Role of the Neutrophil to Lymphocyte Ratio in Guillain Barré Syndrome: A Systematic Review and Meta-Analysis

Abstract

In this study, we conducted a systematic review and meta-analysis regarding the role of the neutrophil to lymphocyte ratio (NLR) in Guillain Barré syndrome (GBS). The most recent update to the search was on July 18, 2022, through the databases of Web of Science, PubMed, Embase, and Scopus. The Newcastle-Ottawa scale was used for quality assessment of included studies. Finally, 14 studies were included in the review, and among them, ten studies were included in the meta-analysis. Our results showed that NLR levels were significantly increased in the patients with GBS compared with healthy controls ( SMD = 1.05 ; 95 % CI = 0.59 to 1.50, P < 0.001 ). After treatment, NLR levels were decreased to the extent that they became similar to healthy controls ( SMD = − 0.03 , 95 % CI = − 0.29 to 0.22, P = 0.204 ). Moreover, NLR was a stable predictor of outcome or response to treatment in such patients ( SMD = 1.01 , 95 % CI = 0.65 to 1.37, P < 0.001 ); the higher the NLR, the worse the outcome. In addition, patients who underwent mechanical ventilation had higher levels of NLR compared to those who did not ( SMD = 0.93 , 95 % CI = 0.05 to 1.82, P = 0.03 ). However, NLR levels were not different among distinct GBS subtypes, so it could not distinguish among them. In conclusion, our analysis indicates that the NLR levels are highly elevated in patients with GBS. Therefore, the NLR has the potential to be used as a biomarker to inform diagnosis, prognosis, or treatment responses in GBS, and future studies are warranted.

Conduction System Disease in Victims of COVID-19

“…Moreover, assessing ECG parameters in conduction system disease in victims of COVID-19, ST-T changes, fragmented QRS, axis deviation, presence of S1Q3T3, and poor R wave progression were significantly related to conduction disease in victims of COVID-19. possible suggestive of new-onset myocardial infarctions during the infection, increasing the risk of mortality (38)(39)(40). This may indicate that COVID-19 adversely affects cardiac myocardial tissue more than how it was taken for granted.…”

Neuroinflammation and Microglial Polarity: Sirolimus Shifts Microglial Polarity to M2 phenotype in a Mouse Model of Tuberous Sclerosis Complex

“…In Alzheimer's disease (AD) and Parkinson's disease (PD), typical neurodegenerative diseases, persistent neuroinflammation by microglia is involved in the onset and worsening of these conditions. Furthermore, inflammation is involved in neurological diseases such as epilepsy and Guillain-Barré syndrome [20,21]. Therefore, suppressing neuroinflammation might ameliorate symptoms of neurodegenerative diseases [19].…”

A study on the role of serum uric acid in differentiating acute inflammatory demyelinating polyneuropathy from acute‐onset chronic inflammatory demyelinating polyneuropathy

“…It has been shown that inflammatory factors apart from cellular and humoral immunity play a role in the pathogenesis of GBS [10]. Numerous hematology indicators, including neutrophil-to-lymphocyte ratio (NLR), platelet−lymphocyte ratio (PLR), C-reactive protein, systemic inflammation response index (SIRI) and systemic immune-inflammation index (SII) in GBS patients have been explored in several studies before [11][12][13][14][15], but these parameters have not been studied in inflammatory neuropathies clinical subgroups, and the correlation between these parameters and disease severity needs further research. Additionally, uric acid (UA) is a strong natural scavenger of reactive oxygen and nitrogen species.…”