Multipl Sklerozlu Hastalarda Nötrofil/Lenfosit, Trombosit/Lenfosit, Eozinofil/Lenfosit ve Monosit/Lenfosit Oranları ile Hastalık Aktivitesi Arasındaki İlişkiler

Abstract

Amaç: Multipl skleroz çoğunlukla genç yetişkinleri etkileyen bir hastalıktır. Yaygınlığı dünya çapında artmaktadır, ancak bu artışın nedeni tam olarak anlaşılmamıştır. Hastalık genellikle ataklarla ilerler. Hastalığın aktivasyonunun tanısı klinik olarak ve manyetik rezonans görüntüleme ile yapılır. Manyetik rezonans görüntüleme pahalı ve zaman alıcı bir incelemedir. Aktif hastaların tanısında yardımcı olacak ucuz ve hızlı sonuç veren bir teste ihtiyaç olduğu açıktır. Tam kan sayımından elde edilen veriler bunlardan biri olabilir. Bu çalışmanın amacı, multipl sklerozlu hastalarda nötrofil/lenfosit, trombosit/lenfosit, eozinofil/lenfosit ve monosit/lenfosit oranları ile hastalık aktivitesi arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntemler: Multipl skleroz tanısı almış 120 hasta ve 110 sağlıklı kontrol çalışmaya dahil edildi. Yaş, cinsiyet ve hastalık süresi gibi demografik özellikler, manyetik rezonans lezyon özellikleri ve Genişletilmiş Engellilik Belirti Ölçeği sonuçları kaydedildi. Bulgular: Aktif hastaların ortalama nötrofil/lenfosit oranı değerleri, inaktif hastalık ve kontrol gruplarındakilerden anlamlı derecede yüksekti (p<0,001). Aktif hastaların ortalama monosit/lenfosit oranı değeri, kontrol grubundakilerden anlamlı derecede yüksekti (p=0,002). Aktif ve inaktif hastaların trombosit/lenfosit oranı değerleri, kontrol grubundakilerden anlamlı derecede yüksekti (p<0,001). Sonuç: Bu çalışma, nötrofil/lenfosit, trombosit/lenfosit ve monosit/lenfosit oranlarının multipl sklerozun aktivasyonu ile ilişkili olduğunu göstermektedir. Multipl sklerozda serum nötrofil/lenfosit, trombosit/lenfosit ve monosit/lenfosit oranları ile hastalık aktivitesi arasındaki ilişkiyi açıklığa kavuşturmak için artık daha geniş hasta popülasyonları ve sağlıklı kontrollerle daha kapsamlı çalışmalara ihtiyaç vardır.

Keywords

• Multipl skleroz
• nötrofil/lenfosit oranı
• monosit/lenfosit oranı
• trombosit/lenfosit oranı
• eozinofil/lenfosit oranı

THE RELATIONSHIPS BETWEEN THE NEUTROPHIL/LYMPHOCYTE, PLATELET/LYMPHOCYTE, EOSINOPHIL/LYMPHOCYTE, AND MONOCYTE/LYMPHOCYTE RATIOS AND DISEASE ACTIVITY IN PATIENTS WITH MULTIPLE SCLEROSIS

Abstract

Objective: Multiple sclerosis primarily affects young adults. The prevalence is increasing worldwide, although the reason for this rise is not fully understood. The disease usually progresses with attacks. The diagnosis of disease activation is made clinically and by magnetic resonance imaging. Magnetic resonance imaging is an expensive and time-consuming examination. It is obvious that there is a need for an inexpensive and fast-resulting test that will aid in the diagnosis of active patients. Data from a complete blood count may be one of them.This study aimed to examine the association between disease activity in multiple sclerosis patients and the ratios of neutrophils to lymphocytes, platelets to lymphocytes, eosinophils to lymphocytes, and monocytes to lymphocytes. Material and Methods: One hundred and twenty patients diagnosed with multiple sclerosis and 110 healthy controls were enrolled. Demographic characteristics such as age, sex, and duration of disease, magnetic resonance lesion characteristics, and Expanded Disability Symptom Scale results were recorded. Results: The mean neutrophil-to-lymphocyte ratio in active patients was significantly higher compared to both the inactive disease group and the control group (p<0.001). Similarly, the mean monocyte-to-lymphocyte ratio in active patients was significantly also higher compared to the control group (p=0.002). The active and inactive patients’ platelet/lymphocyte ratio values were both significantly higher than those of the control group (p<0.001). Conclusion: This study suggests that the neutrophil/lymphocyte, platelet/lymphocyte and monocyte/lymphocyte ratios are associated with the activation of multiple sclerosis. More extensive studies with larger patient populations and healthy controls are now needed to clarify the association between serum neutrophil/lymphocyte, platelet/lymphocyte and monocyte/lymphocyte ratios and disease activity in multiple sclerosis.

Keywords

• Multiple sclerosis
• neutrophil/lymphocyte ratio
• monocyte/lymphocyte ratio
• platelet/lymphocyte ratio
• eosinophil/lymphocyte ratio

References

1. Kara A, Guven M, Yilmaz MS, Demir D, Elden H. Are neutrophil, platelet and eosinophil-to-lymphocyte ratio and red blood cell distribution width can be used for nasal polyposis? Eur Arch Otorhinolaryngol. 2018;275(2):409- 413.
2. Yenigun A, Sezen S, Calim OF, Ozturan O. Evaluation of the eosinophil-to-lymphocyte ratio in pediatric patients with allergic rhinitis. Am J Rhinol Allergy. 2016;30(2):e21-25.
3. Yuan C, Li N, Mao X, Liu Z, Ou W, Wang SY. Elevated pretreatment neutrophil/white blood cell ratio and monocyte/lymphocyte ratio predict poor survival in patients with curatively resected non-small cell lung cancer: Results from a large cohort. Thorac Cancer. 2017;8(4):350-358.
4. Bisgaard AK, Pihl-Jensen G, Frederiksen JL. The neutrophil-to-lymphocyte ratio as disease actvity marker in multiple sclerosis and optic neuritis. Mult Scler Relat Disord. 2017;18:213-217.
5. Demirci S, Demirci S, Kutluhan S, Koyuncuoglu HR, Yurekli VA. The clinical significance of the neutrophil-to- lymphocyte ratio in multiple sclerosis. Int J Neurosci. 2016;126(8):700-706.
6. Hemond CC, Glanz BI, Bakshi R, Chitnis T, Healy BC. The neutrophil-to-lymphocyte and monocyte-to- lymphocyte ratios are independently associated with neurological disability and brain atrophy in multiple sclerosis. BMC Neurol. 2019;19(1):23.
7. Naegele M, Tillack K, Reinhardt S, Schippling S, Martin R, Sospedra M. Neutrophils in multiple sclerosis are characterized by a primed phenotype. J Neuroimmunol. 2012;242(1-2):60-71.
8. Steinbach K, Piedavent M, Bauer S, Neumann JT, Friese MA. Neutrophils amplify autoimmune central nervous system infiltrates by maturing local APCs. J Immunol. 2013;191(9):4531-4539.

9. Khademi M, Kockum I, Andersson ML et al. Cerebrospinal fluid CXCL13 in multiple sclerosis: A suggestive prognostic marker for the disease course. Mult Scler. 2011;17(3):335-343.
10. Reich DS, Lucchinetti CF, Calabresi PA. Multiple Sclerosis. N Engl J Med. 2018;378(2):169-180.
11. Martins TB, Rose JW, Jaskowski TD et al. Analysis of proinflammatory and anti-inflammatory cytokine serum concentrations in patients with multiple sclerosis by using a multiplexed immunoassay. Am J Clin Pathol. 2011;136(5):696-704.
12. Gumus H, Akkurt E, Odabas F, Yılmaz H, Uca A. Neutrophil-lymphocyte ratio as disease activity indicator in multiple sclerosis patients. HealtMED. 2015;9:185-189.
13. Kuyumcu ME, Yesil Y, Oztürk ZA et al. The evaluation of neutrophil-lymphocyte ratio in Alzheimer's disease. Dement Geriatr Cogn Disord. 2012;34(2):69-74.
14. Akıl E, Bulut A, Kaplan İ, Özdemir HH, Arslan D, Aluçlu MU. The increase of carcinoembryonic antigen (CEA), high-sensitivity C-reactive protein, and neutrophil/lymphocyte ratio in Parkinson's disease. Neurol Sci. 2015;36(3):423-428.
15. Liu H, Zhan F, Wang Y. Evaluation of monocyte-to-high- density lipoprotein cholesterol ratio and monocyte-to- lymphocyte ratio in ischemic stroke. J Int Med Res. 2020;48(7):300060520933806.
16. Vogel D, Kooij G, Heijnen P et al. GM-CSF promotes migration of human monocytes across the blood brain barrier. Eur J Immunol. 2015;45(6):1808-1819.
17. Rasouli J, Ciric B, Imitola J, Gonnella P, Hwang D, Mahajan K, et al. Expression of GM-CSF in T cells is increased in multiple sclerosis and suppressed by IFN-β therapy. J Immunol. 2015;194(11):5085-9503.
18. Putnam TJ. Evidences of vascular occlusion in multiple sclerosis and "encephalomyelitis". Arch Neurol & Psychiatry. 1937;37(6):1298-1321.
19. Kuenz B, Lutterotti A, Khalil M et al. Plasma levels of soluble adhesion molecules sPECAM-1, sP-selectin and sE-selectin are associated with relapsing-remitting disease course of multiple sclerosis. J Neuroimmunol. 2005;167(1-2):143-149.
20. Marcos-Ramiro B, Oliva Nacarino P, Serrano-Pertierra E et al. Microparticles in multiple sclerosis and clinically isolated syndrome: Effect on endothelial barrier function. BMC Neurosci. 2014;15:110.