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Abstract：
Relapsing polychondritis (RP) as a rare autoimmune disease is characterized by recurrent inflammation of the organs containing cartilage. Currently, no biomarkers have been integrated into clinical practice. This study aimed to construct and evaluate models based on laboratory parameters to aid in RP diagnosis, assess activity assessment, and explore associations with the pathological process.
RP patients and healthy controls (HCs) were recruited at the Peking Union Medical College Hospital from July 2017 to July 2023. Clinical data including Relapsing Polychondritis Disease Activity Index (RPDAI) score and laboratory tests were collected. Differences in laboratory data between RP patients and HCs and active and inactive patients were analyzed.
The discovery cohort (cohort 1) consisted of 78 RP patients and 94 HCs. A model based on monocyte counts and neutrophil to lymphocyte ratio (NLR) could effectively distinguish RP patients from HCs with an AUC of 0.845. Active RP patients exhibited increased erythrocyte sedimentation rate, complement 3, platelet to lymphocyte ratio (PLR), NLR, and C-reactive protein to albumin ratio (CAR) compared with stable patients, which were also positively correlated with RPDAI. Notably, CAR emerged as an independent risk factor of disease activity (OR = 4.422) and could identify active patients with an AUC of 0.758. To confirm the reliability and stability of the aforementioned models, a replication cohort (cohort 2) was enrolled, including 79 RP patients and 94 HCs. The monocyte-combined NLR and CAR showed a sensitivity of 0.886 and 0.577 and a specificity of 0.830 and 0.833 in RP diagnosis and activity prediction, respectively. Furthermore, lower natural killer cell levels in RP patients and higher B-cell levels in active patients may contribute to elucidating the pathological mechanisms of disease occurrence and exacerbation.
The utilization of laboratory parameters provides cost-effective and valuable markers that can assist in RP diagnosis, identify disease activity, and elucidate pathogenic mechanisms.
RP patients and healthy controls (HCs) were recruited at the Peking Union Medical College Hospital from July 2017 to July 2023. Clinical data including Relapsing Polychondritis Disease Activity Index (RPDAI) score and laboratory tests were collected. Differences in laboratory data between RP patients and HCs and active and inactive patients were analyzed.
The discovery cohort (cohort 1) consisted of 78 RP patients and 94 HCs. A model based on monocyte counts and neutrophil to lymphocyte ratio (NLR) could effectively distinguish RP patients from HCs with an AUC of 0.845. Active RP patients exhibited increased erythrocyte sedimentation rate, complement 3, platelet to lymphocyte ratio (PLR), NLR, and C-reactive protein to albumin ratio (CAR) compared with stable patients, which were also positively correlated with RPDAI. Notably, CAR emerged as an independent risk factor of disease activity (OR = 4.422) and could identify active patients with an AUC of 0.758. To confirm the reliability and stability of the aforementioned models, a replication cohort (cohort 2) was enrolled, including 79 RP patients and 94 HCs. The monocyte-combined NLR and CAR showed a sensitivity of 0.886 and 0.577 and a specificity of 0.830 and 0.833 in RP diagnosis and activity prediction, respectively. Furthermore, lower natural killer cell levels in RP patients and higher B-cell levels in active patients may contribute to elucidating the pathological mechanisms of disease occurrence and exacerbation.
The utilization of laboratory parameters provides cost-effective and valuable markers that can assist in RP diagnosis, identify disease activity, and elucidate pathogenic mechanisms.
摘要：
■复发性多软骨炎（RP）作为一种罕见的自身免疫性疾病，其特征是含有软骨的器官反复发炎。目前,尚未将生物标志物纳入临床实践.本研究旨在建立和评估基于实验室参数的模型，以帮助RP诊断，评估活动评估，并探讨与病理过程的关系。
■RP患者和健康对照（HCs）于2017年7月至2023年7月在北京协和医院招募。收集临床数据，包括复发性多软骨炎疾病活动指数（RPDAI）评分和实验室检查。分析了RP患者和HC以及活跃和不活跃患者之间实验室数据的差异。
■发现队列（队列1）由78名RP患者和94名HC组成。基于单核细胞计数和中性粒细胞与淋巴细胞比率（NLR）的模型可以有效地将RP患者与HC区分开，AUC为0.845。活动期RP患者红细胞沉降率增加，补体3，血小板与淋巴细胞比率（PLR），NLR,与稳定患者相比，C反应蛋白与白蛋白之比（CAR），与RPDAI呈正相关。值得注意的是,CAR是疾病活动性的独立危险因素（OR=4.422），可以识别AUC为0.758的活动性患者。为了确认上述模型的可靠性和稳定性，纳入一个复制队列（队列2），包括79例RP患者和94例HCs。单核细胞联合NLR和CAR在RP诊断和活性预测中的敏感性为0.886和0.577，特异性为0.830和0.833，分别。此外，RP患者较低的自然杀伤细胞水平和活跃患者较高的B细胞水平可能有助于阐明疾病发生和恶化的病理机制。
■实验室参数的利用提供了具有成本效益且有价值的标志物，可以协助RP诊断，识别疾病活动，并阐明致病机制。
■RP患者和健康对照（HCs）于2017年7月至2023年7月在北京协和医院招募。收集临床数据，包括复发性多软骨炎疾病活动指数（RPDAI）评分和实验室检查。分析了RP患者和HC以及活跃和不活跃患者之间实验室数据的差异。
■发现队列（队列1）由78名RP患者和94名HC组成。基于单核细胞计数和中性粒细胞与淋巴细胞比率（NLR）的模型可以有效地将RP患者与HC区分开，AUC为0.845。活动期RP患者红细胞沉降率增加，补体3，血小板与淋巴细胞比率（PLR），NLR,与稳定患者相比，C反应蛋白与白蛋白之比（CAR），与RPDAI呈正相关。值得注意的是,CAR是疾病活动性的独立危险因素（OR=4.422），可以识别AUC为0.758的活动性患者。为了确认上述模型的可靠性和稳定性，纳入一个复制队列（队列2），包括79例RP患者和94例HCs。单核细胞联合NLR和CAR在RP诊断和活性预测中的敏感性为0.886和0.577，特异性为0.830和0.833，分别。此外，RP患者较低的自然杀伤细胞水平和活跃患者较高的B细胞水平可能有助于阐明疾病发生和恶化的病理机制。
■实验室参数的利用提供了具有成本效益且有价值的标志物，可以协助RP诊断，识别疾病活动，并阐明致病机制。
