The systemic inflammation markers as possible indices for predicting respiratory failure and outcome in patients with myasthenia gravis

Abstract

Objective This study aimed to explore the relationship between systemic inflammation markers and clinical activity, respiratory failure, and prognosis in patients with myasthenia gravis (MG). Methods One hundred and seventeen MG patients and 120 controls were enrolled in this study. Differences in the four immune‐related markers of two groups based on blood cell counts: neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), and systemic immune‐inflammation index (SII) were measured. The stability of the associations between systemic inflammation markers and respiratory failure in MG patients was confirmed by adjusted logistic regression analysis. Moreover, Kaplan–Meier curve and multivariate COX regression models were applied to assess the factors affecting the outcome of MG. Results NLR, PLR, and SII were higher in MG patients than those in controls and were positively associated with MGFA classification, but not LMR. Adjusted logistic regression analysis showed that PLR was an independent predictor of MG with respiratory failure. The ROC curve demonstrated that PLR showed good sensitivity and specificity for the diagnosis of MG with respiratory failure. Kaplan–Meier curve showed that GMG, positive AchR‐Ab, respiratory failure, high NLR, PLR, SII, and IVIg exposure correlated with the risk for poor outcomes in MG patients. The multivariate COX regression models indicated that GMG and high SII was a risk factor for poor outcome of MG. Interpretation The systemic inflammation markers expressed abnormally in MG patients, in which PLR may be an independent predictor of respiratory failure, and high SII and GMG were predictive risk factors for poor outcomes in MG patients.

Serum amyloid A facilitates expansion of CD4+ T cell and CD19+ B cell subsets implicated in the severity of myasthenia gravis patients

“…Obviously, hyperreactive inflammation is a typical immune feature that dominates the crisis, so a readily accessible and reliable biomarker is necessary to help identify MC. Previous reports, including ours, have demonstrated that systemic inflammation markers (NLR, PLR, LMR, SII and SIRI) were associated with MG (Duan et al., 2022; Huang et al., 2023; Jiang et al., 2021). Here, we reported for the first time that these systemic inflammation markers were abnormally expressed in MC patients.…”

“…were associated with MG (Duan et al, 2022;Huang et al, 2023;Jiang et al, 2021). Here, we reported for the first time that these systemic inflammation markers were abnormally expressed in MC patients.…”

The Relationship Between Newly Derived Inflammatory Biomarkers from Hemogram and Serum Vitamin D Concentration in Pediatric Intensive Care Patients

“…In this situation, researchers find it more accessible to investigate the relationship between vitamin D levels and inflammation using inflammatory markers derived from easily measurable, repeatable, and inexpensive hematologic parameters such as neutrophilto-lymphocyte ratio (NLR) (17,18), platelet-to-lymphocyte ratio (PLR) (17,18), platelet distribution width (PDW) (19), and red cell distribution width (RDW). (18,21,22) The statistical relationship between neutrophil-tolymphocyte ratio and infectious diseases, malignancies, cardiovascular diseases, metabolic syndrome, endstage kidney disease, and other various inflammatory conditions has been demonstrated (5,(22)(23)(24) [28][29][30][31][32][33][34][35][36][37][38]. Additionally, similar relationships have been observed for platelet-neutrophil ratio (18,25).…”

Comparison of immune cell profiles associated with heatstroke, sepsis, or cardiopulmonary bypass: Study protocol for an exploratory, case-control study trial

“…Respiratory failure will be defined as pH < 7.35 and PaCO 2 > 45 mmHg or as PaO 2 /FiO 2 < 200 based on invasive or non-invasive ventilation or arterial blood gas analysis ( 26 , 27 ) within 30 days. If patients with concomitant pulmonary diseases prior to admission meet above diagnostic criteria, the patient will not be considered to have lung injury caused by heatstroke and will be excluded.…”