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Spari D, Zwicky SN, Yilmaz B, Salm L, Candinas D, Beldi G. Intestinal dysbiosis as an intraoperative predictor of septic complications: evidence from human surgical cohorts and preclinical models of peritoneal sepsis. Sci Rep 2023; 13:22921. [PMID: 38129468 PMCID: PMC10739899 DOI: 10.1038/s41598-023-49034-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 12/03/2023] [Indexed: 12/23/2023] Open
Abstract
Major surgery exposes the intestinal microbiota to inflammatory and antibiotic stressors, which alter the microbiota composition of the intestinal lumen and fecal contents. However, it is not sufficiently understood, if such dysbiosis develops already during surgery and if alterations in microbiota may be the cause of surgical complications. End-of-surgery composition of the microbiota in the rectum was assessed in 41 patients undergoing either rectal or duodenopancreatic resection and was compared to baseline before surgery using 16S-rRNA sequencing. A subset of patients developed severe dysbiosis at the end of surgery, which was characterized by an overgrowth of the Proteobacteria phylum that includes the facultative pathogen E. coli. To test if dysbiosis impacts on surgical outcomes, dysbiosis was modeled in mice by a single oral administration of vancomycin prior to cecal ligation and puncture. Dysbiosis was associated with impaired post-surgical survival, dysregulation of the host's immune response, elevated bacterial virulence and reduced bacterial metabolism of carbon sources. In conclusion, dysbiosis can be detected already at the end of surgery in a fraction of patients undergoing major surgery. Modelling surgery-associated dysbiosis in mice using single-shot administration of vancomycin induced dysbiosis and resulted in elevated mortality.
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Affiliation(s)
- Daniel Spari
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
| | - Simone N Zwicky
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
| | - Bahtiyar Yilmaz
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
| | - Lilian Salm
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
| | - Daniel Candinas
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland
| | - Guido Beldi
- Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010, Bern, Switzerland.
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Crocetto F, Imbimbo C, Barone B, Turchino D, Bracale UM, Peluso A, Panagrosso M, Falcone A, Mirto BF, De Luca L, Sicignano E, Del Giudice F, Busetto GM, Lucarelli G, Giampaglia G, Manfredi C, Ferro M, Tarantino G. Which inflammatory marker, between systemic immune-inflammation index and neutrophil to eosinophil ratio, is associated with Peyronie's disease and are there any implications for a better understanding of its mechanisms? Basic Clin Androl 2023; 33:38. [PMID: 38110896 PMCID: PMC10729439 DOI: 10.1186/s12610-023-00213-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/04/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Peyronie's disease affects up to 9% of men and is often accompanied by pain and/or erectile dysfunction. It is characterized by an inflammatory process that is the grassroots of the subsequent fibrosis stage. There is an unmet need to evaluate its onset and progression. Among the newly proposed biomarkers of inflammation, authors developed a novel systemic immune-inflammation index (SII) based on lymphocyte, neutrophil, and platelet counts. Similarly, a recent study reported that a neutrophil-to-eosinophil ratio (NER) represents systemic inflammation. RESULTS A 49-patient group with Peyronie's disease as confronted with 50 well-matched for age and BMI controls. As laboratory evaluation of inflammation, SII, NER and the eosinophil to neutrophil ratio (ENR) were studied. As a likely risk factor for the presence of Peyronie's disease, a higher prevalence of hypercholesterolemia, hyperglycemia and hypertension was discovered in the patients compared to controls. A significant difference was found in the median values of the NER between the two selected groups, i.e., 32.5 versus 17.3 (p = 0.0021). As expected, also ENR was significantly different. The receiver operating characteristic curves for SII, ENR and NER were 0.55, 0.32 and 0.67, respectively, highlighting the best performance of NER. The cut-off for NER was 12.1, according to the Youden test. CONCLUSIONS According to our results, any evaluation of circulating eosinophil, evaluated as NER, beyond being a signature of immuno-inflammatory response, help assess tissue homeostasis, since eosinophils are now considered multifunctional leukocytes and give a picture of the inflammatory process and repair process belonging to Peyronie's disease.
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Affiliation(s)
- Felice Crocetto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131, Naples, Italy
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131, Naples, Italy
| | - Biagio Barone
- Division of Urology, Department of Surgical Sciences, AORN Sant'Anna e San Sebastiano, 81100, Caserta, Italy.
| | - Davide Turchino
- Department of Public Health, Vascular Surgery Unit, University of Naples Federico II, 80131, Naples, Italy
| | - Umberto Marcello Bracale
- Department of Public Health, Vascular Surgery Unit, University of Naples Federico II, 80131, Naples, Italy
| | - Antonio Peluso
- Department of Public Health, Vascular Surgery Unit, University of Naples Federico II, 80131, Naples, Italy
| | - Marco Panagrosso
- Department of Public Health, Vascular Surgery Unit, University of Naples Federico II, 80131, Naples, Italy
| | - Alfonso Falcone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131, Naples, Italy
| | - Benito Fabio Mirto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131, Naples, Italy
| | - Luigi De Luca
- Division of Urology, AORN "Antonio Cardarelli", Naples, Italy
| | - Enrico Sicignano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131, Naples, Italy
| | - Francesco Del Giudice
- Department of Maternal Infant and Urologic Sciences, Policlinico Umberto I Hospital, "Sapienza" University of Rome, 00161, Rome, Italy
| | - Gian Maria Busetto
- Department of Urology and Organ Transplantation, University of Foggia, 71122, Foggia, Italy
| | - Giuseppe Lucarelli
- Urology, Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari, 70124, Bari, Italy
| | - Gaetano Giampaglia
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131, Naples, Italy
| | - Celeste Manfredi
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80131, Naples, Italy
| | - Matteo Ferro
- Department of Urology, IEO, European Institute of Oncology IRCCS, 20141, Milan, Italy
| | - Giovanni Tarantino
- Department of Clinical Medicine and Surgery, Federico II Medical School of Naples, Naples, Italy
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Li J, Liang L, Feng L, Cao S, Cai YS, Li X, Qian Z, Brightling CE, Tong Z. The Prognostic Value of Blood Eosinophil Level in AECOPD is Influenced by Corticosteroid Treatment During Hospitalization. J Inflamm Res 2023; 16:3233-3243. [PMID: 37555013 PMCID: PMC10404713 DOI: 10.2147/jir.s421605] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/24/2023] [Indexed: 08/10/2023] Open
Abstract
PURPOSE Blood eosinophil is a promising biomarker for phenotyping patients with acute exacerbation of COPD (AECOPD). We aimed to evaluate the prognostic value of eosinophil on short- and long-term outcomes stratified by corticosteroid treatment among AECOPD inpatients. PATIENTS AND METHODS In this retrospective cohort study, we included patients hospitalized for AECOPD from July 2013 to June 2021 in Beijing, China. Clinical data were collected from electronic medical records. The blood eosinophil count was measured within 24h after admission. Eosinophilic AECOPD was defined as having an eosinophil percentage ≥ 2%. The study outcomes were length of stay (LOS), treatment failure, and AECOPD readmission risk within 3 years of discharge. Multivariable models were used to analyze the associations between blood eosinophil count and outcomes stratified by corticosteroid treatment during hospitalization. RESULTS A total of 2406 AECOPD patients were included. The median LOS of AECOPD patients was 10 (interquartile range: 8-14) days. The eosinophil percentage was negatively associated with LOS (P-trend=0.014). Compared with the non-eosinophilic AECOPD group, the eosinophilic group had a 58% lower risk of treatment failure (OR=0.42, 95% CI: 0.20-0.89) in patients treated with systemic corticosteroids, but no association was observed in those treated with inhaled corticosteroids (ICS) only (OR=0.95, 95% CI: 0.60-1.52). The eosinophilic group had an increased risk of 90-day re-admission in patients treated with ICS only (HR=1.51, 95% CI: 1.00-2.29), but not in patients treated with systemic corticosteroids during hospitalization (HR=0.67, 95% CI: 0.39-1.15). No statistically significant results were found for 180-day, 1-year, or 3-year readmission risk. CONCLUSION Elevated blood eosinophils in AECOPD were associated with shorter length of stay and improved response to treatment with systemic corticosteroids, but not inhaled corticosteroids. Our study suggested that a therapeutic approach of using systemic corticosteroid may benefit patients present with eosinophilic AECOPD.
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Affiliation(s)
- Jiachen Li
- Department of Clinical Epidemiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Lirong Liang
- Department of Clinical Epidemiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Lin Feng
- Department of Clinical Epidemiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Siyu Cao
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Yutong Samuel Cai
- Centre for Environmental Health and Sustainability, Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Xiaobo Li
- Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing, People’s Republic of China
| | - Zhenbei Qian
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Christopher E Brightling
- Institute for Lung Health, NIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, UK
| | - Zhaohui Tong
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China
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4
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Prediletto I, Giancotti G, Nava S. COPD Exacerbation: Why It Is Important to Avoid ICU Admission. J Clin Med 2023; 12:jcm12103369. [PMID: 37240474 DOI: 10.3390/jcm12103369] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/21/2023] [Accepted: 05/03/2023] [Indexed: 05/28/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the major causes of morbidity and mortality worldwide. Hospitalization due to acute exacerbations of COPD (AECOPD) is a relevant health problem both for its impact on disease outcomes and on health system resources. Severe AECOPD causing acute respiratory failure (ARF) often requires admission to an intensive care unit (ICU) with endotracheal intubation and invasive mechanical ventilation. AECOPD also acts as comorbidity in critically ill patients; this condition is associated with poorer prognoses. The prevalence reported in the literature on ICU admission rates ranges from 2 to 19% for AECOPD requiring hospitalization, with an in-hospital mortality rate of 20-40% and a re-hospitalization rate for a new severe event being 18% of the AECOPD cases admitted to ICUs. The prevalence of AECOPD in ICUs is not properly known due to an underestimation of COPD diagnoses and COPD misclassifications in administrative data. Non-invasive ventilation in acute and chronic respiratory failure may prevent AECOPD, reducing ICU admissions and disease mortality, especially when associated with a life-threating episode of hypercapnic ARF. In this review, we report on up to date evidence from the literature, showing how improving the knowledge and management of AECOPD is still a current research issue and clinical need.
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Affiliation(s)
- Irene Prediletto
- Alma Mater Studiorum University of Bologna, Department of Medical and Surgical Science (DIMEC), Via Massarenti 9, 40138 Bologna, Italy
- IRCCS Azienda Ospedaliero Universitaria di Bologna, Respiratory and Critical Care Unit, Policlinico S. Orsola-Malpighi di Bologna, Via Albertoni 15, 40138 Bologna, Italy
| | - Gilda Giancotti
- Alma Mater Studiorum University of Bologna, Department of Medical and Surgical Science (DIMEC), Via Massarenti 9, 40138 Bologna, Italy
| | - Stefano Nava
- Alma Mater Studiorum University of Bologna, Department of Medical and Surgical Science (DIMEC), Via Massarenti 9, 40138 Bologna, Italy
- IRCCS Azienda Ospedaliero Universitaria di Bologna, Respiratory and Critical Care Unit, Policlinico S. Orsola-Malpighi di Bologna, Via Albertoni 15, 40138 Bologna, Italy
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5
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Pu J, Yi Q, Luo Y, Wei H, Ge H, Liu H, Li X, Zhang J, Pan P, Zhou H, Zhou C, Yi M, Cheng L, Liu L, Zhang J, Peng L, Aili A, Liu Y, Zhou H. Blood Eosinophils and Clinical Outcomes in Inpatients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Prospective Cohort Study. Int J Chron Obstruct Pulmon Dis 2023; 18:169-179. [PMID: 36879668 PMCID: PMC9985424 DOI: 10.2147/copd.s396311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 02/15/2023] [Indexed: 03/06/2023] Open
Abstract
Purpose The prognostic value of blood eosinophils in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) remains controversial. This study aimed to evaluate whether blood eosinophils could predict in-hospital mortality and other adverse outcomes in inpatients with AECOPD. Methods The patients hospitalized for AECOPD were prospectively enrolled from ten medical centers in China. Peripheral blood eosinophils were detected on admission, and the patients were divided into eosinophilic and non-eosinophilic groups with 2% as the cutoff value. The primary outcome was all-cause in-hospital mortality. Results A total of 12,831 AECOPD inpatients were included. The non-eosinophilic group was associated with higher in-hospital mortality than the eosinophilic group in the overall cohort (1.8% vs 0.7%, P < 0.001), the subgroup with pneumonia (2.3% vs 0.9%, P = 0.016) or with respiratory failure (2.2% vs 1.1%, P = 0.009), but not in the subgroup with ICU admission (8.4% vs 4.5%, P = 0.080). The lack of association still remained even after adjusting for confounding factors in subgroup with ICU admission. Being consistent across the overall cohort and all subgroups, non-eosinophilic AECOPD was also related to greater rates of invasive mechanical ventilation (4.3% vs 1.3%, P < 0.001), ICU admission (8.9% vs 4.2%, P < 0.001), and, unexpectedly, systemic corticosteroid usage (45.3% vs 31.7%, P < 0.001). Non-eosinophilic AECOPD was associated with longer hospital stay in the overall cohort and subgroup with respiratory failure (both P < 0.001) but not in those with pneumonia (P = 0.341) or ICU admission (P = 0.934). Conclusion Peripheral blood eosinophils on admission may be used as an effective biomarker to predict in-hospital mortality in most AECOPD inpatients, but not in patients admitted into ICU. Eosinophil-guided corticosteroid therapy should be further studied to better guide the administration of corticosteroids in clinical practice.
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Affiliation(s)
- Jiaqi Pu
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Qun Yi
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China.,Sichuan Cancer Hospital and Institution, Sichuan Cancer Center, Cancer Hospital Affiliate to School of Medicine, UESTC, Chengdu, People's Republic of China
| | - Yuanming Luo
- State Key Laboratory of Respiratory Disease, Guangzhou Medical University, Guangzhou, People's Republic of China
| | - Hailong Wei
- Department of Respiratory and Critical Care Medicine, People's Hospital of Leshan, Leshan, People's Republic of China
| | - Huiqing Ge
- Department of Respiratory and Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Huiguo Liu
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Xianhua Li
- Department of Respiratory and Critical Care Medicine, the First People's Hospital of Neijiang City, Neijiang, People's Republic of China
| | - Jianchu Zhang
- Department of Respiratory and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Pinhua Pan
- Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Hui Zhou
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Chengdu University, Chengdu, People's Republic of China
| | - Chen Zhou
- West China School of Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Mengqiu Yi
- Department of Emergency, First People's Hospital of Jiujiang, Jiu Jiang, People's Republic of China
| | - Lina Cheng
- Department of Emergency, First People's Hospital of Jiujiang, Jiu Jiang, People's Republic of China
| | - Liang Liu
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Chengdu University, Chengdu, People's Republic of China
| | - Jiarui Zhang
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Lige Peng
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Adila Aili
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Yu Liu
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Haixia Zhou
- Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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Liu P, Zhang H, Zeng H, Meng Y, Gao H, Zhang M, Zhao L. LncRNA CASC2 is involved in the development of chronic obstructive pulmonary disease via targeting miR-18a-5p/IGF1 axis. Ther Adv Respir Dis 2021; 15:17534666211028072. [PMID: 34266334 PMCID: PMC8290508 DOI: 10.1177/17534666211028072] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
AIMS Chronic obstructive pulmonary disease (COPD) is a systemic disease. Several long non-coding RNAs (lncRNAs) have been identified to be aberrantly expressed in COPD patients. This study investigated the role of lncRNA cancer susceptibility candidate 2 (CASC2) in COPD, as well as its potential mechanism. METHODS Fifty smokers with COPD and another 50 smokers without COPD were recruited. Receiver operating characteristic curve was constructed to assess the diagnostic value of CASC2 in COPD patients. 16HBE cells were treated with cigarette smoke extract (CSE) to establish a cell model. qRT-PCR was used for the measurement of mRNA levels. The cell viability and apoptosis were detected by using Cell Counting Kit-8 and flow cytometry assay. Enzyme-linked immunosorbent assay was performed to detect the levels of proinflammatory cytokines. Luciferase reporter assay was performed for the target gene analysis. RESULTS Serum CASC2 was dramatically decreased in COPD patients compared with smokers without COPD, and was positively associated with FEV1 (forced expiratory volume in one second). Serum CASC2 was overexpressed in severe COPD patients, and had the diagnostic accuracy to distinguish COPD patients from smokers. CASC2 overexpression alleviated CSE-induced apoptosis and inflammation in 16HBE cells. CASC2 functions as a ceRNA of miR-18a-5p. Upregulation of miR-18a-5p reversed the influence of CASC2 on cell apoptosis and inflammation in 16HBE cells. IGF1 was the target gene of miR-18a-5p. CONCLUSION CASC2 was downregulated in COPD patients and it might be a promising biomarker for the disease diagnosis. Overexpression of CASC2 might inhibit the bronchial epithelial cell apoptosis and inflammation via targeting miR-18a-5p/IGF1 axis.The reviews of this paper are available via the supplemental material section.
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Affiliation(s)
- Panpan Liu
- Department of Pulmonary and Critical Care Medicine, Shanghai Pudong New Area Gongli Hospital, Shanghai, PR China
| | - Huali Zhang
- Department of Pulmonary and Critical Care Medicine, Shanghai Pudong New Area Gongli Hospital, Shanghai, PR China
| | - Haizhu Zeng
- Department of Pulmonary and Critical Care Medicine, Shanghai Pudong New Area Gongli Hospital, Shanghai, PR China
| | - Yingxia Meng
- Department of Pulmonary and Critical Care Medicine, Shanghai Pudong New Area Gongli Hospital, Shanghai, PR China
| | - Hongchang Gao
- Department of Pulmonary and Critical Care Medicine, Shanghai Pudong New Area Gongli Hospital, Shanghai, PR China
| | - Meilan Zhang
- Department of Pulmonary and Critical Care Medicine, Shanghai Pudong New Area Gongli Hospital, Shanghai, PR China
| | - Lei Zhao
- Department of Pulmonary and Critical Care Medicine, Shanghai Pudong New Area Gongli Hospital, 219 Miao-Pu Road, Shanghai 200315, PR China
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7
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Cai H, Huang H, Yang C, Ren J, Wang J, Gao B, Pan W, Sun F, Zhou X, Zeng T, Hu J, Chen Y, Zhang S, Chen G. Eosinophil-to-Neutrophil Ratio Predicts Poor Prognosis of Acute Ischemic Stroke Patients Treated With Intravenous Thrombolysis. Front Neurol 2021; 12:665827. [PMID: 34322078 PMCID: PMC8310951 DOI: 10.3389/fneur.2021.665827] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 06/11/2021] [Indexed: 11/17/2022] Open
Abstract
Background and Purpose: The eosinophil-to-neutrophil ratio (ENR) was recently reported as a novel inflammatory marker in acute ischemic stroke (AIS). However, few studies reported the predictive value of ENR in AIS patients, especially for those with intravenous thrombolysis. Methods: Two hundred sixty-six AIS patients receiving intravenous thrombolysis were retrospectively recruited in this study and followed up for 3 months and 1 year. The Modified Rankin Scale (mRS) and the time of death were recorded. Poor outcome was defined as mRS 3–6. After excluding patients who were lost to follow-up, the remaining 250 patients were included in the 3-month prognosis analysis and the remaining 223 patients were included in the 1-year prognosis analysis. Results: ENR levels in the patients were lower than those in the healthy controls. The optimal cutoff values for the ability of ENR × 102 to predict 3-month poor outcome were 0.74 with 67.8% sensitivity and 77.3% specificity. Patients with ENR × 102 ≥ 0.74 have a lower baseline National Institutes of Health Stroke Scale (NIHSS) score (median: 7 vs. 11, p < 0.001). After multivariate adjustment, patients with ENR × 102 ≥ 0.74 were more likely to come to a better 3-month outcome (OR = 0.163; 95% CI, 0.076–0.348, p < 0.001). At the 1-year follow-up, the patients with ENR × 102 ≥ 0.74 showed a lower risk of mortality (HR = 0.314; 95% CI, 0.135–0.731; p = 0.007). Conclusions: A lower ENR is independently associated with a 3-month poor outcome and a 3-month and 1-year mortality in AIS patients treated with intravenous thrombolysis.
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Affiliation(s)
- Haoye Cai
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Honghao Huang
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Chenguang Yang
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Junli Ren
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Jianing Wang
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Beibei Gao
- Department of Internal Medicine, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wenjing Pan
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Fangyue Sun
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Xinbo Zhou
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Tian Zeng
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Jingyu Hu
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Yilin Chen
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.,School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Shunkai Zhang
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Guangyong Chen
- Department of Neurology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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