HALP score for chronic spontaneous urticaria: Does it differ from healthy subjects?

Year 2023, Volume: 40 Issue: 4, 677 - 680, 03.01.2024

Hüseyin Erdal , Fatma Gunaydin

Abstract

The immune inflammatory response has an important role in urticaria. In this study, we aimed to understand whether HALP score and systemic inflammatory response index (SII) role in predicting urticaria. This study, we evaluated medical records of 69 patients with chronic spontaneous urticaria (CSU) and 71 healthy controls. HALP score was calculated according to this formula HALP score = (hemoglobin (g/L) × albumin (g/L) × lymphocytes (/L))/platelets (/L). Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte (PLR), systemic inflammatory index (SII) index (neutrophil x platelet/lymphocyte count) were calculated. We demonstrated that NLR, PLR, SII levels were not statistically significant in patients with CSU compared to the heathy subjects (p>0.05). However, HALP score levels were statistically significant between the groups (p<0.05). HALP scoe is a newly designed index that are known as easily calculable and comprehensive indicator of treatment response precursors in patients with CSU.

Keywords

Inflammation, biomarkers, hemoglobin, albumin, lymphocytes, blood platelets

References

• 1. Kolkhir P, Gimenez-Arnau AM, Kulthanan K, Peter J, Metz M, Maurer M. Urticaria. Nature reviews Disease primers. 2022;8(1):61. Epub 2022/09/16. doi: 10.1038/s41572-022-00389-z. PubMed PMID: 36109590.
• 2. Radonjic-Hoesli S, Hofmeier KS, Micaletto S, Schmid-Grendelmeier P, Bircher A, Simon D. Urticaria and Angioedema: an Update on Classification and Pathogenesis. Clin Rev Allergy Immunol. 2018;54(1):88-101. Epub 2017/07/28. doi: 10.1007/s12016-017-8628-1. PubMed PMID: 28748365.
• 3. Kulthanan K, Tuchinda P, Chularojanamontri L, Chanyachailert P, Korkij W, Chunharas A, et al. Clinical practice guideline for diagnosis and management of urticaria. Asian Pac J Allergy Immunol. 2016;34(3):190-200. Epub 2016/10/04. PubMed PMID: 27690471.
• 4. Lang DM. Chronic Urticaria. The New England journal of medicine. 2022;387(9):824-31. Epub 2022/09/03. doi: 10.1056/NEJMra2120166. PubMed PMID: 36053507.
• 5. Saini SS, Kaplan AP. Chronic Spontaneous Urticaria: The Devil's Itch. J Allergy Clin Immunol Pract. 2018;6(4):1097-106. Epub 2018/07/24. doi: 10.1016/j.jaip.2018.04.013. PubMed PMID: 30033911; PubMed Central PMCID: PMC6061968.
• 6. Goncalo M, Gimenez-Arnau A, Al-Ahmad M, Ben-Shoshan M, Bernstein JA, Ensina LF, et al. The global burden of chronic urticaria for the patient and society. Br J Dermatol. 2021;184(2):226-36. Epub 2020/09/22. doi: 10.1111/bjd.19561. PubMed PMID: 32956489.
• 7. Özcan O EH, Çakırca G, Yönden Z Oxidative stress and its impacts on intracellular lipids, proteins and DNA. J Clin Exp Invest. 2015;6(3):331-6.
• 8. Dilek F, Ozceker D, Ozkaya E, Guler N, Tamay Z, Kesgin S, et al. Oxidative Stress in Children with Chronic Spontaneous Urticaria. Oxidative medicine and cellular longevity. 2016;2016:3831071. Epub 2016/04/30. doi: 10.1155/2016/3831071. PubMed PMID: 27127547; PubMed Central PMCID: PMC4834172.
• 9. Erdal H, Turgut F. Thiol/disulfide homeostasis as a new oxidative stress marker in patients with Fabry disease. J Investig Med. 2023:10815589231191966. Epub 2023/07/24. doi: 10.1177/10815589231191966. PubMed PMID: 37485970.
• 10. Erdal H, Gunaydin F, Karaoğlanoğlu S. Oxidative Stress in Asthma. Aksaray University Journal of Sport and Health Researches. 2023;4(1):62-70.
• 11. Erdal H, Demirtas MS, Kilicbay F, Tunc G. Evaluation of Oxidative Stress Levels and Dynamic Thiol-disulfide Balance in Patients with Retinopathy of Prematurity. Curr Eye Res. 2023:1-8. Epub 2023/03/14. doi: 10.1080/02713683.2023.2185569. PubMed PMID: 36912268.
• 12. Erdal H, Ciftciler R, Tuncer SC, Ozcan O. Evaluation of dynamic thiol-disulfide homeostasis and ischemia-modified albumin levels in patients with chronic lymphocytic leukemia. J Investig Med. 2023;71(1):62-6. Epub 2022/08/30. doi: 10.1136/jim-2022-002568. PubMed PMID: 36038148.
• 13. Erdal H, Özcan O, Turgut FH, Neşelioğlu S, Özcan E. Evaluation of dynamic thiol-disulfide balance and ischemia modified albumin levels in patients with chronic kidney disease. MKU Tıp Dergisi. 2022;13(47): 237-42.
• 14. Demirtas MS, Erdal H, Kilicbay F, Tunc G. Association between thiol-disulfide hemostasis and transient tachypnea of the newborn in late-preterm and term infants. BMC Pediatr. 2023;23(1):135. Epub 2023/03/26. doi: 10.1186/s12887-023-03936-z. PubMed PMID: 36966275; PubMed Central PMCID: PMC10039555.
• 15. Demirtas MS, Kilicbay F, Erdal H, Tunc G. Oxidative Stress Levels and Dynamic Thiol-Disulfide Balance in Preterm Newborns with Bronchopulmonary Dysplasia. Lab Med. 2023. Epub 2023/03/11. doi: 10.1093/labmed/lmad010. PubMed PMID: 36896684.
• 16. Demirtas MS, Erdal H. Evaluation of thiol-disulfide homeostasis and oxidative stress parameters in newborns receiving phototherapy. J Investig Med. 2023;71(3):183-90. Epub 2023/02/22. doi: 10.1177/10815589221140594. PubMed PMID: 36803043.
• 17. Demirtas MS, Erdal H. Evaluation of thiol disulfide balance in adolescents with vitamin B12 deficiency. Italian journal of pediatrics. 2023;49(1):3. Epub 2023/01/08. doi: 10.1186/s13052-022-01396-2. PubMed PMID: 36611205; PubMed Central PMCID: PMC9824957.
• 18. Cugno M, Asero R, Tedeschi A, Lazzari R, Marzano AV. Inflammation and coagulation in urticaria and angioedema. Curr Vasc Pharmacol. 2012;10(5):653-8. Epub 2012/01/26. doi: 10.2174/157016112801784558. PubMed PMID: 22272913.
• 19. Bansal CJ, Bansal AS. Stress, pseudoallergens, autoimmunity, infection and inflammation in chronic spontaneous urticaria. Allergy Asthma Clin Immunol. 2019;15:56. Epub 2019/09/19. doi: 10.1186/s13223-019-0372-z. PubMed PMID: 31528163; PubMed Central PMCID: PMC6737621.
• 20. Cosansu NC, Kara RO, Yaldiz M, Dikicier BS. New markers to predict the response to omalizumab in chronic spontaneous urticaria. Dermatol Ther. 2022;35(8):e15589. Epub 20220608. doi: 10.1111/dth.15589. PubMed PMID: 35582853.
• 21. Genc SO, Erdal H. Are pan-immune-inflammation value, systemic inflammatory response index and other hematologic inflammatory indexes clinically useful to predict first-trimester pregnancy loss? Ann Clin Anal Med. 2023; 14(5): 473-7.
• 22. Erdal H, Gunaydin FE. Are pan-immune inflammation-value, systemic inflammatory response index clinically useful to predict in patients with chronic spontaneous urticaria? Ann Clin Ann Med. 2023; doi: 10.4328/ACAM.21799.15..
• 23. Gunaydin FE, Erdal H. Is there a relationship between systemic immune-inflammatory indices and asthma? Ann Clin Anal Med 2023; doi: 10.4328/ACAM.21807.
• 24. Yagcı BA, Erdal H. Can pan-immune inflammation value and systemic inflammatory response index be used clinically to predict inflammation in patients with cataract? Ann Clin Anal Med 2023; doi: 10.4328/ACAM.2165725.
• 25. Xu H, Zheng X, Ai J, Yang L. Hemoglobin, albumin, lymphocyte, and platelet (HALP) score and cancer prognosis: A systematic review and meta-analysis of 13,110 patients. Int Immunopharmacol. 2023;114:109496. Epub 20221130. doi: 10.1016/j.intimp.2022.109496. PubMed PMID: 36462339.
• 26. Johal KJ, Saini SS. Current and emerging treatments for chronic spontaneous urticaria. Ann Allergy Asthma Immunol. 2020;125(4):380-7. Epub 2019/09/09. doi: 10.1016/j.anai.2019.08.465. PubMed PMID: 31494233; PubMed Central PMCID: PMC7056515.
• 27. Varghese R, Rajappa M, Chandrashekar L, Kattimani S, Archana M, Munisamy M, et al. Association among stress, hypocortisolism, systemic inflammation, and disease severity in chronic urticaria. Ann Allergy Asthma Immunol. 2016;116(4):344-8 e1. Epub 2016/02/26. doi: 10.1016/j.anai.2016.01.016. PubMed PMID: 26905640.
• 28. Tarkowski B, Ławniczak J, Tomaszewska K, Kurowski M, Zalewska-Janowska A. Chronic Urticaria Treatment with Omalizumab—Verification of NLR, PLR, SIRI and SII as Biomarkers and Predictors of Treatment Efficacy. Journal of clinical medicine. 2023;12(7):2639.
• 29. Coşansu NC, Kara RÖ, Yaldiz M, Dikicier BS. New markers to predict the response to omalizumab in chronic spontaneous urticaria. Dermatologic Therapy. 2022;35(8):e15589.
• 30. Zeynep G. Halp Score: A Simple and Easily Accessible Index for Predicting Prognosis in Colorectal Cancer Patients. Genel Tıp Dergisi. 2022;32(5):577-82.
• 31. Tian M, Li Y, Wang X, Tian X, Pei LL, Wang X, et al. The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score Is Associated With Poor Outcome of Acute Ischemic Stroke. Front Neurol. 2020;11:610318. Epub 2021/01/30. doi: 10.3389/fneur.2020.610318. PubMed PMID: 33510706; PubMed Central PMCID: PMC7835486