Comparison of the effects of second generation antihistamines and omalizumab treatment on neutrophil / lymphocyte ratio, platelet / lymphocyte ratio and mean platelet volume in patients with chronic spontaneous urticaria with each other and with the control group

Comparison of the Effects of Second Generation Antihistamines and Omalizumab Treatment on Neutrophil / Lymphocyte Ratio, Platelet / Lymphocyte Ratio and Mean Platelet Volume in Patients with Chronic Spontaneous Urticaria with Each Other and with the Control Group Objective: Chronic spontaneous urticaria is a recurrent systemic inflammatory disease that lasts for more than 6 weeks and often has no etiological cause. The role of neutrophils, lymphocytes and thrombocytes, which are parts of inflammation, in CSU is not clear. Studies have shown that neutrophil / lymphocyte ratio (NLR), thrombocyte / lymphocyte ratio (PLR) and MPV can be used in CSU to evaluate inflammation marker and response to treatment. In our study, we aimed to compare the NLR, PLR and MPV values in the control group and pre-treatment patient groups, and to investigate the changes with antihistamine treatment and omalizumab treatment in the CSU patient group and control group. Materials and Methods: 146 patients who applied to Manisa Celal Bayar University Dermatology and Venereal Diseases outpatient clinic, with a diagnosis of chronic spontaneous urticaria, over 18 years of age, without malignancy, no infectious disease, no immunosuppressive medication, and using antihistamine or omalizumab were included in the study. The complete blood count parameters of the antihistamine group before treatment and at the 4th week and of the omalizumab group before treatment and at the 3rd month were retrospectively analyzed. 150-person control group who were not diagnosed with urticaria, whose research exclusion criteria were applied, was retrospectively selected among patients who has no systemic inflammatory, infectious and malignant disease applied to our outpatient clinic and their complete blood count parameters were examined. Results: The neutrophil and NLR values of the antihistamine and omalizumab treatment group with CSU diagnosis were found to be significantly higher than the pre-treatment control group, but there was no significant difference between each other (Neutrophil: antihistamine-control group p= 0.018 and omalizumab-control group p<0.001; NLR: antihistamine-control group p= 0.017 and omalizumab-control group p= 0.024). Platelet value was found to be significantly higher between omalizumab and control group (p= 0.027). MPV value was found to be significantly lower between omalizumab and control group (p<0.001). No significant difference was found in PLR and lymphocyte values. No significant change was measured in the antihistamine group at the 4th week after treatment. In the omalizumab group, a significant decrease in neutrophil counts (p= 0.004) and platelet count (p= 0.019) was measured in the controls at 3rd months. Both groups showed a decrease in NLR and an increase in MPV after treatment, but these changes did not make a significant difference. Conclusion: Objective tests are needed to evaluate disease activity and response to treatment in CSU patients. Neutrophil count, platelet count, NLR values were higher and MPV values were found to be low compared to the control group, these values can be used to measure disease activity. After the treatment, a significant decrease in neutrophil count and platelet count was detected in the omalizumab group. In addition to its anti-IgE effect, omalizumab can show its anti-inflammatory effect by reducing the neutrophil count and platelet count to be within the normal range. Keywords: Chronic spontaneous urticaria, antihistamine, omalizumab, neutrophil, lymphocyte, thrombocyte, NLR, TLR, MPV