Background and purpose: Stroke is a leading cause of death and acquired disability in adults today. Inflammation plays an important role in the pathophysiology of stroke. The peripheral neutrophil-to-lymphocyte ratio (NLR) is an important global inflammatory indicator becoming more mainstream in stroke care. This meta-analysis aims to evaluate the relationship between the baseline NLR and acute ischemic and hemorrhagic stroke, as well as define the clinical significance of NLR in subtypes of ischemic stroke.Methods: This meta-analysis was registered in PROSPERO with the number CRD42018105305. We went through relevant articles from PubMed Central (PMC) and EMBASE. Prospective and retrospective studies were included if related to baseline NLR levels prior to treatment in patients with ischemic or hemorrhagic stroke. Studies were identified up until April 2019. The cutoff value for NLR and the sources of odds ratios (ORs)/risk ratios (RRs) were measured. Modified Rankin Scale (mRS) was used to investigate the outcomes during clinical follow-up. Predefined criteria were used to evaluate the risk of bias in eligible studies. P-values < 0.05 were considered statistically significant. STATA version 14.0 (STATA, College Station, TX) was used in all statistical analyses.Results: Thirty-seven studies with 43,979 individuals were included in the final analysis. Higher NLR levels were correlated with increased risk of ischemic stroke (ORs/RRs = 1.609; 95% CI = 1.283–2.019), unfavorable functional outcome at 3 months (ORs/RRs = 1.851; 95% CI = 1.325–2.584), and increased mortality in patients with ischemic stroke (ORs/RRs = 1.068; 95% CI = 1.027–1.111). While in terms of hemorrhagic stroke (including SAH and ICH), elevated NLR levels only had deleterious effects on mortality (ORs/RRs = 1.080; 95% CI = 1.018–1.146).Conclusions: Baseline NLR level is a promising predictor of the clinical outcomes in both ischemic and hemorrhagic stroke. In addition, elevated NLR is also associated with a high risk of ischemic stroke occurrence. However, future studies are needed to demonstrate the underlying mechanisms and further explain this association.
al. Molecular allergy diagnostics refines characterization of children sensitized to dog dander. J Allergy Clin Immunol. 2019;144:S19-S19. 2. Auge J, Vent J, Agache I, et al. EAACI Position paper on the standardization of nasal allergen challenges. Allergy. 2018;73(8):1597-1608. 3. Nopp A, Cardell LO, Johansson SG. CD-sens can be a reliable and easy-to-use complement in the diagnosis of allergic rhinitis. Int Arch Allergy Immunol. 2013;161(1):87-90. 4. Dahlen B, Nopp A, Johansson SG, Eduards M, Skedinger M, Adedoyin J. Basophil allergen threshold sensitivity, CD-sens, is a measure of allergen sensitivity in asthma. Clin Exp Allergy. 2011;41(8):1091-1097. 5. Erwin EA, Woodfolk JA, James HR, Satinover SM, Platts-Mills TA. Changes in cat specific IgE and IgG antibodies with decreased cat exposure. Ann Allergy Asthma Immunol. 2014;112(6):545-50.e1. 6. Lebel B, Bousquet J, Morel A, Chanal I, Godard P, Michel FB. Correlation between symptoms and the threshold for release of mediators in nasal secretions during nasal challenge with grass-pollen grains. J Allergy Clin Immunol 1988;82(5 Pt 1):869-877. 7. Burnett M, Wegienka G, Havstad S, et al. Relationship of dog-and cat-specific IgE and IgG4 levels to allergic symptoms on pet exposure. J Allergy Clin Immunol Pract. 2013;1(4):350-353. 8. Perzanowski MS, Ronmark E, James HR, et al. Relevance of specific IgE antibody titer to the prevalence, severity, and persistence of asthma among 19-year-olds in northern Sweden. J Allergy Clin Immunol. 2016;138(6):1582-1590.were not able to assess the association between obesity/overweight and AR over time and were therefore unable to come to any specific conclusion on the causal factors. Second, although the immune system matures at around 12 years of age, for the present analysis, we defined children as those aged <18 years, in line with most of the studies included in this meta-analysis. Thus, we strongly suggest that for the purpose of similar studies in the future, authors should define children as ≤12 years old, adolescents as 13-18 years old, and adults as >18 years old. Third, these studies show a high degree of heterogeneity, particularly due to the ascertainment of exposure, adjustment by different confounding factors, and measurement of results mainly assessed by self-reported questionnaires. Finally, as is the case for any systematic review and meta-analysis, despite a thorough literature search, some potentially relevant studies might have been missed by our search strategy. In conclusion, our results suggest that obesity/overweight may be associated with a higher risk of AR in children. Further large cohort studies designed to investigate the temporal role of obesity/overweight in AR, as well as the mechanisms by which obesity/overweight affects AR, should confirm these findings and additionally provide valuable information on targeted therapeutic interventions.
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