The Diagnostic Value of Neutrophil-Lymphocyte Ratio in Diagnosis of Autism Spectrum Disorders

Abstract

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder, progressive disruption of brain development and synaptic connections, which causes impaired communication and behavioral disorders. However, the etiology is unknown. A damaged perinatal environment causes chronic nerve inflammation in genetically susceptible children of ASD, dysregulation of the immune system, which leads to ASD. The ratio of Neutrophil to Lymphocyte (NLR) as one of the markers of inflammation is frequently associated with inflammation-related psychiatric diseases and is potentially used as a diagnostic instrument. A cross-sectional study was carried out from June to November 2019 by using medical records of Outpatients with growth and development disorders and ASD and involving 69 children. The diagnosis of ASD was confirmed by the fifth edition Diagnostic and Manual of Mental Disorders criteria (DSM-V). A routine hematology test was carried out with a flow cytometry method. Diagnostic tests were performed in 43 children with developmental disorders (mean NLR 1.01±0.07) and 26 ASD children (mean NLR 1.02±0.06), with a cut-off value of 0.68. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of NLR were 84.62%; 27.9%; 41.51%; 25%; and 50.2%, respectively. Neutrophil to lymphocyte is sensitive to diagnose ASD but its accuracy is low. Immune dysfunction and complex neurodevelopmental disorders that are affected by chronic inflammation play a role in the occurrence of ASD. Other inflammatory markers are needed to improve the accuracy of laboratory tests to diagnose ASD.

Some Immunological and Physiological Parameters Levels in Iraq Children with Autism Spectrum Disorders

“…Despite the fact that numerous studies have discovered elevations in inflammatory cytokines in ASD, few have isolated and stimulated circulating monocytes to uncover dynamic responses of these cells in children with ASD. These studies' findings revealed that children with ASD have more monocytes than usual 33,34 and neutrophiles 35,36 refuting the conclusions of Ellul et al, 2022 and the current investigation, which found no differences between the monocytes from ASD and controls as well neutrophils. But compared to the control group, our findings showed that the ASD group had more total WBCs and lymphocytes.…”

Mesenchymal Umbilical Cord Stem Cells Treatment for Autism

“…This data were recorded for eight years children (Prevention, 2021). For Indonesia, the growth rate is 1.14%, and autism is estimated to affect about 2.4 million people, where the increase is approximately five hundred people per year (Sari et al, 2020).…”