Neutrophil to-lymphocyte ratio as a possible predictor of prognosis in recently diagnosed multiple sclerosis patients

Yetkin, Mehmet Fatih; Mirza, Meral

doi:10.1016/j.jneuroim.2020.577307

Cited by 13 publications

(16 citation statements)

References 17 publications

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“…Six studies evaluated NLR or CRP levels in association with disease activity in MS patients. 8,19,25,28,32,33 CRP levels were reported to be elevated in patients in relapses in one study; however, there were no associations between CRP levels and other measures of disease activity such as MRI activity and annualized relapse rate. 8 None of the other studies reported associations between CRP levels and disease activity.…”

Section: Crp and Nlr As Biomarkers Of Disease Activity In Msmentioning

confidence: 90%

“…Disease activity was investigated in six of the included studies. 8,19,25,28,32,33 Of those, four studies investigated NLR related to disease activity, and all found significant associations. 19,25,28,33 No difference in CRP levels between SPMS/PPMS (median 0.6, range 0.5;4.1) and RRMS (median 0.5, range 0.5;2.5, p = 0.63) or between SPMS and PPMS (median 0.5 mg/dL, range 0.5;3.2 vs. median 0.5 mg/dL, range 0.…”

Section: Disease Activity In Ms Patientsmentioning

confidence: 99%

“…One of the most recent studies evaluated in this review investigated whether baseline NLR values could predict worsening of disability, MRI activity, and relapses in 270 treatment-naïve RRMS patients. 33 Furthermore, patients were stratified into groups depending on treatment escalation or not. NLR was higher at baseline in patients that escalated therapy compared with those not escalating (p < 0.001).…”

Section: Disease Course Disability and Treatment Effectsmentioning

confidence: 99%

“…On the other hand, NLR was found to be associated with disease activity in all studies assessing this. 19,25,28,33 All four studies excluded patients who had received immunosuppressants or immunomodulating therapies within six months prior to blood sampling, and three of the studies additionally excluded patients who had received corticosteroid treatment within four weeks before blood sampling, 19,28,33 The strengths of this review include the following: First, we conducted our search in multiple databases; second, we included non-published studies in our search strategy to minimize the risk of selection bias; third, all abstracts and titles were assessed by two reviewers independently; fourth, relatively small studies were included; and fifth, year of publication was not an exclusion criterion; however, among the included publications the earliest year of publication was 2005. A limitation was that we did not include non-English language studies, which can have biased our conclusion.…”

Section: Crp and Nlr As Biomarkers Of Disease Activity In Msmentioning

confidence: 99%

“…This can help to support that an elevated NLR is not necessarily driven by infection 28. In addition, NLR seemed to be able to predict the need for treatment escalation from a first line to a second line DMT, which can be considered as a surrogate measure for disease activity 33. All studies on NLR and disease activity excluded patients treated with DMTs the last 6 months to avoid confounding.…”

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confidence: 99%

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Neutrophil‐to‐lymphocyte ratio and CRP as biomarkers in multiple sclerosis: A systematic review

et al. 2021

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Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system, which causes demyelination and neuroaxonal damage. Low-grade systemic inflammation has been suggested to contribute to the pathogenesis due to amplification of pathogenic immune activation. However, there is a lack of reliable biomarkers of systemic inflammation predicting disease activity and progression in MS. The neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) have been identified as biomarkers of severity and disease activity in various disorders. In September 2020, we conducted a systematic literature search on multiple databases on studies reporting NLR values or CRP levels in MS. The aim of this systematic review was to highlight the current knowledge about the potential of NLR and CRP as biomarkers in MS. A total of nineteen articles qualified for inclusion. Data on CRP were included in fourteen studies and NLR in nine studies. The results regarding CRP were inconsistent, and present literature does not support the use of CRP as a diagnostic or prognostic biomarker in MS. In contrast, NLR values were increased in MS patients compared with healthy controls in all case-control studies. Furthermore, NLR was associated with disease activity in untreated patients. Our systematic review therefore indicates that NLR might serve as a potential biomarker of disease activity.Given that the results of NLR are mainly drawn from retrospective case-control or cross-sectional studies, future prospective studies with long-term follow-up are required to accurately determine optimal timing and cutoff values that may be used in the clinical setting.

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Section: Crp and Nlr As Biomarkers Of Disease Activity In Msmentioning

confidence: 90%

Section: Disease Activity In Ms Patientsmentioning

confidence: 99%

Section: Disease Course Disability and Treatment Effectsmentioning

confidence: 99%

Section: Crp and Nlr As Biomarkers Of Disease Activity In Msmentioning

confidence: 99%

mentioning

confidence: 99%

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Neutrophil‐to‐lymphocyte ratio and CRP as biomarkers in multiple sclerosis: A systematic review

et al. 2021

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Neutrophil-to-Lymphocyte Ratio: a Marker of Neuro-inflammation in Multiple Sclerosis Patients: a Meta-analysis and Systematic Review

Elgenidy

Atef

Nasar

et al. 2023

SN Compr. Clin. Med.

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Neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio are associated with a 2-year relapse in patients with multiple sclerosis

Huang

Lin

Hsu

et al. 2022

Multiple Sclerosis and Related Disorders

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Background:The association between increased neutrophil-to-lymphocyte ratio (NLR) and multiple sclerosis has been demonstrated in several studies. The monocyte-to-lymphocyte ratio (MLR) is an emerging biomarker for disease monitoring. Moreover, there has not been a published Taiwanese study to date. Aim: To investigate the correlation of NLR, MLR and white blood cell (WBC) count as possible biomarkers for predicting a 2-year relapse in patients with multiple sclerosis (MS). Materials and methods: A total of 641 Taiwanese patients with MS were enrolled in the present study between January 1, 2001, and December 31, 2018. We collected data on NLR, MLR, WBC count, disease-modifying therapy (DMT) use, and the time between first diagnosis and first relapse in all patients within a 2-year duration. Results: In the relapse group, there were significantly more patients with NLR >median or MLR >median (p = 0.006 and p = 0.020, respectively). There were also more patients with WBC count >median, although the difference was not statically significant (p = 0.069). The adjusted hazard ratio for relapse and NLR >median was 1.61(p = 0.008). The adjusted hazard ratio for relapse and MLR >median was 1.43 (p = 0.044). Patients with NLR >median or MLR >median had a significantly (p = 0.008 and p = 0.039, respectively) increased risk of MS relapse in the 2 years, compared with those who had NLR

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Neutrophil to-lymphocyte ratio as a possible predictor of prognosis in recently diagnosed multiple sclerosis patients

Cited by 13 publications

References 17 publications

Neutrophil‐to‐lymphocyte ratio and CRP as biomarkers in multiple sclerosis: A systematic review

Neutrophil‐to‐lymphocyte ratio and CRP as biomarkers in multiple sclerosis: A systematic review

Neutrophil-to-Lymphocyte Ratio: a Marker of Neuro-inflammation in Multiple Sclerosis Patients: a Meta-analysis and Systematic Review

Neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio are associated with a 2-year relapse in patients with multiple sclerosis

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