High Neutrophil-to-Lymphocyte Ratio Is an Early Predictor of Bronchopulmonary Dysplasia

Abstract

Background and Objective: Bronchopulmonary dysplasia (BPD) is a common complication in preterm infants; predicting the degree of BPD at an early life stage is difficult. Inflammation is a crucial risk factor for BPD pathogenesis, and the neutrophil-to-lymphocyte ratio (NLR) is a potential systemic inflammatory biomarker. We aimed to assess the predictive value of the NLR for BPD.Methods: We carried out a retrospective, single-center, observational study of neonates with gestational ages (GAs) <32 weeks and assessed the association between the NLR and BPD.Results: The study population included 296 preterm infants with BPD (n = 144) or without BPD (n = 152). Among the infants, 75 (25.3%) had mild BPD, 37 (12.5%) had moderate BPD, and 32 (10.8%) had severe BPD. The BPD group had a higher NLR at birth and at 72 h than the non-BPD group. The NLR cutoff value at 72 h for the prediction of BPD was 3.035 (sensitivity = 0.519, specificity = 0.964), and the area under the curve (AUC) was 0.714. The NLR cutoff value at 72 h for predicting severe BPD was 3.105 (sensitivity = 0.607, specificity = 0.819), with an AUC of 0.756. At the NLR cutoff value at 72 for the prediction of BPD, the AUCs were 0.640 and 0.970 in the preterm infants with EOS and congenital pneumonia, respectively.Conclusions: The NLR is an inexpensive, accessible and convenient tool; an increase in the NLR at 72 h could be an early predictor of BPD, especially severe BPD. Additionally, the NLR at 72 h could be a predictor of BPD in preterm infants with intrauterine infections.

Chitin-Derived AVR-48 Prevents Experimental Bronchopulmonary Dysplasia (BPD) and BPD-Associated Pulmonary Hypertension in Newborn Mice

“…In agreement with published literature and prior studies [32][33][34], there was a significant increase in neutrophils [35] and dendritic cells [36] in the BPD group over the RA group (Supplemental Figure S7C). Interestingly, AVR-48 treated BPD animals had decreased neutrophils and increased macrophages compared to untreated BPD animals, and these cell populations were at similar levels as the RA control group.…”

Low-Dose Vitamin D Protects Hyperoxia-Induced Bronchopulmonary Dysplasia by Inhibiting Neutrophil Extracellular Traps

“…Activation, infiltration and delayed clearance of polymorphonuclear neutrophils (PMNs), the most crucial innate immune cells, play important roles in the pathogenesis of BPD (4). Similarly, we found that neutrophil counts and the neutrophil-to-lymphocyte ratio (NLR) of patients with BPD were higher than those in individuals without BPD at birth and at 72 h. The neutrophil counts and NLR at 72 h of the group with severe BPD were higher than those in the group with mild BPD, and our previous study showed that an increase in the NLR at 72 h could be an early predictor of BPD, especially severe BPD (5).…”

Neutrophil-to-Lymphocyte Ratio and Systemic Immune-Inflammation Index—Biomarkers in Interstitial Lung Disease

“…In addition, the lower NLR value in deceased patients supports the presence of a non-inflammatory component in the disease progression. Patients with a predominantly fibrosing reaction have a much worse prognosis compared to patients with a predominant inflammatory reaction [21]. The cut-off value is highly controversial; for example, in patients with systemic involvement such as systemic sclerosis (SSc), NLR values higher than 2.59 were useful in the prediction of interstitial lung disease (ILD).…”