The Effect of Etanercept Treatment on the levels of Albumin and C-reactive Protein and their Ratio in Iraqi Psoriatic Patients
DOI:
https://doi.org/10.32007/jfacmedbaghdad3258Keywords:
Albumin, Biomarkers, C-reactive protein to albumin ratio, Etanercept treatment, PsoriasisAbstract
Background: Psoriasis, a common chronic autoimmune dermatological disease, is identified by scaling and inflammation seen in the skin. Both environmental and genetic factors contribute to its pathogenesis.
Objectives: To examine changes in albumin and C-reactive protein levels and their ratios, and the effect of Etanercept treatment on these indicators in the serum of Iraqi Psoriasis patients compared to healthy individuals.
Methods: A total of 100 Psoriatic patients were enrolled in the study and matched with healthy individuals (n=93) attending the Department of Venereology and Dermatology at Baghdad Teaching Hospital from November 2024 to April 2025. The levels of C-reactive protein and albumin, as well as their ratio in these patients, were compared with those of the control group. Furthermore, the effects of the biologic treatment were followed up for these parameters using 30 patients, before receiving any treatment, and after three months of Etanercept treatment.
Results: The serum level of albumin showed a highly significant decrease, with a highly significant increase in the concentrations of both serum C-reactive protein and the CRP/albumin ratio in the patient group compared to the control group, respectively. Furthermore, the three-month treatment with Etanercept induced a substantial difference in the albumin levels, and a very notable decrease in both C-reactive protein concentration and CRP/albumin ratio.
Conclusion: Psoriasis is a disease that affects the albumin and C-reactive protein levels, as well as their ratio. In the interim, using Etanercept for three months as biotherapy revealed alterations in the measured levels, achieving concentrations nearly similar to those of normal healthy individuals.
Received: Jan 2026
Revised: Feb. 2026
Accepted: March 2026
Published Online: March 2026
Published: April 2026
References
1. Hasan HR, Abdel Rasul RJ. Impact of Psoriasis disease and its treatment with Etanercept on serum and saliva thiol-disulfide homeostasis. Egyptian Journal of Chemistry. 2023;66(9):37-46. https://doi.org/10.21608/ejchem.2022.150769.6530. DOI: https://doi.org/10.21608/ejchem.2022.150769.6530
2. Yolbaş S, Yalvaç y. Association of the platalet-to-albumin ratio with disease activity scores in psoriatic arthritis patients. Rheumatology Quarterly. 2023;1(4):162-5. https://doi.org/10.4274/qrheumatol.galenos.2023.96168. DOI: https://doi.org/10.4274/qrheumatol.galenos.2023.96168
3. Abdel Rasul RJ, Hasan HR. The oxidative status in sera and saliva of Iraqi Psoriasis patients: a correlation study. Annals of Tropical Medicine and Public Health. 2020;23(19): 232109. https://doi.org/10.36295/ASRO.2020.232109. DOI: https://doi.org/10.36295/ASRO.2020.232109
4. Koç HA, Altınöz Güney C, Aktaş A. The relationship of disease severity with C-reactive protein/albumin ratio and hematological parameters in patients with rosacea. Archives of Dermatological Research. 2025;317(1):420. https://doi.org/10.1007/s00403-025-03861-4. DOI: https://doi.org/10.1007/s00403-025-03861-4
5. Ehlting C, Wolf SD, Bode JG. Acute-phase protein synthesis: a key feature of innate immune functions of the liver. Biological chemistry. 2021;402(9):1129-45. https://doi.org/10.1515/hsz-2021-0209. DOI: https://doi.org/10.1515/hsz-2021-0209
6. Janve YS, Kakadiya J. Exploring Traditional and Novel Diagnostic Biomarkers for Liver Fibrosis: A Comprehensive Review. Journal of Young Pharmacists. 2024;16(2). https://doi.org/10.5530/jyp.2024.16.23. DOI: https://doi.org/10.5530/jyp.2024.16.23
7. Taha M, Shafique U, Rashid W, et al. Diagnostic Accuracy of C-reactive Protein, Procalcitonin, White Blood Cell Count, and Neutrophil-Lymphocyte Ratio in the Early Detection of Post-surgical Infections: A Systematic Review. Cureus. 2025;17(4). https://doi.org/10.7759/cureus.81853. DOI: https://doi.org/10.7759/cureus.81853
8. Sari AP, Ratnawati R, Aniwidyaningsih W, et al. Neutrophyl–Lymphocyte Ratio (NLR) and C-Reactive Protein (CRP) Levels in Stable and Exacerbated Chronic Obstructive Pulmonary Disease (COPD) Patients in Persahabatan Hospital Jakarta. Respiratory Science. 2022;2(2):78-91 https://doi.org/10.36497/respirsci.v2i2.38. DOI: https://doi.org/10.36497/respirsci.v2i2.38
9. Skutnik-Radziszewska A, Maciejczyk M, Flisiak I, et al. Saliva and Plasma of Patients with Plaque Psoriasis. Saliva and Oral Diseases. 2021;9: 23. Available from: https://mdpi-res.com/bookfiles/book/3833/Saliva_and_Oral_Diseases.pdf?v=1740708191 DOI: https://doi.org/10.3390/jcm9030745
10. Parmar D, Salvi D. Comparative assessment of Psoriasis area and severity index and fasting blood sugar levels in psoriatic patients with diabetes mellitus. International Journal of Research. 2019;5(4):732. https://doi.org/10.18203/issn.24554529.IntJResDermatol20194659. DOI: https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20194659
11. Compagnucci P, Dello Russo A, Mohanty S, et al. Catheter ablation of atrial fibrillation in patients with Psoriasis: a multicenter study. Journal of the American Heart Association. 2025;14(6):e038882. https://doi.org/10.1161/JAHA.124.038882. DOI: https://doi.org/10.1161/JAHA.124.038882
12. Chimenti MS, D’Antonio A, Conigliaro P, et al. An update for the clinician on biologics for the treatment of psoriatic arthritis. Biologics: Targets and Therapy. 2020:53-75. https://doi.org/10.2147/BTT.S260754. DOI: https://doi.org/10.2147/BTT.S260754
13. Doumas BT, Watson WA, Biggs HG. Albumin standards and the measurement of serum albumin with bromcresol green. Clinica chimica acta. 1997;258(1):21-30. https://doi.org/10.1016/S0009-8981(96)06447-9. DOI: https://doi.org/10.1016/S0009-8981(96)06447-9
14. Singer JM, Plotz CM, Pader E, et al. The latex-fixation test: III. Agglutination test for C-reactive protein and comparison with the capillary precipitin method. American journal of clinical pathology. 1957;28(6):611-7. https://doi.org/10.1093/ajcp/28.6.611. DOI: https://doi.org/10.1093/ajcp/28.6.611
15. Wang Q, Luo X, Su Y, et al. Tanshinone I Ameliorates Psoriasis-Like Dermatitis by Suppressing Inflammation and Regulating Keratinocyte Differentiation. Drug Design, Development and Therapy. 2025:539-52. https://doi.org/10.2147/DDDT.S504485 DOI: https://doi.org/10.2147/DDDT.S504485
16. Sahoo SR, Das K, Panda B, et al. Serum interleukin (IL)-6, lipid profile, and association with disease severity in patients with Psoriasis: a cross-sectional study. Cureus. 2024;16(9). https://doi.org/10.7759/cureus.69599. DOI: https://doi.org/10.7759/cureus.69599
17. Shakh S, Naik R, Dakhure S, et al. Evaluation of Inflammatory Markers In Psoriatic Patients. CME Journal Geriatric Medicine. 2025;17:88-92. https://doi.org/10.61336/cmejgm/2025-03-12. DOI: https://doi.org/10.61336/cmejgm/2025-03-12
18. Solak B, Kara RÖ. Assessing systemic inflammatory markers in Psoriasis: A retrospective study. Tropical Medicine & International Health. 2024;29(11):971-8. https://doi.org/10.1111/tmi.14052. DOI: https://doi.org/10.1111/tmi.14052
19. De Benedittis G, D’Antonio A, Latini A, et al. Study of lncRNAs expression profile in the response to biological drugs in Psoriatic Arthritis: MEG3 could be a potential genomic biomarker of therapy efficacy. International Immunopharmacology.2024;134:112239. https://doi.org/10.1016/j.intimp.2024.112239. DOI: https://doi.org/10.1016/j.intimp.2024.112239
20. Ataş H, Atak T, Kartal SP, et al. The association of C-reactive protein to albumin ratio wıth lichen planus. Revista da Associação Médica Brasileira. 2025;71(2):e20241166. https://doi.org/10.1590/1806-9282.20241166 DOI: https://doi.org/10.1590/1806-9282.20241166
21. Abdelsalam NA, Abdelhady EI, Rabie M, et al. C-reactive protein/albumin ratio and its improvement with disease activity among axial spondyloarthritis and psoriatic arthritis patients: A prospective study. The Egyptian Rheumatologist. 2024;46(4):180-4. https://doi.org/10.1016/j.ejr.2024.07.002. DOI: https://doi.org/10.1016/j.ejr.2024.07.002
22. Yoshimura A, Sato S, Shibata S. Association between the neutrophil percentage-to-albumin ratio and generalized pustular Psoriasis. Journal of Cutaneous Immunology and Allergy. 2025;8:15227. https://doi.org/10.3389/jcia.2025.15227. DOI: https://doi.org/10.3389/jcia.2025.15227
23. Fan M, Zhang L, Yin Q, et al. Association between hemoglobin albumin lymphocyte and platelet (HALP) score and Psoriasis: Evidence from NHANES. Journal of the National Medical Association. 2025. https://doi.org/10.1016/j.jnma.2025.08.099. DOI: https://doi.org/10.1016/j.jnma.2025.08.099
24. Xiong H, Yu Z. Association between systemic inflammation indicators and Psoriasis: a cross-sectional study from NHANES. Frontiers in Immunology. 2025;16:1556487. https://doi.org/10.3389/fimmu.2025.1556487. DOI: https://doi.org/10.3389/fimmu.2025.1556487
25. Taş-Aygar G, Ataş H, Gönül M, et al. Importance of the C-Reactive protein to albumin ratio in the diagnosis and prognosis of Mycosis Fungoides. Dermatology Practical & Conceptual. 2024;14(2):e2024097. https://doi.org/10.5826/dpc.1402a97. DOI: https://doi.org/10.5826/dpc.1402a97
26. Bakić M, Klisić A, Kocić G, et al. Oxidative stress and metabolic biomarkers in patients with Psoriasis. Journal of Medical Biochemistry. 2024;43(1):97. https://doi.org/10.5937/jomb0-45076. DOI: https://doi.org/10.5937/jomb0-45076
27. Chai C-Z, Ho U-C, Kuo L-T. Systemic inflammation after aneurysmal subarachnoid hemorrhage. International Journal of Molecular Sciences. 2023;24(13):10943. https://doi.org/10.3390/ijms241310943. DOI: https://doi.org/10.3390/ijms241310943
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2026 Rajaa J. Abdel Rasul , Hathama R. Hasan
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons Attribution 4.0 International license..
