High neutrophil-to-lymphocyte ratio predicts short survival duration in amyotrophic lateral sclerosis

Abstract

the present study aimed to investigate the prognostic importance of the neutrophil-to-lymphocyte ratio (NLR) in patients with amyotrophic lateral sclerosis (ALS). Among 322 patients diagnosed as having definite, probable, or possible ALS at a single tertiary hospital, 194 patients were included in the final analysis. Patients were divided into three groups (T1, T2, and T3) according to the tertile of their NLR. Survival rate was significantly lower in T3 compared to the other groups (log-rank test; T1 vs. T3, p = 0.009; T2 vs. T3, p = 0.008). Median survival duration was 37. 0 (24.0-56.0), 32.5 (19.5-51.2), and 22.0 (17.0-38.0) months in T1, T2, and T3, respectively. In a multivariable Cox proportional hazards regression analysis, the hazard ratio of age at onset, bulbar-onset, and NLR (T3/T1) was 1. 04 (1.02-1.06, p < 0.001), 1.68 (1.10-2.57, p = 0.015), and 1.60 (1.01-2.51, p = 0.041), respectively. A high baseline NLR may serve as a useful indicator for short survival duration in patients with ALS.

Diagnostic blood RNA profiles for human acute spinal cord injury

“…4 C ), but none of these were significantly different between AIS grades. We also used these inferred proportions to calculate leukocyte ratios, which have been proven clinically useful in multiple diseases and traumas ( Choi et al, 2020 ; Quan et al, 2020 ; Zhao et al, 2020 ). The neutrophil-to-lymphocyte and the lymphocyte-to-monocyte ratios were both significantly different between the three groups (one-way ANOVA P values 0.0009 and 0.0273, respectively; Fig.…”

Neutrophil: lymphocyte ratio is positively associated with subclinical diabetic cardiomyopathy

“…Recently, NLR has been identified as a useful biomarker in numerous chronic inflammatory diseases including diabetes, which reflects both an increase in the neutrophil counts and a reduction in the lymphocyte counts. For example, a high baseline NLR may serve as a useful indicator for short survival duration in patients with amyotrophic lateral sclerosis (ALS) [28]. Pretreatment NLR and albuminto-gamma-glutamyl transferase ratio (AGR) predict The data are summarized as the mean ± SD for continuous variables or as a numerical proportion for categorical variables.…”

Immunity in amyotrophic lateral sclerosis: blurred lines between excessive inflammation and inefficient immune responses

“…4 ) ( Henkel et al , 2013 ; Sheean et al , 2018 ), whereas there is moderate negative correlation between Th1 and Th17 T cells, ALSFRS-R and forced vital capacity ( Jin et al , 2020 ). Another study observed a positive correlation between high baseline neutrophil-to-lymphocyte ratio and shorter survival, proposing that it can reflect the degree of neuroinflammation in ALS patients ( Choi et al , 2020 ). A higher ratio of classical monocytes (CD14 ++ CD16 − ) over non-classical monocytes (CD14 ++ CD16 ++ ) is found in familial and sporadic ALS patients and precedes disease onset ( Zondler et al , 2016 ).…”

“…4A ). Data to support this neuroprotective to neurotoxic shift came largely from studies in mutant hSOD1 ALS models, in which the initial presymptomatic and early symptomatic phases are dominated by anti-inflammatory immune responses (anti-inflammatory microglia, Treg and Th2 CD4 T cells), whereas late symptomatic and terminal stages are dominated by proinflammatory immune responses (proinflammatory microglia and astrocytes, inflammatory monocytes, cytotoxic CD8 T cells, Th1 and Th17 CD4 T cells, NK cells and neutrophils) ( Henkel et al , 2013 ; Zhao et al , 2013 ; Murdock et al , 2017 ; Sheean et al , 2018 ; Choi et al , 2020 ; Garofalo et al , 2020 ; Jin et al , 2020 ). As previously discussed, once that a hyperinflammatory state of microglia or astrocytes is established, these glial cells directly become toxic and can kill motoneurons ( Roberts et al , 2013 ; Re et al , 2014 ; Zhao et al , 2015 ).…”