PONE-D-21-08384Comparison of mean platelet volume (MPV) and red blood cell distribution width (RDW) between psoriasis patients and controls: a systematic review and meta-analysisPLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: No

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: This is a meta-analysis of RDW and MPV as biomarkers and predictors of disease severity by Jiang et al.

1. Which drugs affecting hematologic diseases were excluded? Was biotin also excluded?

2. Was there a reason why male or female only studies were excluded? While there are potential gender differences in values, you could also run a subset analysis based on gender. Please include reasoning.

3. In limitations, this reviewer suggests adding that it's possible that even aggregated the included studies are not sufficient to detect if there is a difference.

Minor comments:

1. Suggest adding a transition sentence between promising biomarkers and hematologic parameters to improve flow

2. There are spelling/grammar/word errors throughout the paper and highlighting several here:

Introduction- change "The diagnose the psoriasis" to "The diagnosis of psoriasis"

Exclusion standards- change retreated to retracted

Results-11 and 12 should be spelled out

Figure 1- psoriasis is misspelled

Reviewer #2: The present meta-analysis aimed at investigating the association of MPV and RDW with diagnosis and disease severity of psoriasis by extracting data from thirteen studies appropriately chosen according to certain criteria.

The manuscript provides robust statistical analysis on the extracted data to assess the association of MPV and RDW with psoriasis, the heterogeneity among studies and the entity of the publication bias, as well as sensitivity and meta-regression analysis. Nevertheless, more details are needed to clarify the biological aspects related to MPV and RDW involvement in the pathogenesis of psoriasis.

• In the Discussion Section about MPV, authors mention findings from other studies that demonstrate elevation of this parameter in psoriasis patients, suggesting the involvement of increased platelet activation in the pathogenesis of psoriasis. Authors should give a deeper explanation on how MPV can be affected by the clinical-molecular alterations underlying the disease onset and progression, outlining possible mechanisms, pathways or molecular factors related (for instance, recent articles/reviews concerning the role of angiogenesis, cell proliferation, inflammation could be employed for a better introduction of the topic).

• Previous literature suggest RDW as a biomarker of cardiovascular disease susceptibility and inflammation levels in rheumatoid arthritis (RA) and ankylosing spongdylitis (AS). In the Discussion section, authors do not explore the connection between the variation of volume and size of red blood cells (measured by RDW) and the pathological processes underlying the development of psoriasis. Therefore, authors should explain how this parameter could be involved in the pathogenesis of the disease, justifying why clinicians should consider RDW informative in psoriasis patients especially regarding its predictive role in response to treatment.

• This meta-analysis demonstrates a correlation of MPV and RDW with the presence of psoriasis rather than with disease severity. Authors should implement the conclusion suggesting how this finding could help clinicians with the disease management, selection of therapies and patient follow-up, since they purpose these parameters as promising predictive and diagnostic biomarkers of psoriasis.

• References must have the same format even if they come from different databases to allow users easier searching on the source of information mentioned in the manuscript. Therefore, authors should review the bibliography inserting some missing information for example the Digital Object Identifier (doi) and the source of the cited article in all references.

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Reviewer #1: No

Reviewer #2: No

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Comparison of mean platelet volume (MPV) and red blood cell distribution width (RDW) between psoriasis patients and controls: a systematic review and meta-analysis

PONE-D-21-08384R1

Dear Dr. Wang,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Muhammad Tarek Abdel Ghafar, M.D

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #2: All comments have been addressed

Reviewer #3: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #2: Yes

Reviewer #3: Partly

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #2: Yes

Reviewer #3: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #2: Yes

Reviewer #3: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #2: Yes

Reviewer #3: Yes

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6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #2: The present version of the manuscript is considerably improved. In particular, the revised version of the manuscript provides a more detailed and clearer explanation of MPV and RDW involvement in the pathogenesis of psoriasis clarifying its related biological aspects.

Reviewer #3: The present meta-analysis aimed at investigating the association of MPV

and RDW with diagnosis and disease severity of psoriasis. The language of the manuscript is good and the structure is reasonable.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #2: No

Reviewer #3: No