Significance of inflammatory biomarkers in clinical diagnostics: Erythrocyte sedimentation rate versus other inflammatory biomarkers: A review

Inflammation is the immune system's response to various stimuli such as cellular injury, microbial infections, physical and chemical insults, tissue damage, and autoimmune or hypersensitivity reactions. Biomarkers derived from serum, plasma, or blood proteins provide valuable diagnostic and prognostic information regarding these inflammatory conditions. Inflammatory biomarkers, crucial for assessing the presence, severity, and progression of inflammation, include the erythrocyte sedimentation rate (ESR) which remains a key laboratory measure for disease activity, useful in diagnosing and monitoring diseases like polymyalgia, rheumatoid arthritis, systemic lupus erythematosus (SLE), multiple myeloma, Hodgkin’s disease, septic arthritis, and osteomyelitis, thus, commonly measured in clinical practice. ESR is influenced by factors including technical aspects such as room temperature, time from specimen collection, tube orientation, and use of anticoagulants; lifestyle factors like physical activity; as well as serum protein concentrations, age, and gender, prompting the development of more advanced biomarkers which offer improved sensitivity, specificity, and predictive value. Acute-phase proteins like C-reactive protein, serum amyloid A protein, and cytokines such as interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-α), are crucial for understanding disease pathophysiology and improving patient care. Measuring these biomarkers aids in early disease identification, accurate diagnoses, and effective treatments, ultimately enhancing patient outcomes and optimising healthcare spending. While ESR remains widely used, newer biomarkers offer greater sensitivity and specificity, improving decision-making and therapeutic monitoring.