SENSITIVITY OF PLATELET-LYMPHOCYTE RATIO, MONOCYTE-LYMPHOCYTE RATIO, NEUTROPHIL-LYMPHOCYTE RATIO, RED BLOOD CELL DISTRIBUTION WIDTH AND SYSTEMIC IMMUNE INFLAMMATORY INDEX IN MULTIPLE SCLEROSIS PATIENTS: RELATIONSHIP WITH DISEASE SUBTYPES AND DISABILITY

Year 2024, Volume: 25 Issue: 3, 315 - 321, 18.07.2024

Melike Doğan Ünlü Serpil Demirci

https://doi.org/10.18229/kocatepetip.1268139

Abstract

OBJECTIVE: Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system (CNS). Although it is not clear how autoimmune responses occur, it is known that peripheral blood cells may promote the initiation and exacerbation of the inflammatory response in MS. The aim of this study was to evaluate the sensitivity and specificity of neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), erythrocyte distribution width (RDW) and systemic immune inflammation index (SIII) in MS and to determine their relationship with disability.
MATERIAL AND METHODS: In this single-center, retrospective case-control study, 104 patients with MS and 65 healthy individuals were included. Disability was assessed with the Expanded Disability Status Scale (EDSS) score, and patients were classified as mild (EDSS<3), moderate (3.5 ≤ EDSS ≥4.5), and severe (EDSS≥5) disabilities. NLR, MLR, PLR, RDW and SIII values were calculated according to the complete blood counts of the patients and the control group. Inflammation markers between the control group and MS patients, MS subtypes, and relapsing-remitting MS (RRMS) attack and remission periods were compared. the relationship between these markers and duration of illness, number of attacks and disability was examined.
RESULTS: MLR and RDW were higher in MS than the controls. There was no significant difference in these values between MS subtypes. It was observed that RDW increased as the disease duration, number of attacks and EDSS increased.
CONCLUSIONS: In our study, in evaluating inflammation it was seen that MLR and RDW were more determinative than PLR, NLR and SIII. The fact that RDW is higher in MS patients and is affected by disease disability indicates that RDW may have an important role in the follow-up of MS patients and in evaluating the degree of disability.

Keywords

Multiple sclerosis, Inflammatory response, Inflammation, Lymphocyte, Erythrocyte distribution volume

MULTİPL SKLEROZ HASTALARINDA PLATELET LENFOSİT ORANI, MONOSİT LENFOSİT ORANI, NÖTROFİL LENFOSİT ORANI, ERİTROSİT DAĞILIM GENİŞLİĞİ VE SİSTEMİK İMMÜN İNFLAMASYON İNDEKSİ DUYARLILIĞI: HASTALIK ALT TİPLERİ VE ENGELLİLİK İLE İLİŞKİSİ

Abstract

AMAÇ: Multipl skleroz (MS) merkezi sinir sisteminin (MSS) süreğen, inflamatuar otoimmün bir hastalığıdır. Otoimmün yanıtların nasıl oluştuğu netlik kazanmasa da periferik kan hücrelerinin MS'te inflamatuar yanıtın başlamasına ve şiddetlenmesine katkıda bulunabileceği bilinmektedir. Bu çalışmanın amacı MS’de nötrofil-lenfosit oranı (NLR), monosit-lenfosit oranı (MLR), platelet-lenfosit oranı (PLR), eritrosit dağılım genişliği (RDW) ve sistemik immün inflamasyon indeksi (SIII) duyarlılığını ve özgüllüğünü değerlendirmek ve engellilik ile arasındaki ilişkiyi belirlemektir.
GEREÇ VE YÖNTEM: Bu tek merkezli, retrospektif vaka kontrol çalışmasına toplam 104 MS hastası ile yaş ve cinsiyet uyumlu 65 sağlıklı birey alındı. Engellilik, Genişletilmiş Engellilik Durumu Ölçeği (EDSS) ile değerlendirildi ve buna göre hastalar, hafif (EDSS<3), orta (3,5 ≤ EDSS ≥4,5) ve şiddetli (EDSS≥5) engelliler olarak sınıflandırıldı. Hastaların ve kontrol grubunun tam kan sayımlarına göre NLR, MLR, PLR, RDW ve SIII değerleri hesaplandı. Kontrol grubu ile MS hastaları, MS alt tipleri ve relapsing-remitting MS (RRMS) atak ve remisyon dönemi arasındaki inflamasyon belirteçleri karşılaştırıldı. Bu belirteçler ile hastalık süresi, atak sayısı ve özürlülük arasındaki ilişkiye bakıldı.
BULGULAR: MLR ve RDW, MS’de kontrol grubuna göre daha yüksekti. MS alt tiplerin arasında bu değerlerde anlamlı farklılık yoktu. Hastalık süresi, atak sayısı ve EDSS arttıkça RDW’nin de arttığı görüldü.
SONUÇ: Çalışmamızda MLR ve RDW’nin PLR, NLR ve SIII’ye göre inflamasyonu değerlendirmede daha belirleyici olduğu görülmüştür. RDW'nin MS hastalarında daha yüksek olması ve hastalık disabilitesinden etkilenmesi, MS hastalarının takibinde ve özürlülük derecesinin değerlendirilmesinde RDW'nin önemli bir rolü olabileceğini göstermektedir.

Keywords

Multipl skleroz, İnflamatuar yanıt, İnflamasyon, Lenfosit, Eritrosit dağılım hacmi

Supporting Institution

yoktur

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