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Klinik olarak stabil multipl sklerozda radyolojik hastalık aktivitesinin bir göstergesi olarak nötrofil/lenfosit oranı

Yıl 2024, Cilt: 49 Sayı: 3, 721 - 727, 30.09.2024
https://doi.org/10.17826/cumj.1477602

Öz

Amaç: Multipl Skleroz (MS), merkezi sinir sisteminin demiyelinizan bir hastalığıdır ve gençlerde engelliliğe neden olan en yaygın nörolojik bozukluktur. Hem tanı hem de takip için hassas ve spesifik bir belirteç yoktur. Nötrofil/lenfosit oranı kolay uygulanabilir bir yöntemdir ve bu çalışmada MS'de izole radyolojik aktivite varlığında bu orandaki değişiklikleri gözlemlemeyi amaçladık.
Gereç ve Yöntem: Klinik atak veya nörolojik progresyonu olmayan ve sadece radyolojik aktivitesi olan 20 aktif MS hastasını, yaş ve cinsiyet açısından eşleştirilmiş 20 klinik ve radyolojik olarak stabil MS hastasıyla NLR açısından karşılaştırdık.
Bulgular: Radyolojik olarak aktif hasta grubunda ortalama NLR değeri 2.22±0.87 (Min 1.08-Maks 4.28), kontrol grubunda ise ortalama NLR değeri 2.31±1.37 (Min 0.96-Maks 5.92) olarak bulundu. Sadece radyolojik aktivitesi olan hastalardaki NLR değerlerinin hem klinik hem de radyolojik stabilitesi olan hastalardaki NLR değerlerinden anlamlı derecede farklı olmadığını gözlemledik.
Sonuç: MS'in tanı ve takibinde belirteç çalışmaları hızla devam etmektedir. NLR gibi basit, kolay uygulanabilir, non-invaziv, ucuz yöntemlerin MS hastalık aktivitesi ile ilişkisini ortaya koymak için çok daha geniş kohortu içeren prospektif çalışmalar yol gösterici olabilir.

Destekleyen Kurum

Yok

Teşekkür

Yok

Kaynakça

  • Weiner HL. Multiple sclerosis is an inflammatory T-cell-mediated autoimmune disease. Arch Neurol. 2004;61:1613-15.
  • Compston A, Coles A. Multiple sclerosis. Lancet. 2008;372:1502-17.
  • Dendrou CA, Fugger L, Friese MA. Immunopathology of multiple sclerosis. Nat Rev Immunol. 2015;15:545-58.
  • Goodin DS. The epidemiology of multiple sclerosis: insights to disease pathogenesis. Handb Clin Neurol. 2014;122:231-66.
  • Nylander A, Hafler DA. Multiple sclerosis. J. Clin. Invest. 2012;122:1180–8.
  • Roach ES. Is multiple sclerosis an autoimmune disorder? Arch Neurol. 2004;61:1615-6.
  • Thompson AJ, Banwell BL, Barkhof F, Carroll WM, Coetzee T, Comi G et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17:162-73.
  • Wattjes MP, Ciccarelli O, Reich DS, Banwell B, de Stefano N, Enzinger C et al. 2021 MAGNIMS-CMSC-NAIMS consensus recommendations on the use of MRI in patients with multiple sclerosis. Lancet Neurol. 2021;20:653-70.
  • Lublin FD, Reingold SC. Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis. Neurology. 1996;46:907-11.
  • Lublin FD, Reingold SC, Cohen JA, Cutter GR, Sørensen PS, Thompson AJ et al. Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology. 2014;83:278-86.
  • Grange E, Solaro C, Di Giovanni R, Marengo D. The correlation between 9-HPT and patient-reported measures of upper limb function in multiple sclerosis: a systematic review and meta-analysis. J Neurol. 2023;270:4179-91.
  • Amato MP, Ponziani G. Quantification of impairment in MS: discussion of the scales in use. Mult Scler. 1999;5:216-9.
  • Cagol A, Schaedelin S, Barakovic M, Benkert P, Todea RA, Rahmanzadeh R et al. Association of brain atrophy with disease progression independent of relapse activity in patients with relapsing multiple sclerosis. JAMA Neurol. 2022;79:682-92.
  • McGinley MP GC, Rae-Grant AD. Diagnosis and treatment of multiple sclerosis: a review. JAMA. 2021;325:765-79.
  • Disanto G, Barro C, Benkert P, Naegelin Y, Schädelin S, Giardiello A et al. Serum Neurofilament light: A biomarker of neuronal damage in multiple sclerosis. Ann Neurol. 2017;81:857-70.
  • İdiman E. Multipl skleroz: immünopatogenetik özellikler. In Temel ve Klinik Nöroimmunoloji (Ed R Karabudak):193-200. Ankara, Ada Yayıncılık, 2013.
  • Song M, Graubard BI, Rabkin CS, Engels EA. Neutrophil-to-lymphocyte ratio and mortality in the United States general population. Sci Rep. 2021;11:464
  • Kaunzner UW, Al-Kawaz M, Gauthier SA. Defining disease activity and response to therapy in MS. Curr. Treat. Options Neurol. 2017;19:20
  • Barzegar M, Najdaghi S, Afshari-Safavi A, Nehzat N, Mirmosayyeb O, Shaygannejad V. Early predictors of conversion to secondary progressive multiple sclerosis. Mult Scler Relat Disord. 2021;54:103115.
  • Vacaras V, Nistor C, Schiopu AM, Vacaras C, Marin GE, Muresanu DF. The psychological impact of the COVID-19 pandemic on people with multiple sclerosis. Mult Scler Relat Disord. 2023;76:104825
  • Faissner S, Plemel JR, Gold R, Yong VW. Progressive multiple sclerosis: from pathophysiology to therapeutic strategies. Nat Rev Drug Discov. 2019;18:905-22.
  • Suzuki K. Chronic inflammation as an immunological abnormality and effectiveness of exercise. Biomolecules. 2019;9:223.
  • Sen BB, Rifaioglu EN, Ekiz O, Inan MU, Sen T, Sen N. Neutrophil to lymphocyte ratio as a measure of systemic inflammation in psoriasis. Cutan Ocul Toxicol. 2014;33:223-7.
  • Acarturk G, Acay A, Demir K, Ulu MS, Ahsen A, Yuksel S. Neutrophil-to-lymphocyte ratio in inflammatory bowel disease - as a new predictor of disease severity. Bratisl Lek Listy. 2015;116:213-7.
  • Fu H, Qin B, Hu Z, Ma N, Yang M, Wei T et al. Neutrophil- and platelet-to-lymphocyte ratios are correlated with disease activity in rheumatoid arthritis. Clin Lab. 2015;61:269-73.
  • Hu ZD, Sun Y, Guo J, Huang YL, Qin BD, Gao Q et al. Red blood cell distribution width and neutrophil/lymphocyte ratio are positively correlated with disease activity in primary Sjögren's syndrome. Clin Biochem. 2014;47:287-90.
  • Mercan R, Bitik B, Tufan A, Bozbulut UB, Atas N, Ozturk MA et al. The association between neutrophil/lymphocyte ratio and disease activity in rheumatoid arthritis and ankylosing spondylitis. J Clin Lab Anal. 2016;30:597-601.
  • Wang L, Song Q, Wang C, Wu S, Deng L, Li Y et al. Neutrophil to lymphocyte ratio predicts poor outcomes after acute ischemic stroke: A cohort study and systematic review. J Neurol Sci. 2019;406:116445
  • Huang WC, Lin HC, Yang YH, Hsu CW, Chen NC, Tsai WC et al. Neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio are associated with a 2-year relapse in patients with multiple sclerosis. Mult Scler Relat Disord. 2022;58:103514.
  • Sayed A, Bahbah EI, Kamel S, Barreto GE, Ashraf GM, Elfil M. The neutrophil-to-lymphocyte ratio in Alzheimer's disease: Current understanding and potential applications. J Neuroimmunol. 2020;349:577398.
  • 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;36:423-28.
  • Woodberry T, Bouffler SE, Wilson AS, Buckland RL, Brüstle A. The emerging role of neutrophil granulocytes in multiple sclerosis. J Clin Med. 2018;7:511.

Neutrophil/lymphocyte ratio as an indicator of radiological disease activity in clinically stable multiple sclerosis

Yıl 2024, Cilt: 49 Sayı: 3, 721 - 727, 30.09.2024
https://doi.org/10.17826/cumj.1477602

Öz

Purpose: Multiple sclerosis (MS) is a demyelinating disease of the central nervous system and the most common neurological disorder causing disability in young people. There is no sensitive and specific marker for both diagnosis and follow-up. Neutrophil to lymphocyte ratio is an easily applicable method and in this study we aimed to observe the changes in this ratio in the presence of isolated radiologic activity in MS.
Materials and Methods: We compared 20 MS active patients with no clinical attack or neurologic progression and only radiologic activity with 20 age- and sex-matched clinically and radiologically stable MS patients in terms of NLR.
Results: Mean NLR value was 2.22±0.87 in radiologically active patient group (Min 1.08-Max 4.28) and mean NLR value was 2.31±1.37 in control group (Min 0.96-Max 5.92). We observed that NLR values in patients with radiologic activity only were not significantly different from NLR values in patients with both clinical and radiologic stability.
Conclusion: Marker studies in the diagnosis and follow-up of MS continue rapidly. Prospective studies involving a much larger cohort may be instructive in order to demonstrate the association of simple, easily applicable, non-invasive, inexpensive methods such as NLR with MS disease activity.

Kaynakça

  • Weiner HL. Multiple sclerosis is an inflammatory T-cell-mediated autoimmune disease. Arch Neurol. 2004;61:1613-15.
  • Compston A, Coles A. Multiple sclerosis. Lancet. 2008;372:1502-17.
  • Dendrou CA, Fugger L, Friese MA. Immunopathology of multiple sclerosis. Nat Rev Immunol. 2015;15:545-58.
  • Goodin DS. The epidemiology of multiple sclerosis: insights to disease pathogenesis. Handb Clin Neurol. 2014;122:231-66.
  • Nylander A, Hafler DA. Multiple sclerosis. J. Clin. Invest. 2012;122:1180–8.
  • Roach ES. Is multiple sclerosis an autoimmune disorder? Arch Neurol. 2004;61:1615-6.
  • Thompson AJ, Banwell BL, Barkhof F, Carroll WM, Coetzee T, Comi G et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17:162-73.
  • Wattjes MP, Ciccarelli O, Reich DS, Banwell B, de Stefano N, Enzinger C et al. 2021 MAGNIMS-CMSC-NAIMS consensus recommendations on the use of MRI in patients with multiple sclerosis. Lancet Neurol. 2021;20:653-70.
  • Lublin FD, Reingold SC. Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis. Neurology. 1996;46:907-11.
  • Lublin FD, Reingold SC, Cohen JA, Cutter GR, Sørensen PS, Thompson AJ et al. Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology. 2014;83:278-86.
  • Grange E, Solaro C, Di Giovanni R, Marengo D. The correlation between 9-HPT and patient-reported measures of upper limb function in multiple sclerosis: a systematic review and meta-analysis. J Neurol. 2023;270:4179-91.
  • Amato MP, Ponziani G. Quantification of impairment in MS: discussion of the scales in use. Mult Scler. 1999;5:216-9.
  • Cagol A, Schaedelin S, Barakovic M, Benkert P, Todea RA, Rahmanzadeh R et al. Association of brain atrophy with disease progression independent of relapse activity in patients with relapsing multiple sclerosis. JAMA Neurol. 2022;79:682-92.
  • McGinley MP GC, Rae-Grant AD. Diagnosis and treatment of multiple sclerosis: a review. JAMA. 2021;325:765-79.
  • Disanto G, Barro C, Benkert P, Naegelin Y, Schädelin S, Giardiello A et al. Serum Neurofilament light: A biomarker of neuronal damage in multiple sclerosis. Ann Neurol. 2017;81:857-70.
  • İdiman E. Multipl skleroz: immünopatogenetik özellikler. In Temel ve Klinik Nöroimmunoloji (Ed R Karabudak):193-200. Ankara, Ada Yayıncılık, 2013.
  • Song M, Graubard BI, Rabkin CS, Engels EA. Neutrophil-to-lymphocyte ratio and mortality in the United States general population. Sci Rep. 2021;11:464
  • Kaunzner UW, Al-Kawaz M, Gauthier SA. Defining disease activity and response to therapy in MS. Curr. Treat. Options Neurol. 2017;19:20
  • Barzegar M, Najdaghi S, Afshari-Safavi A, Nehzat N, Mirmosayyeb O, Shaygannejad V. Early predictors of conversion to secondary progressive multiple sclerosis. Mult Scler Relat Disord. 2021;54:103115.
  • Vacaras V, Nistor C, Schiopu AM, Vacaras C, Marin GE, Muresanu DF. The psychological impact of the COVID-19 pandemic on people with multiple sclerosis. Mult Scler Relat Disord. 2023;76:104825
  • Faissner S, Plemel JR, Gold R, Yong VW. Progressive multiple sclerosis: from pathophysiology to therapeutic strategies. Nat Rev Drug Discov. 2019;18:905-22.
  • Suzuki K. Chronic inflammation as an immunological abnormality and effectiveness of exercise. Biomolecules. 2019;9:223.
  • Sen BB, Rifaioglu EN, Ekiz O, Inan MU, Sen T, Sen N. Neutrophil to lymphocyte ratio as a measure of systemic inflammation in psoriasis. Cutan Ocul Toxicol. 2014;33:223-7.
  • Acarturk G, Acay A, Demir K, Ulu MS, Ahsen A, Yuksel S. Neutrophil-to-lymphocyte ratio in inflammatory bowel disease - as a new predictor of disease severity. Bratisl Lek Listy. 2015;116:213-7.
  • Fu H, Qin B, Hu Z, Ma N, Yang M, Wei T et al. Neutrophil- and platelet-to-lymphocyte ratios are correlated with disease activity in rheumatoid arthritis. Clin Lab. 2015;61:269-73.
  • Hu ZD, Sun Y, Guo J, Huang YL, Qin BD, Gao Q et al. Red blood cell distribution width and neutrophil/lymphocyte ratio are positively correlated with disease activity in primary Sjögren's syndrome. Clin Biochem. 2014;47:287-90.
  • Mercan R, Bitik B, Tufan A, Bozbulut UB, Atas N, Ozturk MA et al. The association between neutrophil/lymphocyte ratio and disease activity in rheumatoid arthritis and ankylosing spondylitis. J Clin Lab Anal. 2016;30:597-601.
  • Wang L, Song Q, Wang C, Wu S, Deng L, Li Y et al. Neutrophil to lymphocyte ratio predicts poor outcomes after acute ischemic stroke: A cohort study and systematic review. J Neurol Sci. 2019;406:116445
  • Huang WC, Lin HC, Yang YH, Hsu CW, Chen NC, Tsai WC et al. Neutrophil-to-lymphocyte ratio and monocyte-to-lymphocyte ratio are associated with a 2-year relapse in patients with multiple sclerosis. Mult Scler Relat Disord. 2022;58:103514.
  • Sayed A, Bahbah EI, Kamel S, Barreto GE, Ashraf GM, Elfil M. The neutrophil-to-lymphocyte ratio in Alzheimer's disease: Current understanding and potential applications. J Neuroimmunol. 2020;349:577398.
  • 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;36:423-28.
  • Woodberry T, Bouffler SE, Wilson AS, Buckland RL, Brüstle A. The emerging role of neutrophil granulocytes in multiple sclerosis. J Clin Med. 2018;7:511.
Toplam 32 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Nöroloji ve Nöromüsküler Hastalıklar
Bölüm Araştırma
Yazarlar

Esra Tekin Taşkıran 0000-0001-7215-8470

Bilgin Öztürk 0000-0002-8899-9925

Yayımlanma Tarihi 30 Eylül 2024
Gönderilme Tarihi 2 Mayıs 2024
Kabul Tarihi 8 Eylül 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 49 Sayı: 3

Kaynak Göster

MLA Tekin Taşkıran, Esra ve Bilgin Öztürk. “Neutrophil/Lymphocyte Ratio As an Indicator of Radiological Disease Activity in Clinically Stable Multiple Sclerosis”. Cukurova Medical Journal, c. 49, sy. 3, 2024, ss. 721-7, doi:10.17826/cumj.1477602.