The role of systemic ımmune ınflammatory ındex in showing active lesion ın patients with multiple sclerosis

Gökçe, Şeyda Figül; Bolayır, Asli; Çiğdem, Burhanettin; Yildiz, Bülent O.

doi:10.1186/s12883-023-03101-0

Cited by 11 publications

(11 citation statements)

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“…During the COVID-19 epidemic, NLR, PLR, MLR, SII and SIRI all effectively predicted death ( Ghobadi et al, 2022 ). Remarkably, NLR, MLR, PLR, and SII have also been found to be significantly higher in MS patients than in healthy people ( Gokce et al, 2023 ).…”

Section: Introductionmentioning

confidence: 99%

Predictive role of blood-based indicators in neuromyelitis optica spectrum disorders

et al. 2023

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IntroductionThis study aimed to assess the predictive role of blood markers in neuromyelitis optica spectrum disorders (NMOSD).MethodsData from patients with NMOSD, multiple sclerosis (MS), and healthy individuals were retrospectively collected in a 1:1:1 ratio. The expanded disability status scale (EDSS) score was used to assess the severity of the NMOSD upon admission. Receiver operating characteristic (ROC) curve analysis was used to distinguish NMOSD patients from healthy individuals, and active NMOSD from remitting NMOSD patients. Binary logistic regression analysis was used to evaluate risk factors that could be used to predict disease recurrence. Finally, Wilcoxon signed-rank test or matched-sample t-test was used to analyze the differences between the indicators in the remission and active phases in the same NMOSD patient.ResultsAmong the 54 NMOSD patients, neutrophil count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) (platelet × NLR) were significantly higher than those of MS patients and healthy individuals and positively correlated with the EDSS score of NMOSD patients at admission. PLR can be used to simultaneously distinguish between NMOSD patients in the active and remission phase. Eleven (20.4%) of the 54 patients had recurrence within 12 months. We found that monocyte-to-lymphocyte ratio (MLR) (AUC = 0.76, cut-off value = 0.34) could effectively predict NMOSD recurrence. Binary logistic regression analysis showed that a higher MLR at first admission was the only risk factor for recurrence (p = 0.027; OR = 1.173; 95% CI = 1.018–1.351). In patients in the relapsing phase, no significant changes in monocyte and lymphocyte count was observed from the first admission, whereas patients in remission had significantly higher levels than when they were first admitted.ConclusionHigh PLR is a characteristic marker of active NMOSD, while high MLR is a risk factor for disease recurrence. These inexpensive indicators should be widely used in the diagnosis, prognosis, and judgment of treatment efficacy in NMOSD.

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Section: Introductionmentioning

confidence: 99%

Predictive role of blood-based indicators in neuromyelitis optica spectrum disorders

et al. 2023

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“…MS can cause various neurological impairments, such as sensory disturbances, motor weakness, visual loss, cognitive decline, and fatigue, that can affect the quality of life and productivity of patients [3]. The etiology of MS is still unclear, but it is believed to involve a complex interplay of genetic and environmental factors [4,5]. Some ecological factors associated with MS risk or progression are latitude, sunlight exposure, vitamin D levels, Epstein-Barr virus infection, smoking, obesity, and diet [6,7].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and Clinical Features of Multiple Sclerosis in Rafsanjan City, Kerman Province, Iran: A Cross-Sectional Study from 2011 to 2020

Rostami,

Vakilian,

Esmaeilian

et al. 2024

Preprint

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Background: Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system with variable epidemiology and clinical features. This study aimed to examine the epidemiology and clinical characteristics of MS in Rafsanjan City, Iran, from 2011 to 2020. Methods: A cross-sectional study was conducted on patients diagnosed with MS and registered in the Committee for Diagnosis and Treatment of MS. Data were collected using a revised checklist of demographic and clinical variables. The annual incidence and prevalence of MS were calculated with a 95% confidence interval. Descriptive statistics, t-test, and chi-square or Fisher's exact test were used to analyze the data. Results: Out of 361 eligible cases, 220 patients with MS were enrolled. The mean age was 39.44 ± 9.71 years, with 82.3% females and a female-to-male ratio of 4.64. Most patients lived in urban areas (70.5%) and were housekeepers (55.9%). Most births occurred in spring (30.4%) and summer (35.5%). Only 13.2% had a positive family history of MS, and 2.3% had a smoking history. The most common initial symptoms were sensory (28.6%) and visual (17.7%). The dominant disease course was relapsing-remitting MS (RRMS) (79.1%), followed by RPMS (10.9%), PPMS (4.5%), SPMS (4.1%), and CIS (1.4%). The disease course was associated with several demographic and clinical variables. The incidence rate was 4.84 per 100,000, and the prevalence rate was 97.68 per 100,000. Conclusion: MS has a low incidence and prevalence rate in Rafsanjan City. MS mainly affects young urban women who are housekeepers. Sensory and visual impairments are the most frequent initial manifestations, and RRMS is the most common disease course.

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“…There is no literature regarding the utility of other cell ratios, such as neutrophil‐monocyte ratio (NMR), monocyte‐lymphocyte ratio (MLR), systemic immune‐inflammatory index (SII), 17 and systemic inflammatory response index (SIRI 18 ), in this context. Elevation in SII and SIRI scores have been seen in various neurological diseases (e.g., multiple sclerosis, stroke, spinocerebellar ataxia) and correlate with disease severity and prognosis 19–21 . Lactate levels increase during periods of anaerobic respiration and have been shown to be elevated acutely during epileptic seizures.…”

Section: Introductionmentioning

confidence: 99%

“…Elevation in SII and SIRI scores have been seen in various neurological diseases (e.g., multiple sclerosis, stroke, spinocerebellar ataxia) and correlate with disease severity and prognosis. [19][20][21] Lactate levels increase during periods of anaerobic respiration and have been shown to be elevated acutely during epileptic seizures. When measured within 2 h of an event, serum lactate levels differentiate generalized tonic-clonic seizures from seizure mimics such as syncope and PNES, with a sensitivity of 74%-94% and specificity of 88%-93%.…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a peripheral cell ratio and lactate score for differentiating status epilepticus from prolonged psychogenic nonepileptic seizures

Tan,

Sanfilippo,

Colman

et al. 2023

Epilepsia Open

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ObjectiveDifferentiating status epilepticus (SE) from prolonged psychogenic nonepileptic seizures (pPNES) can be difficult clinically. We aimed to define the utility of peripheral cell counts, cell ratios, and lactate levels in distinguishing SE from pPNES.MethodsRetrospective two‐center study investigating the sensitivity and specificity of acute (≤12 h of event offset) peripheral cell counts, cell ratios (neutrophil–lymphocyte ratio, neutrophil–monocyte ratio, monocyte–lymphocyte ratio, platelet–lymphocyte ratio, systemic immune‐inflammatory index [SII], systemic inflammatory response index [SIRI]), and lactate levels in differentiating SE from pPNES. Patients were identified from two tertiary hospitals, with one forming the development cohort and the other the validation cohort. Using generalized additive models to generate biomarker vs time curves, optimal blood collection times were defined for set parameters. Three diagnostic scores combining neutrophil count, SII, or SIRI with lactate levels were developed and validated in separate cohorts.ResultsFor the development cohort, 1262 seizure‐like events were reviewed and 79 SE and 44 pPNES events were included. For the validation cohort, 241 events were reviewed and 20 SE and 11 pPNES events were included. Individually, the biomarkers generally had low sensitivity and reasonable specificity for differentiating SE from pPNES, with the neutrophil count, SIRI, and SII performing best with sensitivities of 0.65–0.84, specificities of 0.64–0.89, and ROC AUCs of 0.78–0.79. Lactate levels peaked at 60 min, while cell counts and ratios peaked after 240 min. Combining early peaking lactate levels and later peaking neutrophil count, SIRI or SII resulted in three scores that improved predictive potential with sensitivities of between 0.75 and 0.79, specificities between 0.93 and 1.00, and ROC AUCs of 0.89–0.91.SignificanceLactate levels peak early post‐SE, whereas cell counts and ratios do so later. The differing post‐event time profiles of lactate levels vs neutrophil count, SIRI, and SII allow incorporation into three separate scores which can assist in differentiating SE from pPNES.

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The role of systemic ımmune ınflammatory ındex in showing active lesion ın patients with multiple sclerosis

Cited by 11 publications

References 50 publications

Predictive role of blood-based indicators in neuromyelitis optica spectrum disorders

Predictive role of blood-based indicators in neuromyelitis optica spectrum disorders

Epidemiology and Clinical Features of Multiple Sclerosis in Rafsanjan City, Kerman Province, Iran: A Cross-Sectional Study from 2011 to 2020

Development and validation of a peripheral cell ratio and lactate score for differentiating status epilepticus from prolonged psychogenic nonepileptic seizures

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