Neutrophil-to-lymphocyte ratio: a marker of neuro-inflammation in multiple sclerosis?

Gelibter, Stefano; Pisa, Marco; Croese, Tommaso; Costa, Gloria Dalla; Orrico, Mario; Preziosa, Paolo; Sangalli, Francesca; Martinelli, Vittorio; Furlan, Roberto; Filippi, Massimo

doi:10.1007/s00415-020-10322-7

Cited by 25 publications

(21 citation statements)

References 16 publications

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“…Recent studies have reported that NLR, recognized as a new in ammatory biomarker, was higher in both MS and clinically isolated syndrome patients compared to healthy individuals, which corroborates our study. This rate was also found to be associated with relapse, increased disability, and brain atrophy [11,12,19].…”

Section: Resultsmentioning

confidence: 84%

“…Many ratios such as neutrophil/lymphocyte (NLR), platelet/lymphocyte (PLR), monocyte/lymphocyte (MLR) ratios, obtained by dividing the cell counts by each other, which are thought to be superior to the use of white blood cell subtypes alone in demonstrating in ammation, are currently in practice [10]. It is known that the NLR value increases in early MS [11].In another study by Hemond et al, high NLR and MLR levels were found to be associated with MS-related disability, independent of all demographic, clinical, treatmentrelated, and psychosocial variables. In addition, while demonstrating the relationship between high MLR and brain atrophy, this study established no correlation with T2 hyperintense lesion volume [12].…”

Section: Introductionmentioning

confidence: 99%

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The Role Of Systemic Immune Inflammatory Index To Show The Active Lesion In The Patients With Multiple Sclerosis

Gökçe

Bolayir

Çiğdem

et al. 2022

Preprint

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Background: Multiple Sclerosis (MS) has two pathophysiological processes, one is inflammatory and the other is degenerative. We searched the relation between inflammatory biomarkers within the serums of patients who have active lesions in neuroimaging, and the existence, number, and localization of active lesions, as an indicator of the inflammatory process. Also, regardless of the imaging, we aim to detect the inflammatory period in which clinical, radiological follow-up, and disease-modifying treatments are effective with serum parameters.Methods: One hundred eighty six MS patients, presented to our hospital between January 2016 to November 2021 and 94 age-and- sex-matched healthy volunteers were recruited for our study. While 99 patients had active lesions in magnetic resonance imaging, 87 patients didn’t have any active lesion. Neutrophil/lymphocyte (NLR), platelet/lymphocyte (PLR), monocyte/lymphocyte (MLR) ratios were determined. SII (systemic immune inflammatory index) value was calculated according to the platelet X neutrophil/lymphocyte ratio formula.Results: NLR, MLR and especially PLR, SII ratios were found to be statistically highest in the patient group with active lesions. According to the presence of active lesions, cut-off values for MLR, PLR, NLR and SII were respectively 0.18, 1.53 and 117.15, 434.45.Conclusions: We found that SII and PLR values were correlated with radiological activity. As easily accessible, inexpensive markers, SII and PLR can detect the inflammatory period in which patients have a higher response to treatment, with sufficient sensitivity and specificity. It can also be a helpful evaluation candidate for the presence of radiological activity.

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Section: Resultsmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

The Role Of Systemic Immune Inflammatory Index To Show The Active Lesion In The Patients With Multiple Sclerosis

Gökçe

Bolayir

Çiğdem

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Related studies have also reported that the neutrophil-to-lymphocyte ratio (NLR) was related to disease activity at the onset of MS ( 56 ). However, another study provided results that did not support the use of NLR as a marker of disease activity and disability in MS patients ( 57 ). The association between NLR and disease severity was also confirmed in NMOSD ( 58 ).…”

Section: Discussionmentioning

confidence: 99%

Monocyte to High-Density Lipoprotein Ratio: A Novel Predictive Marker of Disease Severity and Prognosis in Patients With Neuromyelitis Optica Spectrum Disorders

Zhang

Zhou

et al. 2021

Front. Neurol.

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Background and Purpose: To investigate the association of monocyte to high-density lipoprotein ratio (MHR) with disease severity and prognosis in patients with neuromyelitis optica spectrum disorders (NMOSD).Methods: This retrospective study included 125 patients with NMOSD. Demographic and clinical parameters, including the MHR, were assessed. The initial Expanded Disability Status Scale (EDSS) score and relapse rate were used to evaluate disease severity and prognosis, respectively. Correlations between MHR and disease severity and relapse rate were analyzed. The predictive value of MHR for prognosis was evaluated using receiver operating characteristic (ROC) curve analysis.Results: Compared with the low MHR group, the initial EDSS score (median 4.5 vs. 5.5%, P = 0.025) and relapse rate (51.61 vs. 30.16%, P = 0.015) were significantly higher in the high MHR group. MHR was positively correlated with the initial EDSS score (r = 0.306, P = 0.001). Multivariate analysis showed that MHR was significantly associated with severity (odds ratio = 7.90, 95% confidence interval [CI] = 1.08–57.82, P = 0.041), and it was a significant predictor of disease prognosis (hazard ratio = 3.12, 95% CI = 1.02–9.53, P = 0.046). The median relapse interval of the high MHR group was 24.40 months. When the MHR was higher than 0.565, the risk of relapse was high [sensitivity, 33.3%; specificity, 91.9%; area under the ROC curve, 0.642 (95% CI = 0.54–0.74, P = 0.007)].Conclusion: MHR is a novel predictive marker of disease severity and prognosis in patients with NMOSD. Early monitoring and reduction of MHR may allow earlier intervention and improved prognosis.

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“…Yetkin and Mirza discuss the NLR in 270 MS patients with treatment naïve relapsing onset and suggest that baseline NLR in primary MS may be conducive to the risk group stratification and the choice of disease-modifying therapies [ 87 ] ( Table 1 ). A new study by Gelibter confirms the role of NLR in a cohort of newly diagnosed MS and clinically isolated syndrome (CIS) patients, and the results do not support the NLR as a biomarker of disease activity and disability in patients with MS [ 88 ] ( Table 1 ).…”

Section: Nlr and Clinical Outcome With Ms: The Evidence From Clinical...mentioning

confidence: 99%

Correlation between the Neutrophil-to-Lymphocyte Ratio and Multiple Sclerosis: Recent Understanding and Potential Application Perspectives

Zhou

Jia

Dang

2022

Neurology Research International

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Multiple sclerosis (MS) is a chronic debilitating immune-mediated disease of the central nervous system, which causes demyelination and neuroaxonal damage. Low-grade systemic inflammation has been considered to lead to pathogenesis owing to the amplification of pathogenic immune response activation. However, there is a shortage of reliable systemic inflammatory biomarkers to predict the disease activity and progression of MS. In MS patients, a series of cytokines and chemokines promote the proliferation of neutrophils and lymphocytes and their transfer to the central nervous system. The neutrophil-to-lymphocyte ratio (NLR), which combines the information of the inherent and adaptive parts of the immune system, represents a reliable measure of the inflammatory burden. In this review, we aimed to discuss the inflammatory response in MS, mainly the function of lymphocytes and neutrophils, which can be implemented in the utility of NLR as a diagnostic tool in MS patients. The underlying pathophysiology is highlighted to identify new potential targets for neuroprotection and to develop novel therapeutic strategies.

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Neutrophil-to-lymphocyte ratio: a marker of neuro-inflammation in multiple sclerosis?

Cited by 25 publications

References 16 publications

The Role Of Systemic Immune Inflammatory Index To Show The Active Lesion In The Patients With Multiple Sclerosis

The Role Of Systemic Immune Inflammatory Index To Show The Active Lesion In The Patients With Multiple Sclerosis

Monocyte to High-Density Lipoprotein Ratio: A Novel Predictive Marker of Disease Severity and Prognosis in Patients With Neuromyelitis Optica Spectrum Disorders

Correlation between the Neutrophil-to-Lymphocyte Ratio and Multiple Sclerosis: Recent Understanding and Potential Application Perspectives

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