The relationship between the neutrophil–lymphocyte ratio and disease activity in patients with ulcerative colitis

Demir, Ayşe Kevser; Demirtaş, Ahmet; Kaya, Süheyla Uzun; Tastan, Ibrahim; Bütün, İlknur; Sağcan, Mustafa; Sahin, Şevki; Taşlıyurt, Türker; Yılmaz, Abdülkerim

doi:10.1016/j.kjms.2015.10.001

Cited by 54 publications

(61 citation statements)

References 29 publications

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“…NLR at a cutoff value of 2.35 could discriminate between active and a quiescent UC. NLR was elevated compared to inactive UC patients and controls, and a cutoff value of 2.16 indicated the presence of active disease [21][22][23].…”

Section: Discussionmentioning

confidence: 95%

A Simple Noninvasive Score Predicts Disease Activity and Deep Remission in Ulcerative Colitis

et al. 2018

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Background: There is a need to use noninvasive markers in refining the management of ulcerative colitis to reduce the number of unnecessary colonoscopies, which facilitates the follow-up of activity and the response to treatment. Aim: Postulation of a sensitive, specific, simple and noninvasive score to monitor disease activity in ulcerative colitis. Methods: A case-control study was conducted: 168 patients with ulcerative colitis, 40 healthy individuals, and 60 patients for validation. Patients were divided into new diagnosis (n = 50), clinical remission (n = 60), and relapse (n = 58). The main outcome measures if the score correlates with clinical, endoscopic and histopathological characteristics and if it correlates with deep remission. Results: A scoring system was established composed of lactoferrin at a cutoff of 148.5 μg/mL, neutrophil lymphocyte ratio at a cutoff of 2.35, erythrocyte sedimentation rate at the first hour at a cutoff of 29.5 mm/h, C-reactive protein at a cutoff of 3.85 mg/L, mean platelet volume at a cutoff of 8.8 fL, fecal white blood cells at a cutoff of 9 cells/HPF, and fecal red blood cells at a cutoff of 6 cells/HPF. A score ≥5 can detect 94% of cases of UC as determined by the receiver operating characteristic curve with a sensitivity of 94% and a specificity 100%, AUC 0.92, SE 0.05, p = 0.001, 95% CI 0.82–1.1. In the validation group, it identified severely affected patients with a sensitivity of 95% and a specificity of 85.7%. Conclusions: This easily applied and reproducible noninvasive activity score showed high performance in predicting disease activity and deep remission in ulcerative colitis.

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Section: Discussionmentioning

confidence: 95%

A Simple Noninvasive Score Predicts Disease Activity and Deep Remission in Ulcerative Colitis

et al. 2018

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“…In this context, NLR and PLR could be regarded as simple, inexpensive, and effective inflammation markers that have been linked with several inflammatory and neoplastic diseases [8]. Recent studies have shown that NLR and PLR values are strongly associated with the diagnosis and prognosis of ulcerative colitis, tubo-ovarian abscesses, familial Mediterranean fever, brucella arthritis, and colorectal cancer [8,[14][15][16][17][18]. Although PLR changes in HEG patients have not been studied previously, two recent studies demonstrated that NLR levels are increased and correlated in patients with HEG [6,19].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the hematologic system as a marker of subclinical inflammation in hyperemesis gravidarum: a case control study

et al. 2017

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Objectives: Current evidence suggests that subclinical inflammation plays a significant role in the development of hyperemesis gravidarum (HEG). Simple hematological markers, such as mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), have been shown to reflect inflammatory burden and disease activity in several disorders. This study aimed to determine the diagnostic value of these hematological parameters for HEG. Material and methods:A total of 54 HEG patients and 58 age-and gestational-age-matched control subjects were studied. NLR, MPV, PLR, platelet distribution width (PDW), and red cell distribution width (RDW) values in all patients were calculated and recorded from complete blood cell counts.Results: For HEG patients, the median NLR was 3.2 (1.6-7.1), and the median PLR was 143.7 (78.1-334.6); for control subjects, the values were 2.1 (1.0-4.7) and 93.1 (47.3-194.7), respectively. Although both the NLR and PLR of HEG patients were found to be significantly higher than in the controls, no significant difference was found between the study groups in terms of MPV, RDW, or PDW. Correlation analysis revealed a significant correlation between NLR and CRP (r = 0.872, p < 0.001). Conclusions:Our results show that peripheral blood NLR and PLR values can reflect inflammatory burden in HEG patients and can be used as markers for HEG.

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“…In ulcerative colitis, the extent of neutrophil infiltration correlates with the severity of the disease, and is included in the scoring system of UC severity [11]. Neutrophil-to-lymphocyte ratio (NLR) is increased in the blood of patients with active UC compared to controls [12]. Nevertheless, NLR fails to discriminate between active and non-active UC.…”

Section: Introductionmentioning

confidence: 99%

The Dual Role of Neutrophils in Inflammatory Bowel Diseases

Wéra

Lancellotti

Oury

2016

JCM

227

189

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Inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis, are characterised by aberrant immunological responses leading to chronic inflammation without tissue regeneration. These two diseases are considered distinct entities, and there is some evidence that neutrophil behaviour, above all other aspects of immunity, clearly separate them. Neutrophils are the first immune cells recruited to the site of inflammation, and their action is crucial to limit invasion by microorganisms. Furthermore, they play an essential role in proper resolution of inflammation. When these processes are not tightly regulated, they can trigger positive feedback amplification loops that promote neutrophil activation, leading to significant tissue damage and evolution toward chronic disease. Defective chemotaxis, as observed in Crohn’s disease, can also contribute to the disease through impaired microbe elimination. In addition, through NET production, neutrophils may be involved in thrombo-embolic events frequently observed in IBD patients. While the role of neutrophils has been studied in different animal models of IBD for many years, their contribution to the pathogenesis of IBD remains poorly understood, and no molecules targeting neutrophils are used and validated for the treatment of these pathologies. Therefore, it is crucial to improve our understanding of their mode of action in these particular conditions in order to provide new therapeutic avenues for IBD.

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The relationship between the neutrophil–lymphocyte ratio and disease activity in patients with ulcerative colitis

Cited by 54 publications

References 29 publications

A Simple Noninvasive Score Predicts Disease Activity and Deep Remission in Ulcerative Colitis

A Simple Noninvasive Score Predicts Disease Activity and Deep Remission in Ulcerative Colitis

Evaluation of the hematologic system as a marker of subclinical inflammation in hyperemesis gravidarum: a case control study

The Dual Role of Neutrophils in Inflammatory Bowel Diseases

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