Neutrophil to lymphocyte ratio may be a helpful marker to evaluate disease activity in NMOSD

Lin, Jie; Xue, Binbin; Li, Jia; Xu, Huaqing; Huang, Xu; Yao, Zhichao; Li, Xiang; Xia, Junhui

doi:10.1007/s10072-017-3068-5

Cited by 22 publications

(24 citation statements)

References 33 publications

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“…In this study, compared to HC, NLR is higher in LATAM patients with AQP4-ab-positive NMOSD at disease onset. In general, this finding is similar to that previously reported by Lin et al in a cohort of Chinese adult patients ( 17 ). However, we only included NMOSD patients during their first attack and, therefore, all of them were treatment-naïve at disease onset.…”

Section: Discussionsupporting

confidence: 92%

“…At that point our analysis seems to indicate that, in AQP4-ab-positive NMOSD, NLR might be a potential surrogate for inflammation and not, strictly speaking, for disease activity ( Table 2 ), contrary to what has been described in previous studies ( 16 , 17 ). As this matter was not entirely clear, our study went one step further and directly assessed the prognostic impact of an abnormally high NRL in LATAM patients with AQP4-ab-positive NMOSD.…”

Section: Discussioncontrasting

confidence: 73%

“…Additionally, altered functionality of neutrophils in NMOSD patients was also reported ( 15 ). However, the role of NLR in AQP4-ab-positive NMOSD is currently far from clear and, to the best of our knowledge, only two cross-sectional studies have specifically addressed this issue ( 16 , 17 ).…”

Section: Introductionmentioning

confidence: 99%

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An Abnormally High Neutrophil-to-Lymphocyte Ratio Is Not an Independent Outcome Predictor in AQP4-IgG-Positive NMOSD

et al. 2021

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BackgroundThe neutrophil-to-lymphocyte ratio (NLR) has been investigated in many autoimmune conditions as a biomarker of inflammation and/or disease activity. The role of NLR in AQP4-IgG-positive neuromyelitis optica spectrum disorders (NMOSD) is far from clear. In this study, NLR was evaluated in patients with AQP4-IgG-positive NMOSD at disease onset and its prognostic impact was subsequently assessed.MethodsIn this multicenter study, we retrospectively included all recent/newly diagnosed treatment-naïve patients with AQP4-IgG-positive NMOSD (n=90) from three different countries in Latin America (LATAM): Argentina, Ecuador, and Mexico. NLR was compared between AQP4-IgG-positive NMOSD and healthy controls (HC, n = 365). Demographic, clinical, paraclinical (including imaging), and prognostic data at 12 and 24 months were also evaluated. Multivariate regression analysis was used to describe and identify independent associations between the log-transformed NLR and clinical (relapses and EDSS) and imaging (new/enlarging and/or contrast-enhancing MRI lesions) outcomes.ResultsNLR was higher in NMOSD patients during the first attack compared with HC (2.9 ± 1.6 vs 1.8 ± 0.6; p<0.0001). Regardless of immunosuppressant’s initiation at disease onset, NLR remained higher in NMOSD patients at 12 (2.8 ± 1.3; p<0.0001) and 24 (3.1 ± 1.6; p<0.0001) months. No association was found at 12 and 24 months between the log-transformed NLR and the presence of relapses, new/enlarging and/or contrast-enhancing MRI lesions, and/or physical disability.ConclusionsIn this cohort of LATAM patients with AQP4-IgG-positive NMOSD, NLR was abnormally high in attacks but also during follow-up. However, a high NLR was not an independent predictor of clinical or imaging outcomes in our models.

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Section: Discussionsupporting

confidence: 92%

Section: Discussioncontrasting

confidence: 73%

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An Abnormally High Neutrophil-to-Lymphocyte Ratio Is Not an Independent Outcome Predictor in AQP4-IgG-Positive NMOSD

et al. 2021

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“…As a marker of systemic inflammation, the NLR is more reliable and stable than the WBC count for reflecting inflammatory responses. The NLR might be a useful marker for assessing the disease activity in neuromyelitis optica spectrum disorder, multiple sclerosis (MS), and systemic lupus erythematosus patients 222324. Our team has recently reported that the NLR is a practical and reliable biomarker for monitoring disease progression in patients with AE 9.…”

Section: Discussionmentioning

confidence: 99%

“…The NLR might be a useful marker for assessing the disease activity in neuromyelitis optica spectrum disorder, multiple sclerosis (MS), and systemic lupus erythematosus patients. [22][23][24] Our team has recently reported that the NLR is a practical and reliable biomarker for monitoring disease progression in patients with AE. 9 In the present study, the NLR was higher in the nonremission group before and after treatment, which may be attributed to the severe inflammatory response and the high probability of pulmonary infection in severe patients.…”

Section: Jcnmentioning

confidence: 99%

Factors Affecting the Response to First-Line Treatments in Patients with Anti-N-Methyl-D-Aspartate Receptor Encephalitis

et al. 2019

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Background and Purpose Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is the most common type of autoimmune encephalitis. This study aimed to explore the possible factors affecting the response to first-line treatments in patients with anti-NMDAR encephalitis. Methods We enrolled 29 patients who were diagnosed as anti-NMDAR encephalitis between January 1, 2015, and June 30, 2018. They were divided into the remission and nonremission groups according to their response to first-line treatments. The demographics, clinical manifestations, main ancillary examinations, follow-up treatments, and prognosis of patients were recorded. The symptoms reported on in this study occurred before treatments or during the course of first-line treatments. Results There were 18 patients (62.07%) in the remission group and 11 patients (37.93%) in the nonremission group. Compared to the remission group, a higher proportion of the patients in the nonremission group exhibited involuntary movements, decreased consciousness, central hypoventilation, lung infection, and hypoalbuminemia. The nonremission group had a high incidence of increased intracranial pressure and significant elevations of the neutrophil-to-lymphocyte ratio in peripheral blood (NLR), aspartate aminotransferase, and fibrinogen. Six patients (54.55%) in the nonremission group received second-line immunotherapy. Only one patient (3.45%) died, which was due to multiple-organ failure. Conclusions Anti-NMDAR-encephalitis patients with more symptoms—especially involuntary movements, disturbance of consciousness, central hypoventilation, and accompanying hypoalbuminemia and pulmonary infection—may respond poorly to first-line treatments. Positive second-line immunotherapy therefore needs to be considered. Admission to an intensive-care unit, increased cerebrospinal fluid pressure, and increased NLR might be the significant factors affecting the response to first-line treatments.

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Combined platelet-to-lymphocyte ratio and blood-brain barrier biomarkers as indicators of disability in acute neuromyelitis optica spectrum disorder

Yan,

Wang,

et al. 2023

Neurol Sci

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Neutrophil to lymphocyte ratio may be a helpful marker to evaluate disease activity in NMOSD

Cited by 22 publications

References 33 publications

An Abnormally High Neutrophil-to-Lymphocyte Ratio Is Not an Independent Outcome Predictor in AQP4-IgG-Positive NMOSD

An Abnormally High Neutrophil-to-Lymphocyte Ratio Is Not an Independent Outcome Predictor in AQP4-IgG-Positive NMOSD

Factors Affecting the Response to First-Line Treatments in Patients with Anti-N-Methyl-D-Aspartate Receptor Encephalitis

Combined platelet-to-lymphocyte ratio and blood-brain barrier biomarkers as indicators of disability in acute neuromyelitis optica spectrum disorder

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