Introduction. Interest in the potential role of low-density granulocytes (LDGs) in the development of autoimmune diseases has been renewed recently. Due to their pro-inflammatory action, more and more attention is paid to the role of LDGs, including those expressing the enzyme myeloperoxidase (MPO), in the development of autoimmune hepatitis (AIH). LDGs are actively involved in the formation of neutrophil extracellular traps (NETs). This phenomenon may favour the externalization of the autoantigen and lead to damage to internal organs, including the liver. Aim. The main aim of the study was to assess the diagnostic usefulness of the LDG percentage, including the fraction showing MPO expression as markers of systemic inflammation in AIH. Materials and methods. The study included a group of 25 patients with AIH and 20 healthy volunteers. Mononuclear cells, isolated from peripheral blood, were labelled with monoclonal antibodies conjugated to the appropriate fluorochromes (CD15-FITC, CD14-PE, CD10-PE-Cy5, MPO+) and then analyzed on a Navios Flow Cytometer (Beckman Coulter). Results. Patients with AIH had a higher median percentage of LDG (1.2 vs. 0.1; p = 0.0001) and LDG expressing MPO (0.8 vs. 0.3; p = 0.0017) when compared to healthy volunteers. Moreover, the percentage of LDG was characterised by 100% of sensitivity and 55% of specificity (AUC = 0.84; p < 0.0001), while the percentage of LDG expressing MPO was 92% of sensitivity and 55% of specificity (AUC = 0.78; p = 0.0001) in the detection of AIH. Conclusions. Assessment of inflammatory markers, such as the percentage of LDG and the percentage of LDG expressing MPO, may be helpful in assessing the phenomenon of an increased systemic inflammatory response and in assessing liver fibrosis (LC, Liver cirrhosis), which is inherent in liver decompensation. Taking into account the above arguments, the assessment of the percentage of LDG, including LDG expressing MPO, may turn out to be a useful marker in the diagnosis of AIH.

(1) Introduction: Autoimmune hepatitis (AIH) is a chronic disease. A persistent autoimmune reaction in the liver is significantly related to the systemic inflammatory response. Extended Inflammation Parameters (EIP) can be used to assess the activation of immune cells such as activated neutrophils (NEUT-RI and NEUT-GI) and activated lymphocytes (RE-LYMP and AS-LYMP) in the phase of active inflammation. The role of the systemic inflammatory response markers should also be emphasised, especially: NLR, PLR, and RLR, which have recently been widely studied as markers in autoimmune skin diseases or liver diseases. (2) Materials and Methods: The study included 30 patients with AIH and 30 healthy volunteers. The parameters of the EIP group (RE-LYMP, AS-LYMP, NEUT-RI, NEUT-GI), calculated haematological indices Red Blood Cell Distribution Width-to-Platelet Ratio (RPR), Mean Platelet Volume-to-Platelet Ratio (MPR), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Red Blood Cell Distribution Width-to-Lymphocyte Ratio (RLR), and selected blood morphological and biochemical indices were analysed. The aim of the study was to assess the usefulness of the EIP and systemic inflammatory response markers in the diagnostics of AIH. (3) Results: Compared to the controls, the patients with AIH showed significantly higher EIP values: NEUT-RI (48.05 vs. 43.30), NEUT-GI (152.65 vs. 147.40), RE-LYMP (0.07 vs. 0.03), and the inflammatory response markers: MPR (0.05 vs. 0.04), RPR (0.07 vs. 0.05), and NLR (2.81 vs. 1.42. Among the examined markers, EIP has significant diagnostic potential: NEUT-RI (AUC = 0.86), NEUT-GI (AUC = 0.80), and RE-LYMP (AUC = 0.78), and so do calculated haematological indices, i.e., MPR (AUC = 0.75), PLR (AUC = 1.00), and RLR (AUC = 1.00) Moreover, the importance of NEUT-GI (AUC = 0.89), MPR (AUC = 0.93), PLR (AUC = 0.86), RPR (AUC = 0.91), and FIB-4 (AUC = 0.83) in the detection of liver fibrosis in the course of AIH has also been proven. (4) Conclusions: EIP and systemic inflammatory response markers may turn out to be useful in detecting AIH and in looking for features of already developed liver cirrhosis in its course.

(1) Background: Pemphigus is a blistering autoimmune disease of the skin and/or mucous membranes, characterised by the presence of specific autoantibodies directed against structural proteins of the human skin. Recent reports indicate that new haematological parameters, termed Extended Inflammation Parameters (EIP), can be used to assess the activation of immune cells during active inflammation. These include parameters assessing both neutrophil activation (NEUT-RI, NEUT-GI) and the number of activated lymphocytes (RE-LYMP). The aim of this study was to investigate the relationship between changes in NEUT-RI, NEUT-GI and RE-LYMP and the disease activity in patients with pemphigus. (2) Results: The study involved 32 patients with diagnosed different types of pemphigus. Neutrophil activation parameters (NEUT-RI and NEUT-GI) and lymphocytes (RE-LYMP) were significantly higher in these patients compared to the parameters in healthy participants (respectively p = 0.0127, p = 0.0011 and p = 0.0033). The increased quantity of activated lymphocytes (RE-LYMP) also correlated significantly with the extent of skin and/or mucosal lesions in patients assessed by the PDAI scale (p < 0.02). (3) Conclusions: The NEUT-RI, NEUT-GI and RE-LYMP parameters proved to be appropriate markers of inflammation severity in pemphigus, also in relation to local lesions, which was not possible with the inflammation markers (CRP, ESR) used so far on a routine basis.

In response to various stimuli, neutrophils may release extracellular network (NET – neutrophil extracellular trap) consisting of DNA, proteolytic enzymes and other components of the cell nucleus. The NETosis process was first described in 2004 by Brinkmann et al. as animmunological response to...

Psoriasis is an inflammatory, autoimmune disease that affects approximately 2% of the population. The inflammation in psoriasis can be systemic, so despite a predominantly cutaneous manifestation, it also affects the internal organs. The diagnosis and monitoring of the disease are based on the clinical picture. To assess the disorders of other organs, additional tests need to be performed. Recently, the examination of blood morphology has been enriched with modern haematological parameters, i.e., Extended Inflammation Parameters (EIP), which include RE-LYMPH (activated lymphocytes), AS-LYMPH (antibody-producing B lymphocytes), and NEUT-RI and NEUT-GI (activated neutrophils). In the study, higher values of new haematological parameters were observed in individuals with psoriasis than in healthy controls. A higher EIP value was noted in the group of individuals with plaque psoriasis than in the group of individuals with psoriatic arthritis. Implementation of these parameters into routine laboratory analysis will likely make it possible to estimate the severity of the inflammation and improve its assessment.

Background. Multiple sclerosis (MS) is the most common demyelinating disease of the central nervous system (CNS). It mostly affects young people. Pathological lesions cause destruction of myelin sheath around axons and impede transmission of nerve impulses in CNS. The diagnosis of MS is based on clinical evaluation, biochemical blood tests and cerebrospinal fluid tests as well as on imaging. The study aim was assessment of blood counts of MS patients. Materials and methods. The study group comprised 189 people (77 healthy) and 112 MS patients treated at the Department of Neurology of the Medical University of Lublin. Parameters of EDTA anticoagulated whole blood were determined on the Advia 2012i analyzer. Statistica 12.5 program was used for statistical analysis. Results. Patients evaluated with regard to clinical condition and disease progression demonstrate differences in RBC count, hemoglobin, hematocrit and mean corpuscular volume (MCV). RBC count of patients with relapsing-remitting MS (RRMS) was lower (Me = 4.73 million/μl) than for patients with secondary progressive MS (SPMS) (Me = 5.03 million/μl). Additionally, differences in hemoglobin level were observed between RRMS patients (Me = 13.9 g/dl) and SPMS patients (Me = 14.7 g/dl). Significant differences were also observed in hematocrit; (Me = 40.5%) for RRMS and (Me = 44%) for SPMS patients. Differences in MCV between the examined groups of MS patients and the control group were not statistically significant. The same referred to differences in WBC count; (Me = 6.95 thousand/μl) for MS patients and (Me = 6.59 thousand/μl) for control group as well as platelet count; (Me = 237.5 μs/μl) for SM patients and (Me = 252 thousand/μl) for controls. Conclusion. Analysis of blood parameters reveals significant differences between MS patients and controls as well as differences between RRMS and SPMS patients with regard to red blood cells. An in-depth analysis also in terms of disease duration and stage of clinical advancement may be a valuable source of information on the overall condition of MS patients. Background. Multiple sclerosis (MS) is the most common demyelinating disease of the central nervous system (CNS). It mostly affects young people. Pathological lesions cause destruction of myelin sheath around axons and impede transmission of nerve impulses in CNS. The diagnosis of MS is based on clinical evaluation, biochemical blood tests and cerebrospinal fluid tests as well as on imaging. The study aim was assessment of blood counts of MS patients. Materials and methods. The study group comprised 189 people (77 healthy) and 112 MS patients treated at the Department of Neurology of the Medical University of Lublin. Parameters of EDTA anticoagulated whole blood were determined on the Advia 2012i analyzer. Statistica 12.5 program was used for statistical analysis. Results. Patients evaluated with regard to clinical condition and disease progression demonstrate differences in RBC count, hemoglobin, hematocrit and mean corpuscular volume (MCV). RBC count of patients with relapsing-remitting MS (RRMS) was lower (Me = 4.73 million/μl) than for patients with secondary progressive MS (SPMS) (Me = 5.03 million/μl). Additionally, differences in hemoglobin level were observed between RRMS patients (Me = 13.9 g/dl) and SPMS patients (Me = 14.7 g/dl). Significant differences were also observed in hematocrit; (Me = 40.5%) for RRMS and (Me = 44%) for SPMS patients. Differences in MCV between the examined groups of MS patients and the control group were not statistically significant. The same referred to differences in WBC count; (Me = 6.95 thousand/μl) for MS patients and (Me = 6.59 thousand/μl) for control group as well as platelet count; (Me = 237.5 μs/μl) for SM patients and (Me = 252 thousand/μl) for controls. Conclusion. Analysis of blood parameters reveals significant differences between MS patients and controls as well as differences between RRMS and SPMS patients with regard to red blood cells. An in-depth analysis also in terms of disease duration and stage of clinical advancement may be a valuable source of information on the overall condition of MS patients.