Neutrophil–lymphocyte ratio: a novel predictor for short‐term prognosis in acute‐on‐chronic hepatitis <scp>B</scp> liver failure

Liu, Hongxing; Zhang, H.; Wu, Gang; Yan, Sheng; Chang, Yu Shan; Wang, X.; Zeng, Hui

doi:10.1111/jvh.12160

Cited by 74 publications

(54 citation statements)

References 33 publications

(35 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous studies found that a high baseline NLR was associated with poor treatment response in patients with hepatocellular carcinoma (HCC)[13] and increased risk of mortality in patients with acute pancreatitis or acute coronary syndrome[14, 15]. A few studies have examined the role of NLR in ACLF, but all excluded patients who received ALSS[16]. To our knowledge, this is the first study to shown that the NLR was an independent predictor of mortality in ALSS-treated patients.…”

Section: Discussionmentioning

confidence: 99%

Neutrophil–lymphocyte ratio predicts short term mortality in patients with hepatitis B virus-related acute-on-chronic liver failure treated with an artificial liver support system

et al. 2017

View full text Add to dashboard Cite

AimHepatitis B virus-related acute-on-chronic liver failure has high short-term mortality. Artificial liver support systems (ALSS) may improve outcome and avoid liver transplantation, but predicting short-term prognosis in such patients is difficult. This study aimed to determine whether the neutrophil–lymphocyte ratio (NLR), an inflammation marker, predicted mortality in patients treated with ALSS.MethodsA total of 560 patients with hepatitis B virus-related acute-on-chronic liver failure were enrolled, 338 were treated with ALSS and the others treated with standard of care(SOC). Clinical variables and the NLR were evaluated for prognostic value.ResultsThirty-day mortality was 28.4% in ALSS and 55.4% in SOC patients. The NLR was lower in survivors than in ALSS or SOC patients who died. Univariate and multivariate analysis found that NLR and the chronic liver failure sequential organ failure assessment scores(CLIF-SOFA) were independently associated with 30-day mortality. Among patients with NLRs ≤ 3, 3–6, and >6, 30-day mortality was 7.7%,23.1%, and 69.2% in ALSS and 25.5%, 50.0%, and 75.0% in SOC patients. Among patients with NLRs ≤ 3 or 3–6, mortality was lower in ALSS than in SOC patients (P < 0.01). Mortality rates of ALSS and SOC patients with NLRs > 6 did not different (P >0.05). The area under curve of NLR and CLIF-SOFA was 0.82 and 0.88 in ALSS group, 0.78 and 0.86 in SOC group. The results suggest that liver function in most patients with NLRs ≤ 3 recovered with ALSS treatment, and patients with NLRs > 6 needed emergency liver transplantation.ConclusionNLR was an independent predictor of mortality in ALSS patients and may assist physicians in determining treatment options.

show abstract

Section: Discussionmentioning

confidence: 99%

Neutrophil–lymphocyte ratio predicts short term mortality in patients with hepatitis B virus-related acute-on-chronic liver failure treated with an artificial liver support system

et al. 2017

View full text Add to dashboard Cite

show abstract

“…In the cellular level, various immune imbalances have also emerged as biomarkers in NAFLD, from those in general white blood cells such as neutrophil-to-lymphocyte ratio (NLR), to specific lymphocytes subsets (22–24). The NLR expresses an imbalance in leukocytes with the dominance of neutrophils over lymphocytes and has been increasingly recognized as a predictor of outcomes in NAFLD (25), a role also shown in other chronic liver diseases such as viral hepatitis, liver cirrhosis, and HCC (26–28). Another described cellular imbalance is what occurs at the CD4 + cells level with the dominance of T helper 17 (Th17) subset over the regulatory T (Treg) cells, which results from the polarization of the differentiation of T helper cells, also present in NAFLD and other chronic liver diseases (24, 29–32).…”

Section: Introductionmentioning

confidence: 99%

Immune Imbalances in Non-Alcoholic Fatty Liver Disease: From General Biomarkers and Neutrophils to Interleukin-17 Axis Activation and New Therapeutic Targets

Paquissi

2016

Front. Immunol.

View full text Add to dashboard Cite

Non-alcoholic fatty liver disease (NAFLD) is an increasing problem worldwide and is associated with negative outcomes such as cirrhosis, hepatocellular carcinoma, insulin resistance, diabetes, and cardiovascular events. Current evidence shows that the immune response has an important participation driving the initiation, maintenance, and progression of the disease. So, various immune imbalances, from cellular to cytokines levels, have been studied, either for better compression of the disease pathophysiology or as biomarkers for severity assessment and outcome prediction. In this article, we performed a thorough review of studies that evaluated the role of inflammatory/immune imbalances in the NAFLD. At the cellular level, we gave special focus on the imbalance between neutrophils and lymphocytes counts (the neutrophil-to-lymphocyte ratio), and that which occurs between T helper 17 (Th17) and regulatory T cells as emerging biomarkers. By extension, we reviewed the reflection of these imbalances at the molecular level through pro-inflammatory cytokines including those involved in Th17 differentiation (IL-6, IL-21, IL-23, and transforming growth factor-beta), and those released by Th17 cells (IL-17A, IL-17F, IL-21, and IL-22). We gave particular attention to the role of IL-17, either produced by Th17 cells or neutrophils, in fibrogenesis and steatohepatitis. Finally, we reviewed the potential of these pathways as new therapeutic targets in NAFLD.

show abstract

“…(7,(20)(21)(22). It was reported that the N/L ratio was a poor prognostic factor in non-small cell lung cancer, acute-on-chronic hepatitis B liver failure, advanced pancreatic cancer, and biliary tract cancer (12)(13)(14)23). In patients with idiopathic dilated cardiomyopathy, the N/L ratio is associated with the severity of chronic heart failure (22).…”

Section: Discussionmentioning

confidence: 99%

“…White blood cell (WBC) counts, neutrophil counts, lymphocyte counts, age, sex, and mutation types of patients were extracted. The N/L ratio was calculated by dividing the absolute neutrophil counts with the absolute lymphocyte counts, obtained from the differential WBC count (12)(13)(14)(15)(16)(17).…”

Section: Methodsmentioning

confidence: 99%

“…It was shown that inflammation continues not only during attacks but also during symptom-free periods (8)(9)(10)(11). The neutrophil/lymphocyte (N/L) ratio can be easily obtained from the differential white blood cell (WBC) count and has been studied in the context of many diseases (12)(13)(14)(15)(16)(17). It is a marker of inflammation and predicts disease prognosis (7,15).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Neutrophil-lymphocyte ratio in children with familial Mediterranean fever: original article

Duksal¹,

Alaygut²,

Güven³

et al. 2015

Eur J Rheumatol

View full text Add to dashboard Cite

Objective: The aim of present study was (a) to evaluate the relationship between the neutrophil/lymphocyte (N/L) ratio and mutation types of familial Mediterranean fever (FMF) in children and (b) to evaluate the relationship between the N/L ratio and age.Material and Methods: Three hundred forty-three children with familial Mediterranean fever in the attack-free period and 283 healthy control children were included in the study. Patients were divided into subgroups according to mutation types. Neutrophil and lymphocyte counts were retrieved from medical records of patients and the N/L ratio was calculated from these parameters. Results:The N/L ratio of patients was found to be significantly higher than that of controls (p<0.001). Among 343 patients, homozygous, heterozygous, and compound mutations were observed in 39, 253, and 51 patients, respectively. The differences in the N/L ratio among patients with homozygous, heterozygous, and compound mutations were not statistically significant. The most common mutations were M694V (n=126), E148Q (n=70), M680I, (n=33), and V726A (n=28). Significant differences were not observed among these mutations in terms of the N/L ratio (p>0.05). In all subjects, there was a weak but significant relationship between age and the N/L ratio (r: 0.215, p<0.001). Conclusion:The N/L ratio, which can be determined by simple methods in routine blood tests, may be used for the follow-up monitoring of chronic inflammation in patients. In addition, the N/L ratio may give an idea to clinicians regarding the early initiation of treatment in patients with typical clinical findings of FMF.

show abstract

Neutrophil–lymphocyte ratio: a novel predictor for short‐term prognosis in acute‐on‐chronic hepatitis B liver failure

Cited by 74 publications

References 33 publications

Neutrophil–lymphocyte ratio predicts short term mortality in patients with hepatitis B virus-related acute-on-chronic liver failure treated with an artificial liver support system

Neutrophil–lymphocyte ratio predicts short term mortality in patients with hepatitis B virus-related acute-on-chronic liver failure treated with an artificial liver support system

Immune Imbalances in Non-Alcoholic Fatty Liver Disease: From General Biomarkers and Neutrophils to Interleukin-17 Axis Activation and New Therapeutic Targets

Neutrophil-lymphocyte ratio in children with familial Mediterranean fever: original article

Contact Info

Product

Resources

About