The severity of pathomorphological RA signs depends on genetically determined resistance to hypoxia. For effective prediction of the disease, risk of complications, and treatment efficacy, it is advisable to use the new systemic inflammation biomarkers CAR, ALB/dNLR, and SIRI.

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