Relationship between Neutrophil-to-Lymphocyte Ratio and Systemic Lupus Erythematosus: A Meta-analysis

Wang, Liping; Wang, Chunyan; Jia, Xuqiang; Yang, Minghui; Yu, Jing

doi:10.6061/clinics/2020/e1450

Cited by 31 publications

(21 citation statements)

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“…Fourteen studies with 1246 SLE patients (Ma et al) and 1781 SLE patients (Wang et al) were included in this meta-analysis. The meta-analysis demonstrated elevated levels of NLR and PLR in patients with active SLE (Ma et al) and positive clinical value of NRL for diagnosing SLE, active SLE or LN (Wang et al) [23,24].…”

Section: Discussionmentioning

confidence: 99%

Differential approach to peripheral blood cell ratios in patients with systemic lupus erythematosus and various manifestations

2020

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New markers of systemic lupus erythematosus (SLE) activity are under investigation. In recent years, the researchers have been focusing increased attention on the role of haematological indicators in assessing the disease activity. Specifically, neutrophil-, basophil-, eosinophil-, monocyte-and platelet-to-lymphocyte ratios (NLR, BLR, ELR, MLR and PLR) have been considered. The specific objective of this study was to determine the suitability of the haematological markers for the assessment of SLE activity and SLE-related organ damage. This study is a retrospective analysis of 136 patients with SLE (124 women and 12 men) who received chloroquine/hydroxychloroquine (HQ/HCQ) monotherapy or HQ/HCQ therapy combined with low/medium doses of glucocorticoid. All patients were assessed for disease activity using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) scale. In addition, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) inflammatory parameters were determined in each patient. NLR, BLR, ELR, MLR and PLR were evaluated and correlated with the SLE activity parameters and inflammatory markers. The mean values of the haematological indicators were compared in particular manifestations of SLE-induced organ damage. For numerical variables, descriptive statistics were calculated: median, standard deviation, minimum and maximum values. The Mann-Whitney U test was used for the comparison of continuous variables in the two groups. The Spearman rank correlation test was used to search for any relationships between variables. A p value < 0.05 was considered to be statistically significant. We have found a positive correlation between ELR, MLR and the SLEDAI scale (r = 0.22 and r = 0.27, respectively). NLR, MLR and PLR ratios were significantly correlated with ESR and CRP. Considerably higher NLR values were found in patients with cutaneous and/or mucosal symptoms and with kidney involvement compared to patients without such involvement (4.26 ± 4.2 vs 3.27 ± 2.7; p = 0.05 and 5.45 ± 5.6 vs 3.05 ± 2.0; p < 0.001 respectively). BLR and MLR were significantly higher in patients manifesting symptoms of vasculitis (0.09 ± 0.1 vs 0.02 ± 0.01; p < 0.001 and 3.1 ± 4.2 vs 0.3 ± 0.1; p < 0.001 respectively), arthritis and/or myositis (0.04 ± 0.09 vs 0.02 ± 0.01; p = 0.01 and 1.02 ± 2.6 vs 0.35 ± 0.4; p = 0.01 respectively), whereas elevated ELR ratios were observed in patients with vasculitis (0.4 ± 0.5 vs 0.08 ± 0.06; p < 0.001) compared to patients without such organ involvement. The PLR marker was substantially higher in patients exhibiting haematological disorders in the course of SLE (276.6 ± 226.4 vs 192.6 ± 133.5; p = 0.01). The results indicate that ELR and MLR are effective markers of SLE activity. The haematological indicators may predict SLE-dependent organ damage, particularly cutaneous, mucosal, arthritic, myositic, haematological and kidney involvement.

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Section: Discussionmentioning

confidence: 99%

Differential approach to peripheral blood cell ratios in patients with systemic lupus erythematosus and various manifestations

2020

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“…The systemic inflammatory response was investigated by the neutrophil and lymphocytes counts and by the neutrophil/lymphocyte ratio, as described in other autoimmune diseases [ 22 – 24 ].…”

Section: Methodsmentioning

confidence: 99%

Markers of humoral and cell-mediated immune response in primary autoimmune hypophysitis: a pilot study

et al. 2021

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Introduction Primary autoimmune hypophysitis (PAHs) is a rare inflammatory disease of the pituitary gland. Although largely investigated, the pathogenesis of PAH is not completely clarified. We aimed to investigate the immune response in PAHs. Material and methods Serum anti-pituitary and anti-hypothalamus antibodies (respectively APAs and AHAs) were investigated though an indirect immunofluorescence on monkey hypophysis and hypothalamus slides, serum cytokines though an array membrane and cell-mediated immunity though the white blood cells count. Results Nineteen PAH cases entered the study. APA or AHA were identified in all cases. APA were detected in 13 patients (68.4%) and AHA in 13 patients (68.4%). Ten patients (52.6%) were simultaneously positive for both APA and AHA. The prevalence of APAs and AHAs was higher as compared to those observed in 50 health controls (respectively 14% p < 0.001 and 24% p = 0.004) and in 100 not-secreting pituitary adenoma (NFPAs) (respectively 22% p = 0.002 and 8% p < 0.001). Similarly, the prevalence of simultaneous positivity for APA and AHA (52.9%) was higher as compared to the those detected in patients affected by NFPAs (0%; p < 0.001) and in health controls (16% p = 0.002). No differences were identified between PAHs and controls at qualitative and quantitative analysis of serum cytokines and white blood cells count. Conclusions This study suggest that APA and AHA may be detected in an high percentage of PAH cases and that their simultaneous identification may be useful for the differential diagnosis between PAH and NFPAs, in an appropriate clinical context.

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“…Some studies have found that NLR was a useful marker to assess disease activity both in jSLE and aSLE patients (11,(20)(21)(22). A meta-analysis demonstrated that NLR had positive clinical value for diagnosing SLE, active SLE, and LN (11,24). Ayna et al reported a NLR cut-off value of 1.93 to differentiate SLE patients with or without nephritis (25).…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-to-lymphocyte ratios and platelet-to-lymphocyte ratios in juvenile systemic lupus erythematosus: correlation with disease manifestations

Li¹,

Liu²,

Chen³

et al. 2021

Ann Palliat Med

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Background: This retrospective study aimed to investigate the usefulness of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for organ involvement and disease activity in newly diagnosed juvenile systemic lupus erythematosus (jSLE).Methods: A total of 186 jSLE inpatients were included for analysis. All participants' clinical characteristics and laboratory data were obtained from medical records. The Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score scale was used to assess disease activity. Mann-Whitney U test and Kruskal-Wallis test were performed for non-parametric variables between the groups. Spearman rank correlation coefficient was used to analyze correlations between variables. Results:The NLR was significantly higher in participants with serositis as compared those without serositis [2.72 (1.71-5.0) vs. 2.08 (1.42-3.15), P=0.038]. The PLR was significantly higher in participants manifesting symptoms of cutaneous rash [130.

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Relationship between Neutrophil-to-Lymphocyte Ratio and Systemic Lupus Erythematosus: A Meta-analysis

Cited by 31 publications

References 50 publications

Differential approach to peripheral blood cell ratios in patients with systemic lupus erythematosus and various manifestations

Differential approach to peripheral blood cell ratios in patients with systemic lupus erythematosus and various manifestations

Markers of humoral and cell-mediated immune response in primary autoimmune hypophysitis: a pilot study

Neutrophil-to-lymphocyte ratios and platelet-to-lymphocyte ratios in juvenile systemic lupus erythematosus: correlation with disease manifestations

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