Clinical Predictors for Neutrophil–to–Lymphocyte Ratio Changes in Patients with Chronic Hepatitis B Receiving Peginterferon Treatment

Le, Puo‐Hsien; Liang, Kung–Hao; Chang, Ming‐Ling; Hsu, Chen-Ming; Chen, Yi-Cheng; Lin, Cheng‐Jui; Lin, Wey‐Ran; Lai, Ming‐Wei; Yeh, Chau‐Ting

doi:10.21873/invivo.11121

Cited by 10 publications

(3 citation statements)

References 43 publications

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“…Granulocytes and lymphocytes appeared mutually exclusive, showing a very strong anti-correlation: a behavior that was also detected in the literature [ 46 ]. According to [ 46 , 47 , 48 ], a high neutrophil (granulocytes)/lymphocyte ratio was tied to the inflammatory status of the patient and to impaired cell-mediated immunity. Conversely, a lower ratio could be associated with better outcomes for several diseases, including HBV.…”

Section: Discussionmentioning

confidence: 99%

Multi-View Learning to Unravel the Different Levels Underlying Hepatitis B Vaccine Response

et al. 2023

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The immune system acts as an intricate apparatus that is dedicated to mounting a defense and ensures host survival from microbial threats. To engage this faceted immune response and provide protection against infectious diseases, vaccinations are a critical tool to be developed. However, vaccine responses are governed by levels that, when interrogated, separately only explain a fraction of the immune reaction. To address this knowledge gap, we conducted a feasibility study to determine if multi-view modeling could aid in gaining actionable insights on response markers shared across populations, capture the immune system’s diversity, and disentangle confounders. We thus sought to assess this multi-view modeling capacity on the responsiveness to the Hepatitis B virus (HBV) vaccination. Seroconversion to vaccine-induced antibodies against the HBV surface antigen (anti-HBs) in early converters (n = 21; <2 months) and late converters (n = 9; <6 months) and was defined based on the anti-HBs titers (>10IU/L). The multi-view data encompassed bulk RNA-seq, CD4+ T-cell parameters (including T-cell receptor data), flow cytometry data, and clinical metadata (including age and gender). The modeling included testing single-view and multi-view joint dimensionality reductions. Multi-view joint dimensionality reduction outperformed single-view methods in terms of the area under the curve and balanced accuracy, confirming the increase in predictive power to be gained. The interpretation of these findings showed that age, gender, inflammation-related gene sets, and pre-existing vaccine-specific T-cells could be associated with vaccination responsiveness. This multi-view dimensionality reduction approach complements clinical seroconversion and all single modalities. Importantly, this modeling could identify what features could predict HBV vaccine response. This methodology could be extended to other vaccination trials to identify the key features regulating responsiveness.

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Section: Discussionmentioning

confidence: 99%

Multi-View Learning to Unravel the Different Levels Underlying Hepatitis B Vaccine Response

et al. 2023

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“…Increased numbers of neutrophils promote tumor growth and metastasis through angiogenesis [ 65 , 66 ]. Several studies have established a higher NLR in patients with CHB [ 67 , 68 ].…”

Section: Hepatitis B Virus (Hbv)mentioning

confidence: 99%

Understanding lactate in the development of Hepatitis B virus-related hepatocellular carcinoma

Sheikhrobat,

Mahmoudvand,

Kazemipour-Khabbazi

et al. 2024

Infect Agents Cancer

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Hepatitis B Virus (HBV) is a hepatotropic virus that can establish a persistent and chronic infection in humans. Chronic hepatitis B (CHB) infection is associated with an increased risk of hepatic decompensation, cirrhosis, and hepatocellular carcinoma (HCC). Lactate level, as the end product of glycolysis, plays a substantial role in metabolism beyond energy production. Emerging studies indicate that lactate is linked to patient mortality rates, and HBV increases overall glucose consumption and lactate production in hepatocytes. Excessive lactate plays a role in regulating the tumor microenvironment (TME), immune cell function, autophagy, and epigenetic reprogramming. The purpose of this review is to gather and summarize the existing knowledge of the lactate’s functions in the dysregulation of the immune system, which can play a crucial role in the development of HBV-related HCC. Therefore, it is reasonable to hypothesize that lactate with intriguing functions can be considered an immunomodulatory metabolite in immunotherapy.

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“…Currently, there is an evolving body of literature regarding the concept of the neutrophil-lymphocyte ratio (NLR) and its correlation with the severity and prognosis in a variety of gastrointestinal inflammatory diseases including acute appendicitis, acute pancreatitis, and hepatitis B [6-9]. In this study, we aim to evaluate the prognostic utility of NLR in severe AH.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Neutrophil-lymphocyte Ratio in Patients with Severe Alcoholic Hepatitis

Omar¹,

Randhawa²,

Attar³

et al. 2019

Cureus

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BackgroundPrednisolone is considered the cornerstone treatment for severe alcoholic hepatitis (AH). However, its use is limited by the increased risk of infection in an already immunocompromised patient population. Among patients with severe AH, there exists a group of non-responders who do not benefit from prednisolone therapy. Day-4 Lille score is a widely employed prognostic model used to identify this non-responder subgroup. The present study evaluates the prognostic ability of the inflammatory marker, the neutrophil-lymphocyte ratio (NLR), as a stand-alone model and in conjunction with the day-4 Lille score.MethodsWe retrospectively reviewed the electronic medical records of patients diagnosed with AH. Demographic and biochemical data at diagnosis were collected to calculate Maddrey’s discriminant function (MDF) and model for end-stage liver disease (MELD) score upon admission and also on day 4. Receiver operating characteristic (ROC) curves were plotted for day-4 NLR and day-4 Lille score for prediction of 90-day mortality, and optimal cut-off values were determined. Patients were then subcategorized into groups based on the generated optimal cut-off values. Categorization was validated by comparing the mortality rate in each group with the chi-squared test. We then performed a multivariate analysis for prediction of 90-day mortality using day-4 Lille score and day-4 NLR, constructing a new prediction score based on the odds ratio (OR). The ROC curve of the new score was plotted and the area under a curve (AUC) was reported and compared with previously validated scores.ResultsOur analysis demonstrated that both day-4 NLR and Lille score individually predicted 90-day mortality with statistical significance (p: 0.049, p: <0.001, respectively). The ROC analysis of day-4 Lille score for the prediction of 90-day mortality revealed an AUC of 0.819 with an optimal cut-off value of 0.45 (sensitivity: 83.3%, specificity: 76.1%). Day-4 NLR had an AUC of 0.756 with an optimal cut-off value of 12.3 (sensitivity: 66.7%, specificity: 78.1%) The combined day-Lille-NLR model with a cut-off of 0.55 had an AUC of .889, which was higher than day-4 Lille score and NLR independently.ConclusionDay-4 NLR is an easily assessed prognostic model of mortality in alcoholic hepatitis. However, it often underperforms relative to day-4 Lille score. Combining these two models to create a "modified" Lille score adds increased performance characteristics to the prediction of outcomes/mortality. The "modified" Lille score presented in this study can be used to further cut down the number of non-responders who are often forced to undergo costly and potentially harmful treatment courses.

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Clinical Predictors for Neutrophil–to–Lymphocyte Ratio Changes in Patients with Chronic Hepatitis B Receiving Peginterferon Treatment

Cited by 10 publications

References 43 publications

Multi-View Learning to Unravel the Different Levels Underlying Hepatitis B Vaccine Response

Multi-View Learning to Unravel the Different Levels Underlying Hepatitis B Vaccine Response

Understanding lactate in the development of Hepatitis B virus-related hepatocellular carcinoma

Prognostic Value of Neutrophil-lymphocyte Ratio in Patients with Severe Alcoholic Hepatitis

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