Peripheral blood neutrophil-to-lymphocyte ratio in inflammatory bowel disease and disease activity: A meta-analysis

Fu, Wei; Fu, Hu; Ye, Weixia; Han, Yinsuo; Liu, Xianqiang; Zhu, Shumin; Li, Hongmin; Tang, Rong; Wang, Qin

doi:10.1016/j.intimp.2021.108235

Cited by 33 publications

(30 citation statements)

References 63 publications

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“…Recently, Wang et al conducted a meta-analysis including 2185 IBD patients and 993 healthy controls. In this study, blood NLR were found to be significantly increased in patients with IBD compared with that in healthy controls and more importantly, patients with active IBD showed higher NLR than those in remission, suggesting a role of NLR as a valuable biomarker to predict IBD activity (35). Higher PLR and lower LMR were found between patients with CD and control subjects (17,18).…”

Section: Discussionmentioning

confidence: 53%

Clinical Significance of Novel Neutrophil-Based Biomarkers in the Diagnosis and Prediction of Response to Infliximab Therapy in Crohn’s Disease

et al. 2022

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With the increasing incidence and prevalence, Crohn’s disease (CD) has become one of the most challenging diseases in both diagnosis and treatment of gastroenterology. Evaluation of the disease activity and mucosal healing guides clinical decisions regarding subsequent therapy for CD. In this study, we enrolled a total of 144 patients with CD and 239 healthy controls were enrolled. Clinical characteristics and laboratory parameters of enrolled subjects were retrieved from the electronic medical record database of our hospital. Serum cytokine levels were measured by enzyme-linked immunosorbent assay (ELISA). Mucosa expression levels of inflammatory agents were measured by quantitative RT-PCR (qRT-PCR). We identified two neutrophil-based indexes, the neutrophil-to-albumin ratio (NAR) and neutrophil-to-bilirubin ratio (NBR), both of which had not yet been explored in CD or UC. NAR and NBR were significantly increased in patients with CD compared to those in healthy controls, and both indexes showed significantly positive correlations with CD activity and inflammatory load. In note, NAR and NBR showed better performance than blood neutrophil percentage, serum albumin, or bilirubin alone in these scenarios. More importantly, both NAR and NBR discriminated CD patients who completely or partially responded to infliximab (IFX) induction therapy from those with primary non-response. Our observations suggest that NAR and NBR may serve as promising biomarkers in the diagnosis and prediction of response to IFX therapy in CD.

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Section: Discussionmentioning

confidence: 53%

Clinical Significance of Novel Neutrophil-Based Biomarkers in the Diagnosis and Prediction of Response to Infliximab Therapy in Crohn’s Disease

et al. 2022

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“…Our study showed that a low lymphocyte percentage was a risk factor for depression in elderly patients with CHD. The lymphocyte count is one of the most important peripheral blood inflammatory indices (28). Several studies have shown that peripheral blood inflammatory indices are closely related to depression (29)(30)(31).…”

Section: Discussionmentioning

confidence: 99%

A web-based novel prediction model for predicting depression in elderly patients with coronary heart disease: A multicenter retrospective, propensity-score matched study

Tan

Xu²,

He³

et al. 2022

Front. Psychiatry

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BackgroundDepression is associated with an increased risk of death in patients with coronary heart disease (CHD). This study aimed to explore the factors influencing depression in elderly patients with CHD and to construct a prediction model for early identification of depression in this patient population.Materials and methodsWe used propensity-score matching to identify 1,065 CHD patients aged ≥65 years from four hospitals in Chongqing between January 2015 and December 2021. The patients were divided into a training set (n = 880) and an external validation set (n = 185). Univariate logistic regression, multivariate logistic regression, and least absolute shrinkage and selection operator regression were used to determine the factors influencing depression. A nomogram based on the multivariate logistic regression model was constructed using the selected influencing factors. The discrimination, calibration, and clinical utility of the nomogram were assessed by the area under the curve (AUC) of the receiver operating characteristic curve, calibration curve, and decision curve analysis (DCA) and clinical impact curve (CIC), respectively.ResultsThe predictive factors in the multivariate model included the lymphocyte percentage and the blood urea nitrogen and low-density lipoprotein cholesterol levels. The AUC values of the nomogram in the training and external validation sets were 0.762 (95% CI = 0.722–0.803) and 0.679 (95% CI = 0.572–0.786), respectively. The calibration curves indicated that the nomogram had strong calibration. DCA and CIC indicated that the nomogram can be used as an effective tool in clinical practice. For the convenience of clinicians, we used the nomogram to develop a web-based calculator tool (https://cytjt007.shinyapps.io/dynnomapp_depression/).ConclusionReductions in the lymphocyte percentage and blood urea nitrogen and low-density lipoprotein cholesterol levels were reliable predictors of depression in elderly patients with CHD. The nomogram that we developed can help clinicians assess the risk of depression in elderly patients with CHD.

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“…Blood tests including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), fibrinogen, albumin, bilirubin, uric acid, auto-antibodies (e.g., anti-pTNP, ASCA antibodies) are widely utilized in IBD management ( 10 – 14 ), as well as fecal calprotectin and lactoferrin ( 15 ). Given the crucial role of neutrophils in the disease pathogenesis ( 16 , 17 ), neutrophil-based indexes have been generated and applied in the IBD area ( 18 – 23 ). For example, the neutrophil-to-lymphocyte ratio (NLR) is easily accessible from routine blood tests for both inpatients and outpatients, and it has been strongly suggested as a valuable predictive marker to distinguish patients with IBD from non-IBD controls and differentiate disease activity in IBD ( 24 ).…”

Section: Introductionmentioning

confidence: 99%

A Novel Neutrophil-Based Biomarker to Monitor Disease Activity and Predict Response to Infliximab Therapy in Patients With Ulcerative Colitis

et al. 2022

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BackgroundUlcerative colitis (UC) is characterized by refractory and recurrent mucosal inflammation, leading to a substantial healthcare burden. Diagnostic biomarkers predicting disease activity and treatment response remain elusive. To evaluate the application value of a novel neutrophil-based index (the neutrophil-to-albumin ratio, NAR) as a novel diagnostic biomarker in patients with UC and a predictive marker for disease activity and response to infliximab (IFX) therapy.MethodsClinical characteristics and laboratory parameters of enrolled subjects (patients with UC and healthy controls) were retrieved from the electronic medical record database of our hospital. Serum cytokine and fecal calprotectin levels were measured by enzyme-linked immunosorbent assay (ELISA). Mucosal expression levels of inflammatory agents were measured by quantitative RT-PCR (qRT-PCR).ResultsWe found that NAR, which had not yet been explored in UC, was significantly increased in patients with UC (n = 146) compared to that in controls (n = 133) (1.95 ± 0.41 vs. 1.41 ± 0.23, p < 0.0001). NAR showed a positive association with the disease activity and inflammatory load in patients with UC. Pre-treatment NAR was significantly lower in IFX responders than that in non-responders (2.18 ± 0.29 vs. 2.44 ± 0.21, p = 0.0118), showing a significant ability to discriminate initial responders from primary non-responders to IFX induction therapy (AUC = 0.7866, p = 0.0076). Moreover, pre-treatment NAR predicted postinduction serum IFX trough level.ConclusionOur study provides evidences to utilize NAR in the diagnosis, activity monitoring, and IFX response prediction in patients with UC.

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Peripheral blood neutrophil-to-lymphocyte ratio in inflammatory bowel disease and disease activity: A meta-analysis

Cited by 33 publications

References 63 publications

Clinical Significance of Novel Neutrophil-Based Biomarkers in the Diagnosis and Prediction of Response to Infliximab Therapy in Crohn’s Disease

Clinical Significance of Novel Neutrophil-Based Biomarkers in the Diagnosis and Prediction of Response to Infliximab Therapy in Crohn’s Disease

A web-based novel prediction model for predicting depression in elderly patients with coronary heart disease: A multicenter retrospective, propensity-score matched study

A Novel Neutrophil-Based Biomarker to Monitor Disease Activity and Predict Response to Infliximab Therapy in Patients With Ulcerative Colitis

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