Temporal dynamics of peripheral neutrophil and lymphocytes following acute ischemic stroke

Petrone, Ashley; Eisenman, Rhae D; Steele, Kelsey N; Mosmiller, Lindsey T; Urhie, Ogaga; Zdilla, Matthew J.

doi:10.1007/s10072-019-03919-y

Cited by 46 publications

(40 citation statements)

References 41 publications

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“…Therefore, the NLR, as a combined inflammatory biomarker, integrates information from the two leukocyte subtypes. In particular, it avoids the disadvantage of an absolute value of a single leukocyte subtype, which may be affected by infection or dehydration, and has higher clinical significance than other independent inflammatory biomarkers (Petrone et al, 2019). In recent years, more and more studies have confirmed that the NLR is associated with atherosclerosis and stroke prognosis (Kocaturk et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Routine Peripheral Blood Biomarkers in Alzheimer’s Disease

Dong

Nao

Shi

et al. 2019

Front. Aging Neurosci.

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BackgroundBiomarker screening is of major significance for the early diagnosis and prevention of Alzheimer’s disease (AD). Routine peripheral blood parameters are easy to collect and detect, making them ideal potential biomarkers. Thus, we aimed to evaluate the parameters from routine blood as potential biomarkers for AD.MethodsWe enrolled 56 AD patients, 57 mild cognitive impairment (MCI) patients, and 59 healthy elderly controls. Receiver operating characteristic (ROC) curves were used to assess the diagnostic values of routine blood biomarkers in patients with cognitive impairment.ResultsThere were significant differences in eight parameters between the groups. Logistic regression revealed that the neutrophil% (odds ratio (OR) 1.34, 95% confidence interval [CI] 1.03–1.75, p = 0.031) and neutrophil-to-lymphocyte ratio (NLR; OR 6.27, 95% CI 3.98–9.82, p = 0.003) differentiated AD patients and controls (areas under the curve [AUCs], 0.728 and 0.721) and that the NLR (OR 1.93, 95% CI 1.07–3.47, p = 0.028) and mean platelet volume (OR 1.67, 95% CI 1.04–2.70, p = 0.036) differentiated MCI patients and controls (AUCs, 0.60 and 0.638). There were no effective diagnostic biomarkers to distinguish AD from MCI.ConclusionSome routine blood biomarkers may correlate with cognitive impairment. Analysis of these biomarkers, such as the NLR, may be useful for the identification of patients with cognitive impairment.

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Section: Discussionmentioning

confidence: 99%

Predictive Value of Routine Peripheral Blood Biomarkers in Alzheimer’s Disease

Dong

Nao

Shi

et al. 2019

Front. Aging Neurosci.

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“…Our results also found that an increase in NC at <12 hours poststroke is predictive of poorer functional recovery at 12 months. An increasing NC from 0 to 48 hours poststroke has been previously reported 17 and may reflect changes in blood-brain barrier (BBB) permeability due to disassembly of the tight junctions by hypoxia-reoxygenation 2 and disruptions to both peripheral and central nervous system immune/inflammatory pathways (see review in Brouns and De Deyn 60 ). Although blood tests at 12 hours poststroke could not be compared to prestroke reference levels, this systemic change is confirmation of several known physiological responses to stroke such as penumbral excitotoxicity and perivascular edema 61 and resulting increased glymphatic perfusion.…”

Section: Discussionmentioning

confidence: 91%

“…It is acknowledged, however, that there are other baseline measures such as infection status or atherosclerosis in relationship to WBC and NC that could be addressed as covariates. Furthermore, there may be large variability in the amplitude of immune responses 17 given the wide acute blood sampling times achieved in this study. It is also noted that this study did not collect lymphocyte cell counts that could be used to explore the neutrophil to lymphocyte ratio which has been suggested to be a better measure of acute inflammation than immune cell counts alone.…”

Section: Discussionmentioning

confidence: 99%

“…15 However, knowing when the most clinically and scientifically valuable time points post stroke onset are to measure blood products such as WBC and neutrophil count (NC) for the prediction of poststroke recovery, has not yet been established. Studies examining the acute trajectory of poststroke WBC 16 and NC 17 have shown that cell counts increase rapidly within the first 0 to 2 days poststroke and then fall between 3 and 7 days. Indeed, both the timing and amplitude of acute poststroke immune responses have been found to correlate with stroke severity within 24 hours of symptom onset 18 and also recently have been reported to correlate with improvement on NIHSS scores over the first week.…”

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confidence: 99%

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Acute Routine Leukocyte and Neutrophil Counts Are Predictive of Poststroke Recovery at 3 and 12 Months Poststroke: An Exploratory Study

Nguyen

Howells

Wijeratne

et al. 2020

Neurorehabil Neural Repair

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Background and Aims. White blood cell (WBC) and neutrophil counts (NC) are common markers of inflammation and neurological stroke damage and could be expected to predict poststroke outcomes. Objective. The aim of this study was to explore the prognostic value of early poststroke WBC and NC to predict cognition, mood, and disability outcomes at 3 and 12 months poststroke. Methods. Routine clinical analyses WBC and NC were collected at 3 time points in the first 4 days of hospitalization from 156 acute stroke patients. Correlations using hierarchical or ordinal regressions were explored between acute WBC and NC and functional recovery, depression, and cognition at 3 and 12 months poststroke, after covarying for age and baseline stroke severity. Results. We found significant increases in NC between <12 hours and 24 to 48 hours time points ( P = .05). Hierarchical regressions, covaried for age and baseline stroke severity, found that 24 to 48 hours WBC ( P = .05) and NC ( P = .04) significantly predicted 3-month cognition scores. Similarly, 24 to 48 hours WBC ( P = .05) and NC ( P = .02) predicted cognition scores at 12 months. Increases in WBC and NC were predictive of increased cognition scores at both 3 and 12 months (positive recovery) though there were no significant associations between WBC and NC and disability or depression scores. Conclusions. Routine acute stroke clinical laboratory tests such as WBC and NC taken between 24 and 48 hours poststroke are predictive of cognition poststroke. It is interpreted that higher rapid immunological activation in the acute phase is an indicator for the trajectory of positive stroke recovery.

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“…Among the proposed functional outcome measures, higher neutrophil-lymphocyte ratio and platelet distribution width are known to be predictive of clinical outcomes and 3-month mortality in patients with AIS. [29][30][31] These indicators, along with RDW values, can be easily measured by conventional whole blood analysis. Therefore, using a prognostic approach that combines these outcome measures to predict long-or short-term mortality in patients with AIS who are treated with IVT would be a more effective, convenient, and innovative alternative to existing clinical diagnostic methods.…”

Section: Discussionmentioning

confidence: 99%

<p>Predicting the One-Year Prognosis and Mortality of Patients with Acute Ischemic Stroke Using Red Blood Cell Distribution Width Before Intravenous Thrombolysis</p>

Ye¹,

Li²,

Li³

et al. 2020

CIA

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These authors contributed equally to this workPurpose: Red blood cell (RBC) distribution width (RDW) is known to reflect the heterogeneity of RBC volume, which may be associated with cardiovascular events or mortality after myocardial infarction. However, the association between RDW and stroke, especially regarding endpoints such as death, remains ambiguous. This study aimed to explore the prognostic value of RDW and its effect on mortality among patients with acute ischemic stroke (AIS) undergoing intravenous thrombolysis (IVT) after one year. Patients and Methods: We retrospectively reviewed patients with AIS treated with IVT between January 2016 and March 2018. We grouped the patients according to modified ranking scale (MRS) scores as follows:0-2, favorable functional outcome group; and 3-6, unfavorable functional outcome. Predictors were determined using multivariate logistic regression (MVLR). The area under receiver-operating characteristic curve (AUC) was used to evaluate the predictive capability of variables. Furthermore, the Cox proportional hazard model was used to assess the contribution of risk factors to the outcome of death at one year later. Results: MVLR analysis showed that RDW (odds ratio [OR], 1.179; 95% confidence interval [CI], 0.900-1.545; p = 0.232) was not an independent predictor of unfavorable functional outcome, but it (OR 1.371; 95% CI 1.109-1.696; p = 0.004) was an independent biomarker for all-cause mortality. The optimal RDW cut-off value to predict mortality was 14.65% (sensitivity: 42%, specificity: 88.3%, AUC: 0.649, p < 0.001). Furthermore, higher RDW (hazard ratio, 2.860; 95% CI, 1.724-4.745; p < 0.001) indicated a greater risk of death. Conclusion: The baseline RDW is a potential predictor of mortality in patients with AIS undergoing IVT, but RDW might not be associated with worse survival function among stroke survivors, which will help us to improve treatments and the management of patients with AIS.

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Temporal dynamics of peripheral neutrophil and lymphocytes following acute ischemic stroke

Cited by 46 publications

References 41 publications

Predictive Value of Routine Peripheral Blood Biomarkers in Alzheimer’s Disease

Predictive Value of Routine Peripheral Blood Biomarkers in Alzheimer’s Disease

Acute Routine Leukocyte and Neutrophil Counts Are Predictive of Poststroke Recovery at 3 and 12 Months Poststroke: An Exploratory Study

<p>Predicting the One-Year Prognosis and Mortality of Patients with Acute Ischemic Stroke Using Red Blood Cell Distribution Width Before Intravenous Thrombolysis</p>

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