The ratio of neutrophil to lymphocyte predicts interstitial lung disease and its prognosis in patients with primary Sjögren’s syndrome: a retrospective analysis

Zhang, Ke; Li, Wengen; Cai, He; He, Xuechun; Hou, Jingyuan

doi:10.21037/apm-21-1043

Cited by 6 publications

(10 citation statements)

References 28 publications

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“…Adverse outcomes included mortality, worsening radiological lung interstitial change, progressive dyspnea and hypoxemia, and FVC decline ≥ 10% per year. Among the included studies, 15 articles (ILD:n = 2,912, Non-ILD: n = 2,868) compared NLR between patients with and without ILD [ 5 , 8 , 11 , 13 , 15 , 17 – 22 , 29 , 31 , 32 , 34 ], and eight articles (favorable outcomes of ILD: n = 340, unfavorable outcomes of ILD: n = 407) compared NLR between ILD patients with favorable and unfavorable outcomes [ 6 , 8 – 10 , 15 , 16 , 32 , 33 ] (Tables 1 and 2 ). The adjusted RR/HR/OR (95% CI) values of ILD patients with adverse outcomes were collected from nine studies [ 6 , 7 , 9 – 12 , 30 – 32 ].…”

Section: Resultsmentioning

confidence: 99%

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A meta-analysis of the clinical significance of neutrophil-to-lymphocyte ratios in interstitial lung disease

Dong

Zheng

et al. 2023

PLoS ONE

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Interstitial lung disease (ILD) is a group of diffuse parenchymal infiltrating diseases of different etiologies. The neutrophil-to-lymphocyte ratio (NLR) can reflect ILD’s existence, progression, and prognosis and is currently regarded as a promising biological marker. This meta-analysis assessed elevated NLR levels in ILD for their predictive value. From inception to July 27, 2022, the Scopus, Cochrane Library, Web of Science, Embase, and PubMed databases were checked thoroughly. We used the weighted mean difference (WMD) and 95% confidence interval (CI) to compare blood NLR values between groups. We examined the relationship between poor prognoses and elevated NLR concentrations in ILD patients using odds ratios (ORs) and 95% CI. After initially including 443 studies, 24 were ultimately analyzed. Fifteen studies(ILD:n = 2,912, Non-ILD: n = 2,868) revealed that the NLR values in the ILD group were relatively high (WMD = 0.61, 95% CI 0.43–0.79, p = 0.001). Eight articles (with poor prognoses: n = 407, without poor prognoses: n = 340) indicated that ILD patients with poor prognoses had higher NLR values (WMD = 1.33, 95% CI 0.32–2.33, p = 0.01). This distinction was especially noticeable in patients with the connective tissue disease (CTD)associated with ILD subgroup (WMD = 3.53, 95% CI 1.54–5.51, p = 0.0005). The pooled OR for increased NLR levels forecasting poor prognoses of ILD was 1.09 (95% CI 1.03–1.15, p = 0.0008). Increasing blood NLR values have clinical significance and application value for detecting ILD and predicting its poor prognosis, especially in CTD patients.

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Section: Resultsmentioning

confidence: 99%

“…Fifteen studies compared NLR levels in patients with and without ILD [ 5 , 8 , 11 , 13 , 15 , 17 – 22 , 29 , 31 , 32 , 34 ]. A random-effects model was utilized because the heterogeneity test showed statistical differences (I 2 = 66.3%; p = 0.000).…”

Section: Resultsmentioning

confidence: 99%

A meta-analysis of the clinical significance of neutrophil-to-lymphocyte ratios in interstitial lung disease

Dong

Zheng

et al. 2023

PLoS ONE

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“…We also excluded those who lacked information on blood counts or had missing follow-up information in the medical records. Those with evidence of other infections were also excluded ( 13 , 17 , 21 ).…”

Section: Methodsmentioning

confidence: 99%

“…The neutrophil-to-lymphocyte ratio (NLR) is a novel inflammatory marker and an easily obtained parameter ( 13 ). The NLR has been used to predict prognosis and disease activity in many neurologic demyelinating diseases, including NMOSD ( 14 ) and multiple sclerosis ( 15 ), and in other systemic immunologic diseases, such as systemic lupus erythematosus ( 16 ), Sjogren’s syndrome (SS) ( 17 ), and Behçet’s disease ( 18 ). There are no previous studies on the association between relapse rate (RR) and the NLR in patients with pregnancy-related NMOSD.…”

Section: Introductionmentioning

confidence: 99%

Pregnancy-Related Attack in Neuromyelitis Optica Spectrum Disorder With AQP4-IgG: A Single-Center Study and Meta-Analysis

Deng

Qiang

2022

Front. Immunol.

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ObjectiveThis study aimed to investigate the demographic characteristic of pregnancy-related attacks (PRAs) in neuromyelitis optica spectrum disorder (NMOSD). In addition, we investigated the predictors of PRAs as well as the effect of immunosuppressive (IS) therapy in patients with pregnancy-related NMOSD.MethodWe retrospectively analyzed data on clinical and diagnostic characteristics, therapeutic management, and pregnancy outcomes for PRAs in AQP4-IgG-positive NMOSD patients admitted to the Second Xiangya Hospital of Central South University. Moreover, we searched the literature (without any temporal restriction) to identify all such similar cohorts and performed a meta-analysis to evaluate the effectiveness and safety of IS therapy on NMOSD patients with PRAs.ResultWe collected clinical data on 117 women with AQP4 antibody-positive NMOSD; we ultimately included 33 patients (34 pregnancies). Ten patients were relapse-free during pregnancy, and 23 (69.7%) had PRA; attacks were most common during the first trimester of the postpartum period. Maintenance of IS treatment during pregnancy was found to greatly reduce PRAs in patients with NMOSD. PRAs were associated with a higher neutrophil-to-lymphocyte ratio (NLR) at relapse during pregnancy and shorter time interval between the last relapse and conception. The meta-analysis suggested that maintenance of IS treatment during pregnancy can significantly reduce the RR of NMOSD (95%CI=0.35-0.62; z=5.18, p<0.0001) and had no adverse effect on the miscarriage rate. However, the unhealthy newborn occurrence among those receiving IS treatment was 3.73 times higher than that of those not receiving treatment during pregnancy (95%CI=1.40–9.91; z=2.64, p=0.008).ConclusionOur study results demonstrates that pregnancy can induce the onset or relapse of attacks in NMOSD patients. The increased NLR value and disease activity may be a predictor for PRAs in patients with NMOSD. Moreover, administration of IS treatment during pregnancy can reduce the relapse rate. However, the dosage of drugs and risks of adverse effects to the fetus need to be considered. Future prospective studies with larger sample sizes are needed to confirm and extend our findings.

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“…In particular, the NLR has been studied more and more as a marker of systemic inflammation, especially considering its rapid, extensive, and relatively economic evaluation [ 20 ]. NLR is related to the disease activity of numerous autoimmune diseases, such as inflammatory bowel disease [ 75 ], Sjogren's syndrome [ 76 ], rheumatoid arthritis [ 77 ], and ankylosing spondylitis [ 78 ]. The predictive value of NLR exceeds the neutrophil count alone, and NLR may serve as an inexpensive and easily available supplemental marker in MS [ 79 ].…”

Section: Nlr and Clinical Outcome With Ms: The Evidence From Clinical...mentioning

confidence: 99%

Correlation between the Neutrophil-to-Lymphocyte Ratio and Multiple Sclerosis: Recent Understanding and Potential Application Perspectives

Zhou

Jia

Dang

2022

Neurology Research International

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Multiple sclerosis (MS) is a chronic debilitating immune-mediated disease of the central nervous system, which causes demyelination and neuroaxonal damage. Low-grade systemic inflammation has been considered to lead to pathogenesis owing to the amplification of pathogenic immune response activation. However, there is a shortage of reliable systemic inflammatory biomarkers to predict the disease activity and progression of MS. In MS patients, a series of cytokines and chemokines promote the proliferation of neutrophils and lymphocytes and their transfer to the central nervous system. The neutrophil-to-lymphocyte ratio (NLR), which combines the information of the inherent and adaptive parts of the immune system, represents a reliable measure of the inflammatory burden. In this review, we aimed to discuss the inflammatory response in MS, mainly the function of lymphocytes and neutrophils, which can be implemented in the utility of NLR as a diagnostic tool in MS patients. The underlying pathophysiology is highlighted to identify new potential targets for neuroprotection and to develop novel therapeutic strategies.

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The ratio of neutrophil to lymphocyte predicts interstitial lung disease and its prognosis in patients with primary Sjögren’s syndrome: a retrospective analysis

Cited by 6 publications

References 28 publications

A meta-analysis of the clinical significance of neutrophil-to-lymphocyte ratios in interstitial lung disease

A meta-analysis of the clinical significance of neutrophil-to-lymphocyte ratios in interstitial lung disease

Pregnancy-Related Attack in Neuromyelitis Optica Spectrum Disorder With AQP4-IgG: A Single-Center Study and Meta-Analysis

Correlation between the Neutrophil-to-Lymphocyte Ratio and Multiple Sclerosis: Recent Understanding and Potential Application Perspectives

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