Evaluation of inflammatory biomarkers in patients with keratoconus

Abstract

Objective: To investigate the monocyte-to-HDL-cholesterol ratio (MHR), neutrophil to lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), eosinophil-to-lymphocytes ratio (ELR), platelet distribution width (PDW), red blood cell distribution width (RDW), mean platelet volume (MPV), MPV to platelet count ratio (MPV/PC), and RDW to platelet ratio (RPR) that are accepted as inflammatory markers in patients with keratoconus. Methods: In this study, 43 patients with keratoconus and 43 healthy individuals as the control group were retrospectively evaluated. High density lipoprotein cholesterol (HDL-c), lymphocyte, neutrophil, eosinophil, monocyte, platelet, MPV, PDW, and RDW values were obtained with complete blood count performed on the peripheral blood samples. Results: Absolute monocyte (593 ± 182 vs 492 ± 177; p < 0.05) and neutrophil (4860 ± 1553 vs 3954 ± 1297; p < 0.01) counts were statistically significantly higher in the keratoconus groups compared to the control group. MHR (13.18 ± 5.02 vs 9.88 ± 4.45; p < 0.01) and NLR (2.30 ± 0.87 vs 1.77 ± 0.61; p < 0.01) were statistically significantly higher and LMR (4.07 ± 1.67 vs 5.18 ± 2.06; p < 0.01) was significantly lower in the keratoconus group. As a result of univariate logistic regression analysis, it was observed that MHR and NLR were statistically significant relationship with keratoconus ( p = 0.02 and p = 0.021) (Odds ratio = 5.41 (95% CI: 1.169–6.669) and Odds ratio:5.28 (95% CI: 1.024–6.321); respectively). No statistically significant difference was found between the groups in terms of PLR, ELR, RDW, MPV, PDW, MPV/PC, and RPR. Adjusting for age and gender, multivariate regression analysis revealed that MHR was the most significant parameter to demonstrate relationship with keratoconus ( p = 0.025) (Odds ratio = 4.99 (95% CI: 1.019–6.332)). Conclusion: MHR and NLR values considered as inflammatory markers were statistically significantly higher and LMR value was significantly lower in the keratoconus group. Among these values, MHR was the most reliable parameter.

Single-cell atlas of keratoconus corneas revealed aberrant transcriptional signatures and implicated mechanical stretch as a trigger for keratoconus pathogenesis

“…Beyond that, we also investigated alterations in ImCs. Keratoconus was traditionally regarded as a non-inflammatory disease, while accumulative evidence revealed the role of cytokines in keratoconus corneas and their microenvironment 92 , 93 . With the aid of single-cell data, it was not difficult to clarify this concern.…”

The Diagnostic Value of Neutrophil to Lymphocyte Ratio as an Effective Biomarker for Eye Disorders: A Meta-Analysis

“…Systemic inflammatory indicators such as PLR, monocyte/high-density lipoprotein cholesterol ratio, and red blood cell distribution width have also been demonstrated to be higher in individuals with KC [ 5 , 11 , 13 , 15 ]. However, to date, there has been little agreement on the importance of NLR level in these patients [ 5 , 11 , 13 , 15 , 23 , 27 ].…”

Keratoconus patients exhibit a distinct ocular surface immune cell and inflammatory profile

“…Aberrant neutrophil activation is often associated with pathology in a variety of tissues 13 , 68 . Although neutrophil–lymphocyte ratio (NLR) in the circulation of KC patients was reported to be increased 69 , 70 , the proportion varied between studies and one study reported no significant increase in the NLR in KC patients 71 . Hence, studying the local neutrophil status, such as that on the KC patient's ocular surface, would prove relevant and valuable.…”