Pretreatment neutrophil-to-lymphocyte ratio predicts clinical relapse of ulcerative colitis after tacrolimus induction

Abstract

Objectives Although tacrolimus is useful as an induction therapy in patients with ulcerative colitis (UC), information regarding the long-term outcome after tacrolimus therapy is insufficient. The aim of this study was to evaluate the clinical significance of the pretreatment neutrophil-to-lymphocyte ratio (NLR) as a prognostic factor in patients with UC receiving tacrolimus, to aid treatment selection. Materials and methods Patients with moderate-to-severe active UC who received oral tacrolimus induction therapy and subsequent immunomodulatory maintenance therapy at our hospital between 2009 and 2017 and who showed clinical response at week 12, were retrospectively enrolled. Cox regression analysis was conducted to study the prognostic role of the pretreatment NLR. The combined impact of the NLR and other known prognostic factors was investigated with multivariate regression. Results Among 45 patients included in this study, 21 patients experienced relapse during a median follow-up period of 16.6 months. Multivariate Cox regression analysis identified the pretreatment NLR (hazard ratio [HR]: 0.82, 95% confidence interval [CI]: 0.72–0.94, P < 0.01) and the use of immunomodulators at the start of tacrolimus treatment (HR: 0.18, 95% CI: 0.05–0.66, P = 0.01) as independent predictors of clinical relapse. Conclusions The pretreatment NLR is an independent prognostic factor in patients with UC treated with tacrolimus.

Vitamin D intake is associated with decreased risk of immune checkpoint inhibitor‐induced colitis

“…While some studies have shown that high NLR predicts increased severity of active UC and CD, 61,62 low NLR has also been found to be strongly associated with risk of UC relapse in patients receiving tacrolimus therapy. 63 In our study, NLR evaluated at the threshold of 3 did not yield statistically significant associations with ICI colitis. In addition, our initial finding of decreased risk of ICI colitis in patients with NLR ≥ 5 was not confirmed in the confirmatory cohort.…”

The Combined Anti-inflammatory Strategy of Beta-2 Adrenergic Agonist and Glucocorticoid on the Laying Hen Model of Ovarian Cancer: the Immune Traits and Ovarian Inflammatory Functions

“…On the other hand, GCs indicated the different behavior on lymphocyte numbers rather than neutrophil because GC results in the skew of T cells, activation of NF-κB via stimulation of Toll-like receptors [85], and activation of death-inducing genes and consequently induce apoptosis [86]. Observed increase and decrease in neutrophils and lymphocyte respectively resulted in a rise of NLR in hens administrated by GC Fluticasone that was similar to the some studies showing that treatments using GC had higher NLR values that are mainly derived by higher neutrophil counts [87]. Despite being none signi cant as compared to control, the BAA group had the lowest neutrophil percentage and NLR among other treatments and except to GC, BAA had the same effect on lymphocyte percentage with the other treatments.…”

Diagnostic performances of neutrophil to lymphocyte ratio and lymphocyte to monocyte ratio in acute ischemic stroke caused by cervicocranial arterial dissection

“…Elevated NLR which implies higher inflammatory burden signifies high neutrophil count due to active inflammation and low lymphocyte count correlating with defective response to the inflammatory process 22‐25 . In previous studies, high neutrophil counts have been associated with adverse prognosis in AD and AIS, whereas high lymphocyte counts have been associated with protective effects in cerebrovascular patients 6,14,26 .…”