Monocyte-to-lymphocyte ratio affects prognosis in LAA-type stroke patients

Wang, Cheng-ju; Pang, Chunyang; Huanyu,; Cheng, Yifan; Wang, Hong; Deng, Binbin; Huang, Huanjie

doi:10.1016/j.heliyon.2022.e10948

Cited by 12 publications

(6 citation statements)

References 49 publications

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“…MLR emerges as a predictor of MOGAD recurrence, implying that MOGAD patients with low MLR may require intensified treatment strategies. Previous research has shown that high MLR is correlated with poor prognosis in stroke patients and increased susceptibility to recurrence in AQP4-IgG-positive NMOSD patients ( 14 , 25 ), in contrast to our findings of an association between lower MLR and MOGAD recurrence. These discrepancies potentially arise from functional disparities between neutrophils, monocytes, and lymphocytes across distinct diseases.…”

Section: Discussioncontrasting

confidence: 99%

Systemic inflammation response index is a useful indicator in distinguishing MOGAD from AQP4-IgG-positive NMOSD

Wang,

Xia,

et al. 2024

Front. Immunol.

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ObjectiveTo identify reliable immune-inflammation indicators for distinguishing myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) from anti–aquaporin-4 immunoglobulin G (AQP4-IgG)-positive neuromyelitis optica spectrum disorders (NMOSD). To assess these indicators’ predictive significance in MOGAD recurrence.MethodsThis study included 25 MOGAD patients, 60 AQP4-IgG-positive NMOSD patients, and 60 healthy controls (HCs). Age and gender were matched among these three groups. Participant clinical and imaging findings, expanded disability status scale (EDSS) scores, cerebrospinal fluid (CSF) information, and blood cell counts were documented. Subsequently, immune-inflammation indicators were calculated and compared among the MOGAD, AQP4-IgG-positive NMOSD, and HC groups. Furthermore, we employed ROC curve analysis to assess the predictive performance of each indicator and binary logistic regression analysis to assess potential risk factors.ResultsIn MOGAD patients, systemic inflammation response index (SIRI), CSF white cell count (WCC), and CSF immunoglobulin A (IgA) levels were significantly higher than in AQP4-IgG-positive NMOSD patients (p = 0.038, p = 0.039, p = 0.021, respectively). The ROC curves showed that SIRI had a sensitivity of 0.68 and a specificity of 0.7 for distinguishing MOGAD from AQP4-IgG-positive NMOSD, with an AUC of 0.692 (95% CI: 0.567-0.818, p = 0.0054). Additionally, compared to HCs, both MOGAD and AQP4-IgG-positive NMOSD patients had higher neutrophils, neutrophil-to-lymphocyte ratio (NLR), SIRI, and systemic immune-inflammation index (SII). Eight (32%) of the 25 MOGAD patients had recurrence within 12 months. We found that the monocyte-to-lymphocyte ratio (MLR, AUC = 0.805, 95% CI = 0.616–0.994, cut-off value = 0.200, sensitivity = 0.750, specificity = 0.882) was an effective predictor of MOGAD recurrence. Binary logistic regression analysis showed that MLR below 0.200 at first admission was the only risk factor for recurrence (p = 0.005, odds ratio =22.5, 95% CI: 2.552–198.376).ConclusionElevated SIRI aids in distinguishing MOGAD from AQP4-IgG-positive NMOSD; lower MLR levels may be linked to the risk of MOGAD recurrence.

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Section: Discussioncontrasting

confidence: 99%

Systemic inflammation response index is a useful indicator in distinguishing MOGAD from AQP4-IgG-positive NMOSD

Wang,

Xia,

et al. 2024

Front. Immunol.

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“…This means that NMOSD patients with high MLR should prolong first-line therapy or receive second-line therapy earlier to prevent recurrence. Wang et al (2022) found that MLR was associated with the prognosis of acute ischemic stroke and speculated that MLR might be related to the level of inflammation. However, our results did not find significant changes in MLR levels in patients with NMOSD, suggesting abnormalities in the function, but not the number, of monocytes and lymphocytes in active NMOSD.…”

Section: Discussionmentioning

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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“…MLR has shown associations with hematoma progression and prognosis across various medical conditions. Wang et al [ 31 ] analyzed 296 patients with large artery atherosclerosis ischemic stroke and found that MLR could predict the prognosis of patients with large artery atherosclerosis ischemic stroke, with higher MLR levels being associated with poorer outcomes. Nie et al [ 12 ] conducted a retrospective analysis and found that MLR was independently associated with a 90-day adverse outcome in patients with aneurysmal subarachnoid hemorrhage, demonstrating good predictive ability.…”

Section: Discussionmentioning

confidence: 99%

Association Between Monocyte-to-Lymphocyte Ratio and Hematoma Progression After Cerebral Contusion

Zhang,

Duan,

Zhang

et al. 2023

Neurocrit Care

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Background The objective of this research was to examine the impact of the monocyte-to-lymphocyte ratio (MLR) on the advancement of hematoma after cerebral contusion. Methods The clinical information and laboratory test findings of people with cerebral contusion were retrospectively analyzed. Using the tertiles of MLR, the study participants were categorized into three groups, enabling the evaluation of the correlation between MLR and the advancement of hematoma after cerebral contusion. Results Among the cohort of patients showing progression, MLR levels were significantly higher compared with the nonprogress group (P < 0.001). The high MLR group had a significantly higher proportion of patients with hematoma progression compared with the medium and low MLR groups. However, the medium MLR group had a lower proportion of patients with hematoma progression compared with the low MLR group. High MLR levels were independently linked to a higher risk of hematoma progression (Odds Ratio 3.546, 95% Confidence Interval 1.187–10.597, P = 0.024). By incorporating factors such as Glasgow Coma Scale score on admission, anticoagulant/antiplatelet therapy, white blood cell count, and MLR into the model, the predictive performance of the model significantly improved (area under the curve 0.754). Conclusions Our study suggests that MLR may serve as a potential indicator for predicting the progression of hematoma after cerebral contusion. Further research is necessary to investigate the underlying pathological and physiological mechanisms that contribute to the association between MLR and the progression of hematoma after cerebral contusion and to explore its clinical implications.

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Monocyte-to-lymphocyte ratio affects prognosis in LAA-type stroke patients

Cited by 12 publications

References 49 publications

Systemic inflammation response index is a useful indicator in distinguishing MOGAD from AQP4-IgG-positive NMOSD

Systemic inflammation response index is a useful indicator in distinguishing MOGAD from AQP4-IgG-positive NMOSD

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

Association Between Monocyte-to-Lymphocyte Ratio and Hematoma Progression After Cerebral Contusion

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