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Ijichi H, Tajiri W, Koi Y, Koga C, Nakamura Y, Okamoto M, Tokunaga E. Preoperative Neutrophil-to-Lymphocyte Ratio in Postmenopausal Breast Cancer Patients. J Surg Res 2024; 296:98-105. [PMID: 38266423 DOI: 10.1016/j.jss.2023.11.075] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 10/16/2023] [Accepted: 11/18/2023] [Indexed: 01/26/2024]
Abstract
INTRODUCTION Neutrophil-to-lymphocyte ratio (NLR) has been recognized as a marker of systemic inflammation with a prognostic impact in patients with various cancers, including breast cancer. The aim of this study was to investigate the relationships between the preoperative NLR and breast cancer prognosis in the patients before and after menopausal age, and its relationship with other prognostic factors. METHODS A total of 1868 patients with clinical Stage I-III primary breast cancer were enrolled. The associations between clinicopathological factors and the preoperative NLR were analyzed, and relapse-free survival (RFS) and overall survival (OS) were estimated. RESULTS Statistical analyses stratified by the menopausal status revealed that a high NLR was significantly associated with worse RFS (P < 0.001) and OS (P = 0.001) in postmenopausal patients, but not in premenopausal patients. Although the postmenopausal patients with relapsed cancer tended to have higher NLR levels than those without relapse (P = 0.079), NLR levels of premenopausal patients with relapsed cancer were significantly lower than that of relapse-free patients (P = 0.024). In postmenopausal patients, a high NLR was only associated with worse RFS in patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer (P < 0.001), in those managed without adjuvant chemotherapy (P = 0.003); this association was not observed in patients who received adjuvant chemotherapy. CONCLUSIONS The preoperative NLR can be a useful prognostic marker, especially in postmenopausal breast cancer patients. The relationships between the NLR and breast cancer prognosis may be more evident when patients are assessed according to their menopausal status.
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Affiliation(s)
- Hideki Ijichi
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.
| | - Wakako Tajiri
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yumiko Koi
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Chinami Koga
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yoshiaki Nakamura
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Masahiro Okamoto
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Eriko Tokunaga
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
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Ma C, Yang B, Mao Q. Diagnostic and Prognostic Value of Neutrophil-Lymphocyte Ratio in Adrenocortical Carcinoma. Clin Genitourin Cancer 2024; 22:109-114. [PMID: 37852864 DOI: 10.1016/j.clgc.2023.09.008] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 09/24/2023] [Accepted: 09/25/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND The aim was to explore the value of neutrophil-lymphocyte ratio (NLR) as a biomarker for predicting the prognosis or diagnosis in adrenocortical carcinoma (ACC). METHODS We identified 262 patients with adrenal gland disease who underwent operation at our institution between 2013 and 2018. According to postoperative pathology, patients were divided into 2 groups: ACC and non-ACC groups. The neutrophil and lymphocyte count of patients were recorded. Within the intergroup comparison, data obtained from ACC and non-ACC groups were evaluated using ANOVA test. The cut-off values of NLR for the prognosis in ACC were determined according to 3 methods. RESULTS The NLR values of ACC and non-ACC groups were 5.36 ± 5.30 and (1.73 ± 0.26) ∼ (2.56 ± 1.35), respectively (P < .001). NLR carry a differential property was evaluated with ROC curve to distinguish the above 2 groups. The cut-off value of NLR was estimated as 2.65 according to the Youden index. With this value, sensitivity was found as 67.5%, specificity was 83.8% and AUC was 0.749 (P < .001, confidence interval = 0.638-0.860). In ACC, the higher NLR group was not shown significantly poorer overall survival than the lower NLR group (NLR ≥2.65 vs. NLR < 2.65, NLR ≥5 vs. NLR <5, NLR ≥5.36 vs. NLR <5.36) (P > .05). CONCLUSION According to the data in this study, it can be said that adrenocortical tumors are likely to be malignant by 67.5% if the NLR value is greater than 2.65. When we use the NLR to predict the prognosis of ACC, there is not statistically significant.
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Affiliation(s)
- Chengquan Ma
- Department of Urology, Tianjin Medical University General Hospital, Tianjin, China.
| | - Bin Yang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Quanzong Mao
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Ye M, Huang A, Yuan B, Tan G, Ai J, Liu H. Neutrophil-to-lymphocyte ratio and monocyte-to-eosinophil ratio as prognostic indicators for advanced nasopharyngeal carcinoma. Eur Arch Otorhinolaryngol 2024; 281:1971-1989. [PMID: 38315178 DOI: 10.1007/s00405-024-08474-7] [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: 07/07/2023] [Accepted: 01/09/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE To determine the predictive value of the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), neutrophil-to-eosinophil ratio (NER), lymphocyte-to-eosinophil ratio (LER), monocyte-to-eosinophil ratio (MER), systemic inflammatory response index (SIRI), and ratio of inflammatory cells before and after treatment for predicting survival in advanced nasopharyngeal carcinoma (NPC) and to provide a reference for treatment. METHODS A retrospective review of 70 patients was performed. Serological indexes were obtained by drawing blood before and after systemic therapy. The cutoff values of these indexes were determined by receiver operating characteristic (ROC) curves. The prognostic value of the indexes for overall survival (OS) and distant metastasis free survival (DMFS) was evaluated. RESULTS Survival analysis showed that a smaller pretreatment LMR value was associated with poor OS; larger pretreatment NER, LER, MER, and SIRI values were associated with poor OS; a smaller posttreatment LMR value was associated with poor OS; larger posttreatment NLR, NER, MER, and SIRI values were associated with poor OS; a smaller pretreatment LMR value was associated with poor DMFS; larger pretreatment NLR, NER, LER, and MER values were associated with poor DMFS; and larger posttreatment NLR, NER, LER, and MER values were associated with poor DMFS. Furthermore, a larger neutrophil after treatment-to-neutrophil before treatment ratio was associated with poor OS and DMFS. Logistic regression analysis showed that pretreatment MER and posttreatment NLR were independent predictors of OS in patients with advanced NPC; moreover, pretreatment and posttreatment MER and NLR were independent prognostic factors for DMFS in patients with advanced NPC. CONCLUSIONS The NLR, NER and MER can be used to predict survival in advanced NPC patients. Eosinophils might be one of the factors for the good prognosis of NPC patients. In addition, an increased number of neutrophils after treatment may indicate a favorable prognosis.
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Affiliation(s)
- Maoyu Ye
- Department of Otorhinolaryngology-Head and Neck Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Aijie Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Bo Yuan
- Department of Otorhinolaryngology-Head and Neck Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Guolin Tan
- Department of Otorhinolaryngology-Head and Neck Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Jingang Ai
- Department of Otorhinolaryngology-Head and Neck Surgery, Third Xiangya Hospital, Central South University, Changsha, China
| | - Honghui Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, Third Xiangya Hospital, Central South University, Changsha, China.
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Tokunaga E, Miyoshi Y, Dozono K, Kawaguchi T, Toi M. Association of Neutrophil-to-Lymphocyte Ratio and Absolute Lymphocyte Count With Clinical Outcomes in Advanced Breast Cancer in the MONARCH 2 Trial. Oncologist 2024; 29:e319-e329. [PMID: 37971418 PMCID: PMC10911923 DOI: 10.1093/oncolo/oyad301] [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: 07/26/2023] [Accepted: 10/25/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Established prognostic factors for treatment response to cyclin-dependent kinases 4 and 6 inhibitors are currently lacking. We aimed to investigate the relationship of pretreatment neutrophil-to-lymphocyte ratio (NLR) and absolute lymphocyte count (ALC) to abemaciclib outcomes. PATIENTS AND METHODS This was a post hoc analysis of data from MONARCH 2, a phase III study of abemaciclib or placebo plus fulvestrant in hormone-receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer that progressed on endocrine therapy. Patients were divided into high and low categories based on baseline NLR (cutoff: 2.5) and ALC (cutoff: 1.5 × 109/L). The association of baseline NLR and ALC with progression-free survival (PFS) and overall survival (OS) was explored using Cox models and Kaplan-Meier estimates. Tumor response and safety were also examined. RESULTS NLR and ALC data were available for 645 patients (abemaciclib: N = 426; placebo: N = 219). Low-baseline NLR or high-baseline ALC was consistently associated with positive PFS and OS trends; low-baseline NLR subgroups also showed trends for better response. The abemaciclib treatment effect against placebo was observed regardless of baseline NLR or ALC. Univariate analyses showed baseline NLR and ALC were prognostic of PFS and OS. Baseline NLR remained significant in the multivariate model (P < .0001). No unexpected differences in safety were observed by baseline NLR or ALC. CONCLUSION Baseline NLR was independently prognostic of PFS and OS. Low-baseline NLR was associated with numerically better efficacy outcomes, but the benefit of adding abemaciclib to fulvestrant was similar irrespective of baseline NLR status.
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Affiliation(s)
- Eriko Tokunaga
- Department of Breast Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yasuo Miyoshi
- Department of Surgery, Division of Breast and Endocrine Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Koji Dozono
- Japan Drug Development and Medical Affairs, Eli Lilly Japan K.K., Kobe, Japan
| | - Tsutomu Kawaguchi
- Japan Drug Development and Medical Affairs, Eli Lilly Japan K.K., Kobe, Japan
| | - Masakazu Toi
- Director, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
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Sá MVBDO, de Morais CNL, Gonçalves RSG, Sarteschi C, Vasconcelos LRS. Predicting the outcome of death by CALL Score in COVID-19 patients. Rev Assoc Med Bras (1992) 2024; 70:e20230688. [PMID: 38451572 PMCID: PMC10913782 DOI: 10.1590/1806-9282.20230688] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/08/2023] [Indexed: 03/08/2024]
Abstract
OBJECTIVE The aim of this study was to assess the performance of the CALL Score tool in predicting the death outcome in COVID-19 patients. METHODS A total of 897 patients were analyzed. Univariate and multivariate logistic regression analyses were conducted to determine the association between characteristics of the CALL Score and the occurrence of death. The relationship between CALL Score risk classification and the occurrence of death was also examined. Receiver operating characteristic curve analysis was performed to identify optimal cutoff points for the CALL Score and the outcome. RESULTS The study revealed that age>60 years, DHL>500, and lymphocyte count ≤1000 emerged as independent predictors of death. Higher risk classifications of the CALL Score were associated with an increased likelihood of death. The optimal CALL Score cutoff point for predicting the death outcome was 9.5 (≥9.5), with a sensitivity of 70.4%, specificity of 80.3%, and accuracy of 80%. CONCLUSION The CALL Score showed promising discriminatory ability for death outcomes in COVID-19 patients. Age, DHL level, and lymphocyte count were identified as independent predictors. Further validation and external evaluation are necessary to establish the robustness and generalizability of the CALL Score in diverse clinical settings.
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Affiliation(s)
- Marcus Villander Barros de Oliveira Sá
- Royal Portuguese Charitable Hospital, Royal Medical Clinic – Recife (PE), Brazil
- Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Department of Parasitology and Immunology – Recife (PE), Brazil
| | | | | | - Camila Sarteschi
- Royal Portuguese Charitable Hospital, Royal Medical Clinic – Recife (PE), Brazil
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Güneş ZY, Günaydın FM. The relationship between the systemic immune-inflammation index and obstructive sleep apnea. Sleep Breath 2024; 28:311-317. [PMID: 37725251 DOI: 10.1007/s11325-023-02913-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/18/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023]
Abstract
AIM To investigate the predictive value of the systemic immune-inflammation index (SII) in patients with obstructive sleep apnea (OSA). MATERIAL AND METHODS Patients diagnosed with OSA formed the patient group, and those with a normal polysomnography (PSG) result formed the control group. The neutrophil, thrombocyte, monocyte, and lymphocyte counts obtained from the hemogram were used to calculate the neutrophil-to-lymphocyte ratio (NLR), thrombocyte-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and the SII values. The two groups were compared with respect to the NLR, PLR, MLR, and SII values. Correlations were examined between the PSG parameters and the NLR, PLR, MLR, and SII values in the patient group. RESULTS Evaluation included 146 subjects with 85 in the patient group and 61 in the control group. Statistically significantly higher SII and NLR values were found in the patient group (p = 0.037, p < 0.05; p = 0.015, p < 0.05). A statistically significant negative correlation was observed between the SII and the lowest O2 saturation measurements (r = - 0.246; p = 0.003; p < 0.01). A statistically significant negative correlation was found between the NLR and the lowest O2 saturation measurement (r = - 0.255; p = 0.002; p < 0.01). The cutoff value for SII was found to be 290, with 84.7% sensitivity and 29.5% specificity. A cutoff value of 1.71 for NLR was determined to have 61.2% sensitivity and 60.7% specificity. CONCLUSION SII may be a new, rapid, low-cost, and easy-to-measure biomarker for the prediction of obstructive sleep apnea.
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Affiliation(s)
- Zahide Yılmaz Güneş
- Neurology Clinic, Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey.
| | - Filiz Manga Günaydın
- Neurology Clinic, Kocaeli Derince Education and Research Hospital, Kocaeli, Turkey
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Osunronbi T, Olukoya O, Jesuyajolu D, Alare K, Alemenzohu HO, Bello RO, Omoniyo T, Oyeyemi OV, Yakasai AN, Sharma H. The prognostic utility of neutrophil-lymphocyte ratio in spinal surgery: A systematic review and meta-analysis. J Clin Neurosci 2024; 121:161-168. [PMID: 38412749 DOI: 10.1016/j.jocn.2024.02.021] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 02/18/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE Neutrophil-lymphocyte ratio (NLR) is reportedly an effective prognostic tool across various medical and surgical fields, but its value in spinal surgery is unestablished. We aim to investigate the relationship between elevated baseline/postoperative NLR and patient outcomes in spinal surgery. MATERIALS AND METHODS We performed a systematic search in PubMed, EMBASE, and SCOPUS databases for studies investigating the prognostic value of NLR in spine patients.Odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (CIs) were analysed on the RevMan 5.4 software. Where meta-analysis was not possible, we vote-counted the direction of the effect of elevated NLR. The GRADE framework for prognostic factor research was utilised to assess the certainty of the evidence for each outcome measure. RESULTS Five outcome measures (overall survival, mortality, disease-free survival, functional recovery and complications) were assessed across 16 studies involving 5471 patients. Elevated baseline NLR was associated with reduced overall survival (HR: 1.63, 95 % CI: 1.05 - 2.54) (GRADE: low) and worsened functional recovery (OR: 0.93, 95 % CI: 0.87 - 0.98) (GRADE: low). There was no association between baseline NLR and disease-free survival (HR: 2.42, 95 % CI: 0.49 - 11.83) (GRADE: very low) or mortality (OR: 1.39, 95 % CI: 0.41 - 4.75) (GRADE: very low). Elevated NLR levels measured on days 3-4 and days 6-7 postoperatively, but not NLR measured at baseline or on days 1-2 postoperatively, were associated with greater risks of complications (GRADE: low). CONCLUSIONS NLR is an objective tool with the potential to identify the patients that would benefit from surgery and facilitate shared decision-making.
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Affiliation(s)
- Temidayo Osunronbi
- Neurosurgery Section, Surgery Interest Group of Africa, Lagos, Nigeria; Department of Health Sciences, University of York, York, United Kingdom.
| | - Olatomiwa Olukoya
- Neurosurgery Section, Surgery Interest Group of Africa, Lagos, Nigeria
| | | | - Kehinde Alare
- Neurosurgery Section, Surgery Interest Group of Africa, Lagos, Nigeria
| | | | - Raheem O Bello
- Neurosurgery Section, Surgery Interest Group of Africa, Lagos, Nigeria
| | - Taiwo Omoniyo
- Neurosurgery Section, Surgery Interest Group of Africa, Lagos, Nigeria
| | - Opeyemi V Oyeyemi
- Neurosurgery Section, Surgery Interest Group of Africa, Lagos, Nigeria
| | - Amina N Yakasai
- Neurosurgery Section, Surgery Interest Group of Africa, Lagos, Nigeria
| | - Himanshu Sharma
- Southwest Neurosurgery Centre, University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom
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Wang D, Wang Y, Dong X, Yu M, Cai H. The significance of preoperative neutrophil-to-lymphocyte ratio in predicting short-term complications and survival benefits of pancreaticoduodenectomy: A systematic review and meta-analysis. Am J Surg 2024; 229:76-82. [PMID: 38101977 DOI: 10.1016/j.amjsurg.2023.11.030] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/08/2023] [Accepted: 11/24/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND The established association between the inflammatory marker, neutrophil-lymphocyte ratio (NLR), and both long-term surgical prognosis and short-term postoperative complications is well-recognized. However, its prognostic value in pancreaticoduodenectomy (PD) is yet to be ascertained. This meta-analysis investigates the prognostic relevance of preoperative NLR in PD patients. METHOD We systematically searched electronic databases to identify studies exploring the relationship between pre-treatment blood NLR levels and overall survival (OS), disease-free survival (DFS), and immediate postoperative complications in PD patients. Statistical evaluations, using RevMan 5.4 and Stata 12, focused on hazard ratios (HRs) and risk ratios (RRs). Additionally, subgroup analyses, publication bias tests, and sensitivity analyses were performed. RESULT Our analysis encompassed 18 retrospective studies, with NLR cutoff values ranging from 2 to 3.8. The meta-analysis revealed that PD patients with elevated NLR had diminished OS and DFS, evidenced by an HR of 1.35 (95% CI: 1.11-1.64, p = 0.003) and 1.62 (95% CI: 1.15-2.27, p = 0.005), respectively. Moreover, NLR emerged as an independent determinant of immediate postoperative complications, indicated by an OR of 1.91 (95% CI: 1.01-3.59, p = 0.013) and an HR of 2.15 (95% CI: 1.23-3.73, p < 0.01). CONCLUSION NLR serves as a significant prognostic indicator for both OS and DFS following PD and is a reliable predictor of postoperative complications. Preoperative Neutrophil-to-Lymphocyte Ratio (NLR) is a significant prognostic indicator for overall survival (OS) and disease-free survival (DFS) in patients undergoing pancreaticoduodenectomy (PD).
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Affiliation(s)
- Da Wang
- Jiangsu University, Zhenjiang, 212000, China; Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology in Gansu Province, Gansu Provincial Hospital, Lanzhou, 730000, China; General Surgery Clinical Medical Center, Gansu Provincial Hospital, Lanzhou, 730000, China
| | | | - Xiaohua Dong
- Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology in Gansu Province, Gansu Provincial Hospital, Lanzhou, 730000, China; General Surgery Clinical Medical Center, Gansu Provincial Hospital, Lanzhou, 730000, China; First Clinical College of Medicine, Lanzhou University, Lanzhou, 730000, China
| | - Miao Yu
- Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology in Gansu Province, Gansu Provincial Hospital, Lanzhou, 730000, China; General Surgery Clinical Medical Center, Gansu Provincial Hospital, Lanzhou, 730000, China
| | - Hui Cai
- Jiangsu University, Zhenjiang, 212000, China; Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology in Gansu Province, Gansu Provincial Hospital, Lanzhou, 730000, China; General Surgery Clinical Medical Center, Gansu Provincial Hospital, Lanzhou, 730000, China.
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Materna M, Delmonte OM, Bosticardo M, Momenilandi M, Conrey PE, Muylder BCD, Bravetti C, Bellworthy R, Cederholm A, Staels F, Ganoza CA, Darko S, Sayed S, Le Floc’h C, Ogishi M, Rinchai D, Guenoun A, Bolze A, Khan T, Gervais A, Krüger R, Völler M, Palterer B, Sadeghi-Shabestari M, de Septenville AL, Schramm CA, Shah S, Tello-Cajiao JJ, Pala F, Amini K, Campos JS, Lima NS, Eriksson D, Lévy R, Seeleuthner Y, Jyonouchi S, Ata M, Al Ali F, Deswarte C, Pereira A, Mégre t J, Le Voyer T, Bastard P, Berteloot L, Dussiot M, Vladikine N, Cardenas PP, Jouanguy E, Alqahtani M, Hasan A, Thanaraj TA, Rosain J, Al Qureshah F, Sabato V, Alyanakian MA, Leruez-Ville M, Rozenberg F, Haddad E, Regueiro JR, Toribio ML, Kelsen JR, Salehi M, Nasiri S, Torabizadeh M, Rokni-Zadeh H, Changi-Ashtiani M, Vatandoost N, Moravej H, Akrami SM, Mazloomrezaei M, Cobat A, Meyts I, Etsushi T, Nishimura M, Moriya K, Mizukami T, Imai K, Abel L, Malissen B, Al-Mulla F, Alkuraya FS, Parvaneh N, von Bernuth H, Beetz C, Davi F, Douek DC, Cheynier R, Langlais D, Landegren N, Marr N, Morio T, Shahrooei M, Schrijvers R, Henrickson SE, Luche H, Notarangelo LD, Casanova JL, Béziat V. The immunopathological landscape of human pre-TCRα deficiency: From rare to common variants. Science 2024; 383:eadh4059. [PMID: 38422122 PMCID: PMC10958617 DOI: 10.1126/science.adh4059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 01/26/2024] [Indexed: 03/02/2024]
Abstract
We describe humans with rare biallelic loss-of-function PTCRA variants impairing pre-α T cell receptor (pre-TCRα) expression. Low circulating naive αβ T cell counts at birth persisted over time, with normal memory αβ and high γδ T cell counts. Their TCRα repertoire was biased, which suggests that noncanonical thymic differentiation pathways can rescue αβ T cell development. Only a minority of these individuals were sick, with infection, lymphoproliferation, and/or autoimmunity. We also report that 1 in 4000 individuals from the Middle East and South Asia are homozygous for a common hypomorphic PTCRA variant. They had normal circulating naive αβ T cell counts but high γδ T cell counts. Although residual pre-TCRα expression drove the differentiation of more αβ T cells, autoimmune conditions were more frequent in these patients compared with the general population.
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Affiliation(s)
- Marie Materna
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
| | - Ottavia M. Delmonte
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, USA
| | - Marita Bosticardo
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, USA
| | - Mana Momenilandi
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
| | - Peyton E. Conrey
- Division of Allergy-Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia; Philadelphia, USA
| | | | - Clotilde Bravetti
- Department of Biological Hematology, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP) and Sorbonne Université, Paris, France
- Sorbonne University, Paris Cancer Institute CURAMUS, INSERM U1138, Paris, France
| | - Rebecca Bellworthy
- Deptartment of Human Genetics, Dahdaleh Institute of Genomic Medicine, McGill University, Montreal, Quebec, Canada
| | - Axel Cederholm
- Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Frederik Staels
- Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology and Transplantation, KU Leuven, Belgium
| | | | - Samuel Darko
- Human Immunology Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Samir Sayed
- Division of Allergy-Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia; Philadelphia, USA
| | - Corentin Le Floc’h
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
| | - Masato Ogishi
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, USA
| | - Darawan Rinchai
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, USA
| | | | | | - Taushif Khan
- Research Branch, Sidra Medicine, Doha, Qatar
- The Jackson Laboratory, Farmington, USA
| | - Adrian Gervais
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
| | - Renate Krüger
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Mirjam Völler
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
| | - Boaz Palterer
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, USA
| | - Mahnaz Sadeghi-Shabestari
- Immunology Research Center, TB and Lung Disease Research Center, Mardaniazar children hospital, Tabriz University of Medical Science, Tabriz, Iran
| | - Anne Langlois de Septenville
- Department of Biological Hematology, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP) and Sorbonne Université, Paris, France
| | - Chaim A. Schramm
- Human Immunology Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Sanjana Shah
- Human Immunology Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - John J. Tello-Cajiao
- Division of Allergy-Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia; Philadelphia, USA
- Department of Pathology, The Children’s Hospital of Philadelphia, Philadelphia, USA
| | - Francesca Pala
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, USA
| | - Kayla Amini
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, USA
| | - Jose S. Campos
- Division of Allergy-Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia; Philadelphia, USA
| | - Noemia Santana Lima
- Human Immunology Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Daniel Eriksson
- Department of Immunology, Genetics and Pathology, Uppsala University and University Hospital, Section of Clinical Genetics, Uppsala, Sweden
| | - Romain Lévy
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
- Pediatric Immunology, Hematology and Rheumatology Unit, Necker Hospital for Sick Children, AP-HP, Paris, France
| | - Yoann Seeleuthner
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
| | - Soma Jyonouchi
- Division of Allergy-Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia; Philadelphia, USA
| | - Manar Ata
- Human Immunology Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | | | - Caroline Deswarte
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
| | - Anaïs Pereira
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
| | - Jérôme Mégre t
- Cytometry Core Facility, SFR Necker, INSERM US24-CNRS UAR3633, Paris, France
| | - Tom Le Voyer
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
| | - Paul Bastard
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, USA
- Pediatric Immunology, Hematology and Rheumatology Unit, Necker Hospital for Sick Children, AP-HP, Paris, France
| | - Laureline Berteloot
- Department of Pediatric Radiology, University Hospital Necker-Enfants Malades, AP-HP, Paris, France
| | - Michaël Dussiot
- Imagine Institute, University of Paris-Cité, Paris, France
- Laboratory of Molecular Mechanisms of Hematological Disorders and Therapeutic Implications, INSERM UMR 1163, Paris, France
| | - Natasha Vladikine
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
| | - Paula P. Cardenas
- Department of Immunology, Complutense University School of Medicine and 12 de Octubre Health Research Institute (imas12), Madrid, Spain
| | - Emmanuelle Jouanguy
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, USA
| | - Mashael Alqahtani
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Amal Hasan
- Department of Translational Research, Research Division, Dasman Diabetes Institute, Dasman, Kuwait City, Kuwait
| | - Thangavel Alphonse Thanaraj
- Department of Genetics and Bioinformatics, Research Division, Dasman Diabetes Institute, Dasman, Kuwait City, Kuwait
| | - Jérémie Rosain
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
| | - Fahd Al Qureshah
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, USA
| | - Vito Sabato
- Department of Immunology, Allergology and Rheumatology, University of Antwerp, Antwerp University Hospital, Belgium
| | - Marie Alexandra Alyanakian
- Immunology Laboratory, Necker Hospital for Sick Children, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | | | - Flore Rozenberg
- University of Paris, Institut Cochin, INSERM U1016, CNRS UMR8104, Paris, France
- Virology, Cochin Hospital, AP-HP, APHP-CUP, Paris, France
| | - Elie Haddad
- Department of Pediatrics, Department of Microbiology, Immunology and Infectious Diseases, University of Montreal, CHU Sainte-Justine, Montreal, QC, Canada
| | - Jose R. Regueiro
- Department of Immunology, Complutense University School of Medicine and 12 de Octubre Health Research Institute (imas12), Madrid, Spain
| | - Maria L. Toribio
- Immune System Development and Function Unit, Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas (CSIC), Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Judith R. Kelsen
- Division of Gastroenterology, Hepatology and Nutrition at Children's Hospital of Philadelphia
| | - Mansoor Salehi
- Cellular, Molecular and Genetics Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Genetics and Molecular Biology,Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahram Nasiri
- Department of Pediatric Neurology, Children's Medical Center of Abuzar, Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehdi Torabizadeh
- Golestan Hospital Clinical Research Development Unit, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hassan Rokni-Zadeh
- Department of Medical Biotechnology, School of Medicine, Zanjan University of Medical Sciences (ZUMS), Zanjan, Iran
| | - Majid Changi-Ashtiani
- School of Mathematics, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
| | - Nasimeh Vatandoost
- Department of Genetics and Molecular Biology,Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
- Pediatric Inherited Diseases Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Moravej
- Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Mohammad Akrami
- Medical Genetics Poursina St., Genetic Deptartment, Medical Faculty, Tehran University of Medical Sciences, Tehran, Iran
- Dr. Shahrooei Laboratory, 22 Bahman St., Ashrafi Esfahani Blvd, Tehran, Iran
| | | | - Aurélie Cobat
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, USA
| | - Isabelle Meyts
- Laboratory for Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, Department of Pediatrics, University Hospitals Leuven, KU Leuven, Leuven, Belgium
- Department of Pediatrics, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Toyofuku Etsushi
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Madoka Nishimura
- Department of Pediatrics, NHO Kumamoto Medical Center, Kumamoto, Japan
| | - Kunihiko Moriya
- Department of Pediatrics, National Defense Medical College, Saitama, Japan
| | - Tomoyuki Mizukami
- Department of Pediatrics, NHO Kumamoto Medical Center, Kumamoto, Japan
| | - Kohsuke Imai
- Department of Pediatrics, National Defense Medical College, Saitama, Japan
| | - Laurent Abel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, USA
| | - Bernard Malissen
- Immunology Center of Marseille-Luminy, Aix Marseille University, Inserm, CNRS, Marseille, France
- Immunophenomics Center (CIPHE), Aix Marseille Université, Inserm, CNRS, Marseille, France
| | - Fahd Al-Mulla
- Department of Genetics and Bioinformatics, Research Division, Dasman Diabetes Institute, Dasman, Kuwait City, Kuwait
| | - Fowzan Sami Alkuraya
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- Department of Anatomy and Cell Biology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Nima Parvaneh
- Division of Allergy and Clinical Immunology, Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
| | - Horst von Bernuth
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health (BIH), Berlin, Germany
- Berlin Institute of Health at Charité – Universitätsmedizin Berlin, Germany
- Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité - Universitätsmedizin Berlin, Berlin, Germany
- Labor Berlin GmbH, Department of Immunology, Berlin, Germany
| | | | - Frédéric Davi
- Department of Biological Hematology, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP) and Sorbonne Université, Paris, France
- Sorbonne University, Paris Cancer Institute CURAMUS, INSERM U1138, Paris, France
| | - Daniel C. Douek
- Human Immunology Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Rémi Cheynier
- University of Paris, Institut Cochin, INSERM U1016, CNRS UMR8104, Paris, France
| | - David Langlais
- Deptartment of Human Genetics, Dahdaleh Institute of Genomic Medicine, McGill University, Montreal, Quebec, Canada
| | - Nils Landegren
- Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
- Center for Molecular Medicine, Department of Medicine (Solna), Karolinska Institute, Stockholm, Sweden
| | - Nico Marr
- Department of Human Immunology, Sidra Medicine, Doha, Qatar
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Tomohiro Morio
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Mohammad Shahrooei
- Dr. Shahrooei Laboratory, 22 Bahman St., Ashrafi Esfahani Blvd, Tehran, Iran
- Clinical and Diagnostic Immunology, Department of Microbiology, Immunology, and Transplantation, KU Leuven, Belgium
| | - Rik Schrijvers
- Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology and Transplantation, KU Leuven, Belgium
| | - Sarah E. Henrickson
- Division of Allergy-Immunology, Department of Pediatrics, Children’s Hospital of Philadelphia; Philadelphia, USA
- Institute for Immunology and Immune Health, University of Pennsylvania; Philadelphia, USA
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania; Philadelphia, USA
| | - Hervé Luche
- Immunophenomics Center (CIPHE), Aix Marseille Université, Inserm, CNRS, Marseille, France
| | - Luigi D. Notarangelo
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, USA
| | - Jean-Laurent Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
- Human Immunology Section, Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
- Department of Pediatrics, Necker Hospital for Sick Children, AP-HP, France
- Howard Hughes Medical Institute, The Rockefeller University, New York, USA
| | - Vivien Béziat
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM, Necker Hospital for Sick Children, Paris, France
- Imagine Institute, University of Paris-Cité, Paris, France
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, New York, USA
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10
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Başaran PÖ, Dogan M. The relationship between disease activity with pan-immune-inflammatory value and systemic immune-inflammation index in rheumatoid arthritis. Medicine (Baltimore) 2024; 103:e37230. [PMID: 38428850 PMCID: PMC10906570 DOI: 10.1097/md.0000000000037230] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 01/19/2024] [Indexed: 03/03/2024] Open
Abstract
Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease. Immune system cells have an important role in RA. Our aim was to investigate the relationship between disease activity, systemic immune-inflammation index (SII), and pan-immune-inflammation value (PIV) levels in RA patients. We planned to investigate whether these 2 measurements have an advantage over each other. About 67 patients diagnosed with RA and 49 healthy controls included in this study. RA was diagnosed based on 2010 ACR classification criteria. In this cross-sectional study, peripheral blood tests, C-reactive protein (CRP), hemogram, and erythrocyte sedimentation rate levels were noted after the physical examination of all participants. PIV was calculated with the formula: (neutrophil count × platelet count × monocyte count) / lymphocyte count. SII was calculated as follows: (neutrophil count × monocytes count) / lymphocyte count. The disease activity score 28 (DAS28) were noted in patients with RA. CRP values of active RA group were significantly higher than remission RA and control groups (P < .001), control and remission RA groups were similar (P = .86). PIV and SII are significantly higher in active RA than remission RA and control (P < .001, P < .001) higher in remission RA than control (P < .001, P < .001). Receiver operating characteristic curve analysis in predicting remission compared to the control group, CRP was not significant, PIV and SII was significant and PIV has higher sensitivity and sensitivity, a PIV value of > 217.31 have sensitivity 75.0% and specificity 85.7%. CRP, PIV, and SII are statistically significant in predicting active RA compared to the remission RA and control group. Our findings show that PIV, and SII are easy, inexpensive and reliable markers predicting remission in RA patients. CRP was not significant compared to remission RA and control group, PIV and SII was significant and PIV has higher sensitivity and specificity than SII in the remission group in RA. Patients with high disease activity, PIV, SII, and CRP levels were effective in showing disease activity compared to RA remission group and healthy controls.
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Affiliation(s)
- Pinar Özge Başaran
- Physical Medicine and Rehabilitation Department, Erol Olcok Training and Research Hospital, Hitit University, Corum, Turkey
| | - Murat Dogan
- Faculty of Medicine, Department of Internal Medicine, Hitit University, Corum, Turkey
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11
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Shirai Y, Hamura R, Tanji Y, Taniai T, Yanagaki M, Haruki K, Furukawa K, Onda S, Sakamoto T, Gocho T, Ikegami T. The postoperative platelet-to-lymphocyte ratio predicts the outcome of patients undergoing pancreaticoduodenectomy for pancreatic head cancer. Surg Today 2024; 54:247-257. [PMID: 37488354 DOI: 10.1007/s00595-023-02727-4] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/22/2023] [Indexed: 07/26/2023]
Abstract
PURPOSE The preoperative platelet-to-lymphocyte ratio (PLR) has been reported as an important prognostic index for pancreatic ductal adenocarcinoma (PDAC); however, the significance of the postoperative (post-op) PLR for this disease has not been elucidated. METHODS We analyzed data on 118 patients who underwent pancreaticoduodenectomy for pancreatic head PDAC, collected from a prospectively maintained database. The post-op PLR was obtained by dividing the platelet count after surgery by the lymphocyte count on post-op day (POD) 14. The patients were divided into two groups according to a post-op PLR of < 310 or ≥ 310. Survival data were analyzed. RESULTS A high post-op PLR was identified as a significant prognostic index on univariate analysis for disease-free survival (DFS) and overall survival (OS). The post-op PLR remained significant, along with tumor differentiation and adjuvant chemotherapy, on multivariate analysis for OS (hazard ratio = 2.077, 95% confidence interval: 1.220-3.537; p = 0.007). The post-op PLR was a significant independent prognostic index for poor DFS, along with tumor differentiation and lymphatic invasion, on multivariate analysis (hazard ratio = 1.678, 95% confidence interval: 1.056-2.667; p = 0.028). CONCLUSIONS The post-op PLR in patients with pancreatic head PDAC was an independent predictor of DFS and OS after elective resection.
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Affiliation(s)
- Yoshihiro Shirai
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan.
- Department of Gastrointestinal Surgery, Saku General Hospital Advanced Care Center, Nagano, 385-0051, Japan.
| | - Ryoga Hamura
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan
- Department of Gastrointestinal Surgery, Saku General Hospital Advanced Care Center, Nagano, 385-0051, Japan
| | - Yoshiaki Tanji
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan
| | - Tomohiko Taniai
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan
| | - Mitsuru Yanagaki
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan
| | - Koichiro Haruki
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan
| | - Kenei Furukawa
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan
| | - Shinji Onda
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan
- Department of Gastrointestinal Surgery, Saku General Hospital Advanced Care Center, Nagano, 385-0051, Japan
| | - Taro Sakamoto
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan
| | - Takeshi Gocho
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan
| | - Toru Ikegami
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8461, Japan
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12
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Uslu MF, Yilmaz M, Ateşçelik M, Atilgan FA. The utility of the systemic immune inflammation and systemic inflammation response indices in suspected intermediate-risk pulmonary embolism. Croat Med J 2024; 65:13-19. [PMID: 38433508 PMCID: PMC10915762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 01/05/2024] [Indexed: 03/05/2024] Open
Abstract
AIM To evaluate the utility of the systemic immune inflammation index (SII) and systemic inflammation response index (SIRI) in diagnosing pulmonary embolism (PE) in emergency medicine. METHODS We retrospectively reviewed the data of patients who presented to the emergency department and underwent contrast-enhanced computed tomography pulmonary angiography for suspected PE between January 1 and December 31, 2021. In 81/168 patients, the diagnosis of PE was confirmed and in 87/168 it was rejected. The data were analyzed with receiver operating characteristic analysis and binary logistic regression analysis. RESULTS Patients with PE had a higher white blood cell count (P<0.001), neutrophils (P=0.002), monocytes (P=0.013), neutrophil/lymphocyte ratio (P<0.001), SII (P<0.001), and SIRI (P<0.001), and a lower lymphocyte count (P=0.002). The SII had a sensitivity of 75.31% and a specificity of 71.26%, while the SIRI had a sensitivity of 82.72% and a specificity of 68.97%. Binary logistic regression analysis showed that the Wells score, D-dimer level, and SII independently influenced the diagnosis of PE. CONCLUSION The SII and SIRI may be used to support the diagnosis of PE in the emergency department.
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Affiliation(s)
- Muhammed Fuad Uslu
- Muhammed Fuad Uslu, Department of Internal Medicine, Elazig City Hospital, 23100-Elazig, Turkey,
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Su MX, Lin HW, Nguyen HTH, Lin TC, Chen CJ, Wang HC, Wu CT, Wu YC, He GY, Liu LC, Huang CH. Monitoring trends in the absolute lymphocyte count and the neutrophil-to-lymphocyte ratio in patients with breast cancer receiving eribulin. BMC Cancer 2024; 24:195. [PMID: 38347468 PMCID: PMC10860250 DOI: 10.1186/s12885-024-11923-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/26/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND Studies have shown that the absolute lymphocyte count (ALC) and the neutrophil-to-lymphocyte ratio (NLR) are related to the outcomes in patients with breast cancer receiving specific chemotherapies. However, the reports have focussed on the initial blood test and there is a lack of evidence or data to support that dynamic changes of ALC or NLR are associated with the patients' survival outcomes. METHODS We retrospectively reviewed electronic medical records from patients with breast cancer treated with eribulin from 2015 to 2019 at our institution. Blood test data were available prior to starting eribulin (baseline), and at 1, 3 and 6 months after initiating eribulin. We classified the patients into ALC and NLR high and low groups using the following cut-offs: 1000/µl for ALC and 3 for NLR. We defined ALC and NLR trends as increasing or decreasing compared with the initial data. We assessed the associations between the ALC and NLR with progression-free survival and overall survival. RESULTS There were 136 patients with breast cancer treated with eribulin. Of these patients, 60 had complete blood tests and follow-up data. Neither a high ALC nor a low baseline NLR was associated with the survival outcome. One month after initiating eribulin treatment, a high ALC and a low NLR were significantly associated with longer progression-free survival (p = 0.044 for each). Three months after initiating eribulin, a high ALC was significantly associated with better overall survival (p = 0.006). A high NLR at 3 or 6 months after initiating eribulin was associated with worse overall survival (p = 0.017 and p = 0.001, respectively). The ALC and NLR trends across times were not associated with survivals. CONCLUSION We showed that 1, 3 and 6 months after initiating eribulin, a high ALC and a low NLR may be related to the patients' survival outcomes. The ALC and NLR trends were not associated with survival. Accordingly, we believe patients who maintain a high ALC and a low NLR may have better clinical outcomes after initiating eribulin.
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Affiliation(s)
- Meng-Xia Su
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan
| | - Hsiang-Wen Lin
- School of Pharmacy and Graduate Institute, China Medical University, No. 100, Sec. 1, Jingmao Rd., Taichung, 406040, Taiwan
- Department of Pharmacy, China Medical University Hospital, No. 2, Yude Rd., North Dist., Taichung, 404327, Taiwan
- Department of Pharmacy System, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, 833 S. Wood St., Chicago, 60612, Illinois, United States of America
| | - Hanh T H Nguyen
- School of Pharmacy and Graduate Institute, China Medical University, No. 100, Sec. 1, Jingmao Rd., Taichung, 406040, Taiwan
- Department of Clinical Pharmacy, Hanoi University of Pharmacy, No. 144, Xuan Thuy, Cau giay, Hanoi, Vietnam
| | - Tien-Chao Lin
- School of Pharmacy and Graduate Institute, China Medical University, No. 100, Sec. 1, Jingmao Rd., Taichung, 406040, Taiwan
- Department of Pharmacy, China Medical University Hospital, No. 2, Yude Rd., North Dist., Taichung, 404327, Taiwan
| | - Chih-Jung Chen
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan
| | - Hwei-Chung Wang
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan
| | - Chen-Teng Wu
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan
| | - Yao-Chung Wu
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan
| | - Geng-Yan He
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan
| | - Liang-Chih Liu
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan.
- College of Medicine, China Medical University, No. 100, Sec. 1, Jingmao Rd., Taichung, 406040, Taiwan.
| | - Chih-Hao Huang
- Surgical Department, China Medical University Hospital, No. 2, Yude Rd. North Dist, Taichung, 404327, Taiwan.
- College of Medicine, China Medical University, No. 100, Sec. 1, Jingmao Rd., Taichung, 406040, Taiwan.
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Abolnezhadian F, Aminzadeh M, Iranparast S, Dehnavi S, Dousti F, Sharifat M, Moradzadegan H. Measurement of the Neutrophils Count and Oxidative Burst in Neutrophils of Patients with Sanjad Sakati Syndrome. Iran J Allergy Asthma Immunol 2024; 23:115-121. [PMID: 38485906 DOI: 10.18502/ijaai.v23i1.14959] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 11/28/2023] [Indexed: 03/19/2024]
Abstract
Sanjad Sakati Syndrome (SSS) is categorized as a neuroendocrine-related disease due to disorders of the nervous and hormonal systems. Since hormonal changes in these patients may affect the nature and function of the immune system. Thus, in this study, cell count and phagocytotic function of neutrophils were evaluated which may be influenced by changes in the hormonal rate and growth factors. In this study, the neutrophil count value and the oxidative burst were evaluated in six patients diagnosed with SSS and six healthy individuals. There was a significant reduction in the neutrophil count observed in SSS patients compared to healthy controls (37.41±7.93 percent vs. 66.5±6.8 percent). However, there was no significant difference in neutrophil oxidative index between patients with SSS and control subjects (172.33±55.08 vs. 217.00±77.38). We concluded that in patients with SSS, the phagocytic activity of neutrophils was not affected by hormonal changes, while the number of neutrophils and neutrophil-to-lymphocyte ratio (NLR) index were decreased.
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Affiliation(s)
- Farhad Abolnezhadian
- Department of Pediatrics, Abuzar Children's Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Majid Aminzadeh
- Pediatric Endocrinology and Metabolism, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Sara Iranparast
- Department of Immunology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran AND Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.
| | - Sajad Dehnavi
- Immunology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Fatemeh Dousti
- Immunobiology Center of Pasteur Medical Laboratory, Ahvaz, Iran.
| | - Moosa Sharifat
- Department of Immunology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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15
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Guo J, Huang Y, Pang L, Zhou Y, Yuan J, Zhou B, Fu M. Association of systemic inflammatory response index with ST segment elevation myocardial infarction and degree of coronary stenosis: a cross-sectional study. BMC Cardiovasc Disord 2024; 24:98. [PMID: 38336634 PMCID: PMC10858502 DOI: 10.1186/s12872-024-03751-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 01/28/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Systemic Inflammatory Response Index (SIRI), a composite inflammatory marker encompassing neutrophils, monocytes, and lymphocytes, has been recognized as a reliable marker of systemic inflammation. This article undertakes an analysis of clinical data from ST-segment Elevation Myocardial Infarction (STEMI) patients, aiming to comprehensively assess the relationship between SIRI, STEMI, and the degree of coronary stenosis. METHODS The study involved 1809 patients diagnosed with STEMI between the years 2020 and 2023. Univariate and multivariate logistic regression analyses were conducted to evaluate the risk factors for STEMI. Receiver operating characteristic (ROC) curves were generated to determine the predictive power of SIRI and neutrophil-to-lymphocyte ratio (NLR). Spearman correlation analysis was performed to assess the correlation between SIRI, NLR, and the Gensini score (GS). RESULTS Multivariate logistic regression analysis showed that the SIRI was the independent risk factor for STEMI (adjusted odds ratio (OR) in the highest quartile = 24.96, 95% confidence interval (CI) = 15.32-40.66, P < 0.001). In addition, there is a high correlation between SIRI and GS (β:28.54, 95% CI: 24.63-32.46, P < 0.001). The ROC curve analysis was performed to evaluate the predictive ability of SIRI and NLR for STEMI patients. The area under the curve (AUC) for SIRI was 0.789. The AUC for NLR was 0.754. Regarding the prediction of STEMI in different gender groups, the AUC for SIRI in the male group was 0.771. The AUC for SIRI in the female group was 0.807. Spearman correlation analysis showed that SIRI exhibited a stronger correlation with GS, while NLR was lower (SIRI: r = 0.350, P < 0.001) (NLR: r = 0.313, P < 0.001). CONCLUSION The study reveals a strong correlation between the SIRI and STEMI as well as the degree of coronary artery stenosis. In comparison to NLR, SIRI shows potential in predicting acute myocardial infarction and the severity of coronary artery stenosis. Additionally, SIRI exhibits a stronger predictive capability for female STEMI patients compared to males.
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Affiliation(s)
- Jiongchao Guo
- Department of Cardiology, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Hefei, 230000, Anhui, China
| | - Yating Huang
- Department of Endocrinology, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Hefei, 230000, Anhui, China
| | - Lamei Pang
- Department of Endocrinology, Hefei BOE Hospital, Hefei, 230000, Anhui, China
| | - Yuan Zhou
- Department of Cardiology, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Hefei, 230000, Anhui, China
| | - Jingjing Yuan
- Department of Cardiology, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Hefei, 230000, Anhui, China
| | - Bingfeng Zhou
- Department of Cardiology, Hefei BOE Hospital, Hefei, 230000, Anhui, China.
| | - Minmin Fu
- Department of Cardiology, The Third Affiliated Hospital of Anhui Medical University (The First People's Hospital of Hefei), Hefei, 230000, Anhui, China.
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16
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Yang J, Zhu X, Feng J. The Changes in the Quantity of Lymphocyte Subpopulations during the Process of Sepsis. Int J Mol Sci 2024; 25:1902. [PMID: 38339179 PMCID: PMC10855580 DOI: 10.3390/ijms25031902] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/18/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024] Open
Abstract
Sepsis remains a global challenge, especially in low- and middle-income countries, where there is an urgent need for easily accessible and cost-effective biomarkers to predict the occurrence and prognosis of sepsis. Lymphocyte counts are easy to measure clinically, and a large body of animal and clinical research has shown that lymphocyte counts are closely related to the incidence and prognosis of sepsis. This review extensively collected experimental articles related to lymphocyte counts since the unification of the definition of sepsis. The article categorizes and discusses the relationship between absolute lymphocyte counts, intrinsic lymphocyte subsets, effector T-lymphocytes, B-lymphocytes, dendritic cells, and the incidence and prognosis of sepsis. The results indicate that comparisons of absolute lymphocyte counts alone are meaningless. However, in addition to absolute lymphocyte counts, innate lymphocyte subsets, effector T-cells, B-lymphocytes, and dendritic cells have shown certain research value in related studies.
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Affiliation(s)
- Jiale Yang
- Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China;
- Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Xiaojian Zhu
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China;
| | - Jun Feng
- Department of Emergency Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China;
- Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430074, China
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17
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Huang X, Ni X, Shen J, Chen L, Xu L, Tang X. Associations between neutrophil-to-lymphocyte/platelet-to-lymphocyte and recovery in sudden sensorineural hearing loss. Biomark Med 2024; 18:115-122. [PMID: 38436264 DOI: 10.2217/bmm-2022-0729] [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] [Indexed: 03/05/2024] Open
Abstract
Aims: This study investigated the nonlinear associations between neutrophil-to-lymphocyte (NLR)/platelet-to-lymphocyte (PLR) and recovery rates in sudden sensorineural hearing loss (SSNHL). Methods: Total of 244 SSNHL patients were included. The primary outcome was recovery rate. Results: A nonlinear association was detected between NLR and recovery rate using the LOWESS method, with a knot of 3. Patients with NLR ≥3 had a higher recovery rate than NLR <3. Using the linear-spline function, NLR was significantly associated with high recovery rate when NLR was <3. However, when NLR was ≥3, this association became nonsignificant. The trend test showed a similar result. PLR was not associated with recovery rate. Conclusion: The association between NLR and recovery rate is nonlinear, with a knot of around three. PLR is not associated with recovery rate.
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Affiliation(s)
- Xinmei Huang
- Otolaryngology Department, The Second Affiliated Hospital, Zhejiang University School of Medicine, Zheda Road, Hangzhou, 310027, China
| | - Xupei Ni
- Otolaryngology Department, Jinhua TCM Hospital, Shuangxi Road, Jinhua, 321000, China
| | - Jun Shen
- Otolaryngology Department, Jinhua TCM Hospital, Shuangxi Road, Jinhua, 321000, China
| | - Lihua Chen
- Otolaryngology Department, Jinhua TCM Hospital, Shuangxi Road, Jinhua, 321000, China
| | - Liying Xu
- Emergency Department, Zhejiang Provincial Hospital of TCM, Youdian Road, Hangzhou, 310003, China
| | - Xuxia Tang
- Otolaryngology Department, Zhejiang Provincial Hospital of TCM, Youdian Road, Hangzhou, 310003, China
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Haem Rahimi M, Venet F, Lukaszewicz AC, Peronnet E, Cerrato E, Rimmelé T, Monneret G. Interferon-Gamma-Release assay and absolute CD8 lymphocyte count for acquired immunosuppression monitoring in critically ill patients. Cytokine 2024; 174:156474. [PMID: 38101166 DOI: 10.1016/j.cyto.2023.156474] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/27/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023]
Abstract
Guided biomarker-personalized immunotherapy is advancing rapidly as a means to rejuvenate immune function in injured patients who are the most immunosuppressed. A recent study introduced a fully automated interferon-γ release assay (IGRA) for monitoring the functionality of T lymphocytes in patients with septic shock. While a significant decrease in IFN-γ release capacity was observed, a significant correlation with CD8 lymphocyte absolute count was also reported, raising the question of whether ex-vivo IFN-γ production would be only a surrogate marker for lymphocyte count or if these two parameters conveyed distinct and complementary information. In a large cohort of more than 353 critically ill patients following various injuries (sepsis, trauma, major surgery), the primary objective of the present study was to simultaneously evaluate the association between ex vivo IFN-γ release and CD8 cell count with regard to adverse outcome. Our findings provide a clear-cut result, as they distinctly demonstrate that IGRA offers higher-quality information than CD8 count in terms of an independent association with the occurrence of an adverse outcome. These results strengthen the case for incorporating IGRA into the array of biomarkers of interest for defining endotypes in sepsis. This holds especially true given that fully automated tests are now readily available and could be used in routine clinical practice.
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Affiliation(s)
- Muzhda Haem Rahimi
- Hospices Civils de Lyon, Immunology Laboratory, Hôpital E. Herriot, Lyon, France; Université de Lyon, EA 7426 "Pathophysiology of Injury-Induced Immunosuppression", Université Claude Bernard Lyon_1, Lyon, France
| | - Fabienne Venet
- Hospices Civils de Lyon, Immunology Laboratory, Hôpital E. Herriot, Lyon, France; NLRP3 Inflammation and Immune Response to Sepsis Team, Centre International de Recherche in Infectiology (CIRI), Inserm U1111, CNRS, UMR5308, Ecole Normale Supérieure de Lyon, Claude Bernard University Lyon 1, Lyon, France
| | - Anne-Claire Lukaszewicz
- Université de Lyon, EA 7426 "Pathophysiology of Injury-Induced Immunosuppression", Université Claude Bernard Lyon_1, Lyon, France; Hospices Civils de Lyon, Anesthesiology and Critical Care Medicine Department, Hôpital E. Herriot, Lyon, France
| | - Estelle Peronnet
- Université de Lyon, EA 7426 "Pathophysiology of Injury-Induced Immunosuppression", Université Claude Bernard Lyon_1, Lyon, France; Open Innovation & Partnerships, bioMérieux S.A., Marcy l'Etoile, France
| | - Elisabeth Cerrato
- Université de Lyon, EA 7426 "Pathophysiology of Injury-Induced Immunosuppression", Université Claude Bernard Lyon_1, Lyon, France; Open Innovation & Partnerships, bioMérieux S.A., Marcy l'Etoile, France
| | - Thomas Rimmelé
- Université de Lyon, EA 7426 "Pathophysiology of Injury-Induced Immunosuppression", Université Claude Bernard Lyon_1, Lyon, France; Hospices Civils de Lyon, Anesthesiology and Critical Care Medicine Department, Hôpital E. Herriot, Lyon, France
| | - Guillaume Monneret
- Hospices Civils de Lyon, Immunology Laboratory, Hôpital E. Herriot, Lyon, France; Université de Lyon, EA 7426 "Pathophysiology of Injury-Induced Immunosuppression", Université Claude Bernard Lyon_1, Lyon, France.
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de Fréminville A, Saad M, Sage E, Pricopi C, Fischler M, Trillat B, Salze B, Pascreau T, Vasse M, Vallée A, Guen ML, Fessler J. Relationship Between Preoperative Inflammation Ratios Derived From Preoperative Blood Cell Count and Postoperative Pulmonary Complications in Patients Undergoing Lobectomy: A Single-Center Observational Study. J Cardiothorac Vasc Anesth 2024; 38:482-489. [PMID: 38016820 DOI: 10.1053/j.jvca.2023.11.001] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/19/2023] [Accepted: 11/01/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVE Evaluation of the association of inflammatory cell ratios, especially neutrophil-to-lymphocyte ratio (NLR), based on preoperative complete blood counts, with postoperative complications in lobectomy surgery. DESIGN This was a retrospective monocentric cohort study. SETTING The study was conducted at Foch University Hospital in Suresnes, France. PARTICIPANTS Patients having undergone a scheduled lobectomy from January 2018 to September 2021. INTERVENTIONS There were no interventions. MEASUREMENTS AND MAIN RESULTS The authors studied 208 consecutive patients. Preoperative NLR, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic inflammation index, systemic inflammation response index, and aggregate inflammation systemic index were calculated. Median and (IQR) of NLR was 2.67 (1.92-3.69). No statistically significant association was observed between any index and the occurrence of at least one major postoperative complication, which occurred in 37% of the patients. Median postoperative length of stay was 7 (5-10) days. None of the ratios was associated with prolonged length of stay (LOS), defined as a LOS above the 75th percentile. CONCLUSIONS The results suggested that simple available inflammatory ratios are not useful for the preoperative identification of patients at risk of postoperative major complications in elective lobectomy surgery.
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Affiliation(s)
- Amaury de Fréminville
- Department of Anesthesiology, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Mary Saad
- Department of Anesthesia, Institut Curie, PSL Research University, Saint Cloud, France, and PSL Research University, INSERM, Institut Curies, Saint Cloud, France
| | - Edouard Sage
- Department of Thoracic Surgery and Lung Transplantation, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Ciprian Pricopi
- Department of Thoracic Surgery and Lung Transplantation, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Marc Fischler
- Department of Anesthesiology, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France.
| | - Bernard Trillat
- Department of Information Systems, Hôpital Foch, Suresnes, France
| | - Benjamin Salze
- Department of Anesthesiology, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Tiffany Pascreau
- Department of Clinical Biology, Hôpital Foch, Suresnes, France, and Department of Epidemiology-Data-Biostatistics, Delegation of Clinical Research and Innovation, Hôpital Foch, Suresnes, France
| | - Marc Vasse
- Department of Clinical Biology, Hôpital Foch, Suresnes, France, and Department of Epidemiology-Data-Biostatistics, Delegation of Clinical Research and Innovation, Hôpital Foch, Suresnes, France
| | - Alexandre Vallée
- Department of Epidemiology and Public Health, Hôpital Foch, Suresnes, France
| | - Morgan Le Guen
- Department of Anesthesiology, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
| | - Julien Fessler
- Department of Anesthesiology, Hôpital Foch, Suresnes, France, and Université Versailles-Saint-Quentin-en-Yvelines, Versailles, France
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20
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Comins-Boo A, Pérez-Pla F, Irure-Ventura J, López-Hoyos M, Blanco-Peris L, Martín Alonso MDC, San Segundo Arribas D. Total error in lymphocyte subpopulations by flow cytometry-based in state of the art using Spanish EQAS data. Clin Chem Lab Med 2024; 62:312-321. [PMID: 37548423 DOI: 10.1515/cclm-2023-0470] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/25/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVES Flow cytometry analyses of lymphocyte subpopulations (T, B, NK) are crucial for enhancing clinical algorithms and research workflows. Estimating the total error (TE) values for the percentage and absolute number of lymphocyte subpopulations using the state-of-the-art (SOTA) approach with real data from an external proficiency testing (EPT) scheme was performed. A comparison with previously published Biological Variability (BV)-based specifications was carried out. METHODS A total of 44,998 results from 86 laboratories over 10 years were analysed and divided into two five-year periods (2012-2016) and (2017-2021). Data come from the IC-1 Lymphocytes scheme of the Spanish External Quality Assurance System (EQAS) GECLID Program. This quantitative scheme includes percentages and absolute numbers of CD3+, CD3+CD4+, CD3+CD8+, CD19+, and CD3-CD56+CD16+ NK cells. The percentage of TE was calculated as: |reported value - robust mean|*100/robust mean for each laboratory and parameter. The cut-off for TE is set at 80 % best results of the laboratories. RESULTS A significant reduction in the SOTA-based TE for all lymphocyte subpopulations in 2017-2021 was observed compared to 2012-2016. The SOTA-based TE fulfils the minimum BV-based TE for percentages of lymphocyte subpopulations. The parameter with the best analytical performance calculated with SOTA (2017-2021 period)-based TE was the percentage of CD3+ (TE=3.65 %). CONCLUSIONS The values of SOTA-based specifications from external quality assurance program data are consistent and can be used to develop technical specifications. The technological improvement, quality commitment, standardization, and training, reduce TE. An update of TE every five years is therefore recommended. TE assessment in lymphocyte subsets is a helpful and reliable tool to improve laboratory performance and data-based decision-making trust.
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Affiliation(s)
- Alejandra Comins-Boo
- Immunology Department, Immunopathology Group, Marqués de Valdecilla University Hospital-IDIVAL, Santander, Spain
| | - Fernando Pérez-Pla
- Immunology Department, Immunopathology Group, Marqués de Valdecilla University Hospital-IDIVAL, Santander, Spain
| | - Juan Irure-Ventura
- Immunology Department, Immunopathology Group, Marqués de Valdecilla University Hospital-IDIVAL, Santander, Spain
| | - Marcos López-Hoyos
- Immunology Department, Immunopathology Group, Marqués de Valdecilla University Hospital-IDIVAL, Santander, Spain
| | - Lydia Blanco-Peris
- Centro de Hemoterapia y Hemodonación de Castilla y León, Valladolid, Spain
| | | | - David San Segundo Arribas
- Immunology Department, Immunopathology Group, Marqués de Valdecilla University Hospital-IDIVAL, Santander, Spain
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21
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Li J, Chen Z, Li Q, Liu R, Zheng J, Gu Q, Xiang F, Li X, Zhang M, Kang X, Wu R. Study of miRNA and lymphocyte subsets as potential biomarkers for the diagnosis and prognosis of gastric cancer. PeerJ 2024; 12:e16660. [PMID: 38259671 PMCID: PMC10802158 DOI: 10.7717/peerj.16660] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/21/2023] [Indexed: 01/24/2024] Open
Abstract
Objective The aim of this study was to identify the expression of miRNA and lymphocyte subsets in the blood of gastric cancer (GC) patients, elucidate their clinical significance in GC, and establish novel biomarkers for the early diagnosis and prognosis of GC. Methods The expression of miRNAs in the serum of GC patients was screened using second-generation sequencing and detected using qRT-PCR. The correlation between miRNA expression and clinicopathological characteristics of GC patients was analyzed, and molecular markers for predicting cancer were identified. Additionally, flow cytometry was used to detect the proportion of lymphocyte subsets in GC patients compared to healthy individuals. The correlations between differential lymphocyte subsets, clinicopathological features of GC patients, and their prognosis were analyzed statistically. Results The study revealed that hsa-miR-1306-5p, hsa-miR-3173-5p, and hsa-miR-296-5p were expressed at lower levels in the blood of GC patients, which is consistent with miRNA-seq findings. The AUC values of hsa-miR-1306-5p, hsa-miR-3173-5p, and hsa-miR-296-5p were found to be effective predictors of GC occurrence. Additionally, hsa-miR-296-5p was found to be negatively correlated with CA724. Furthermore, hsa-miR-1306-5p, hsa-miR-3173-5p, and hsa-miR-296-5p were found to be associated with the stage of the disease and were closely linked to the clinical pathology of GC. The lower the levels of these miRNAs, the greater the clinical stage of the tumor and the worse the prognosis of gastric cancer patients. Finally, the study found that patients with GC had lower absolute numbers of CD3+ T cells, CD4+ T cells, CD8+ T cells, CD19+ B cells, and lymphocytes compared to healthy individuals. The quantity of CD4+ T lymphocytes and the level of the tumor marker CEA were shown to be negatively correlated. The ROC curve and multivariate logistic regression analysis demonstrated that lymphocyte subsets can effectively predict gastric carcinogenesis and prognosis. Conclusion These miRNAs such as hsa-miR-1306-5p, hsa-miR-3173-5p, hsa-miR-296-5p and lymphocyte subsets such as the absolute numbers of CD3+ T cells, CD4+ T cells, CD8+ T cells, CD19+ B cells, lymphocytes are down-regulated in GC and are closely related to the clinicopathological characteristics and prognosis of GC patients. They may serve as new molecular markers for predicting the early diagnosis and prognosis of GC patients.
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Affiliation(s)
- Jinpeng Li
- Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zixi Chen
- Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qian Li
- Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Rongrong Liu
- Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jin Zheng
- Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qing Gu
- Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fenfen Xiang
- Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaoxiao Li
- Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mengzhe Zhang
- Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiangdong Kang
- Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Rong Wu
- Department of Laboratory Medicine, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Chen L, Yin Z, Zhou D, Li X, Yu C, Luo C, Jin Y, Zhang L, Song J, Rasche L, Einsele H, Tu L, Zhou X, Bai T, Hou X. Lymphocyte and neutrophil count combined with intestinal bacteria abundance predict the severity of COVID-19. Microbiol Spectr 2024; 12:e0302723. [PMID: 38088542 PMCID: PMC10783053 DOI: 10.1128/spectrum.03027-23] [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: 08/03/2023] [Accepted: 11/06/2023] [Indexed: 01/13/2024] Open
Abstract
IMPORTANCE The 2019 coronavirus disease (COVID-19) patients had a unique profile of gut bacteria. In this study, we characterized the intestinal bacteria in our COVID-19 cohorts and found that there was an increased incidence of severe cases in COVID-19 patients with decreased lymphocytes and increased neutrophils. Levels of lymphocytes and neutrophils and abundances of intestinal bacteria correlated with the severity of COVID-19.
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Affiliation(s)
- Liuying Chen
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhongwei Yin
- Division of Cardiology, Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dan Zhou
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xin Li
- Department of Paediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Cheng Yu
- Ultrasonic Department, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chang Luo
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yu Jin
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lei Zhang
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Song
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Leo Rasche
- Department of Internal Medicine II, University Hospital Würzburg, Julius-Maximilian University of Würzburg, Würzburg, Germany
| | - Hermann Einsele
- Department of Internal Medicine II, University Hospital Würzburg, Julius-Maximilian University of Würzburg, Würzburg, Germany
| | - Lei Tu
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiang Zhou
- Department of Internal Medicine II, University Hospital Würzburg, Julius-Maximilian University of Würzburg, Würzburg, Germany
| | - Tao Bai
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaohua Hou
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Zheng DX, Lv YY, Zhang XJ, Ye JS, Zhang JX, Chen C, Luo B, Yan D. Neutrophil-to-lymphocyte ratio associated with symptomatic saccular unruptured intracranial aneurysm. Eur J Med Res 2024; 29:40. [PMID: 38212838 PMCID: PMC10782625 DOI: 10.1186/s40001-023-01608-3] [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: 08/21/2023] [Accepted: 12/21/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND AND PURPOSE Whether symptomatic unruptured intracranial aneurysms (UIAs) lead to change in circulating inflammation remains unclear. This study aims to evaluate the role of hematological inflammatory indicators in predicting symptomatic UIA. METHODS Adult patients diagnosed with saccular intracranial aneurysm from March 2019 to September 2023 were recruited retrospectively. Clinical and laboratory data, including the white blood cells (WBC), neutral counts (NEUT), lymphocyte counts (LYM), and monocyte counts (MONO) of each patient, were collected. The neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) were calculated as NLR = NEUT/LYM, LMR = LYM/MONO, SII = PLT*NEUT/LYM. The hematological inflammatory indicators were compared in symptomatic saccular and asymptomatic UIA patients. Multivariable logistic regression analyses were performed to explore the factors predicting symptomatic UIA. RESULTS One hundred and fifty UIA patients with a mean age of 58.5 ± 12.4 were included, of which 68% were females. The NLR and LMR were significantly associated with symptomatic UIA, and the association remained in small UIAs (< 7 mm). The multiple logistic regression analysis showed that NLR was independently associated with symptomatic UIA. On ROC curve analysis, the optimal cutoff value of NLR to differentiate symptomatic from asymptomatic was 2.38. In addition, LMR was significantly associated with symptomatic UIA smaller than 7 mm. CONCLUSION There was a significant correlation between NLR and symptomatic UIA. The NLR was independently associated with symptomatic UIA.
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Affiliation(s)
- De-Xiang Zheng
- Department of Clinical Laboratory, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi-Yang Lv
- Department of Blood Transfusion, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiao-Jing Zhang
- Department of Epilepsy Center, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jie-Shun Ye
- School of Civil Engineering and Transportation, South China University of Technology, Guangzhou, 510640, China
| | - Jian-Xing Zhang
- Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, China
| | - Cha Chen
- Department of Clinical Laboratory, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Bin Luo
- Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, China.
| | - Dan Yan
- Department of Ultrasound, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.
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Abbas K, Musharraf W, Zafar MN, Lal J, Dodani S, Rizvi SAH. Correlation of lymphocyte subsets and inflammatory biomarkers with disease severity in COVID-19 patients. J PAK MED ASSOC 2024; 74:78-83. [PMID: 38219170 DOI: 10.47391/jpma.8583] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Objective To determine the correlation of lymphocyte subsets and soluble serum inflammatory biomarkers with disease severity in coronavirus disease-2019 infection. METHODS The retrospective study was conducted at the Department of Immunology, Sindh Institute of Urology and Transplantation (SIUI), Karachi, Pakistan from September 1 to November 30, 2021, and comprised data of patients admitted from June to July 2021 who tested positive for coronavirus disease-2019 on the basis of reverse transcription-polymerase chain reaction of nasopharyngeal swab specimens. The patients were categorised into severe group A and non-severe group B. Initial investigations included complete blood count, neutrophil-to-lymphocytes ratio, C-reactive protein, D-Dimers and serum ferritin levels. Lymphocyte subsets included cluster of differentiation-3+, cluster of differentiation-4+/ cluster of differentiation-3+, cluster of differentiation-8+ T lymphocytes, cluster of differentiation-19+B lymphocytes, cluster of differentiation-16+ cluster of differentiation-56+ Natural Killer cells and serum cytokine levels of interleukin-2, interleukin- 4, interleukin-6, interleukin-10, tumour necrosis factor-alpha and interferon gamma. They were correlated with disease severity. Data was analysed using SPSS 20. RESULTS Of the 54 patients, 33(61.1%) were males and 21(38.9%) were females. There were 29(53.70%) patients in group A with median age 52 years (interquartile range: 43.5-65 years), and 25(46.29%) in group B with median age 50 years (interquartile range: 36.5-59 years) (p=0.241). Disease was significantly more severe in male patients compared to female (p=0.002). In group A, cluster of differentiation-3+ T cells were reduced in 21(72.4%) patients, cluster of differentiation-8+ T cells in 16(55.2%), cluster of differentiation-4+ T cells in 23(79.3%) and cluster of differentiation-19+ B cells in 8(27.6%). In group B, cluster of differentiation-3+ T cells were reduced in 10(40%) subjects, cluster of differentiation-8+ T cells in 7(28%), cluster of differentiation-4+ T cells in 12(48%) and cluster of differentiation-19+ B cells in 4(16%) patients. Serum cytokine levels were not significantly different between the groups (p>0.05). In group A, 7(24.13%) patients died, and in such cases, the neutrophil-to-lymphocytes ratio was significantly higher (p=0.037). Conclusion Pro-inflammatory markers and cytokine levels increased, while lymphocyte subsets decreased with increasing severity of the disease.
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Affiliation(s)
- Khawar Abbas
- Sindh Institute of Urology, and Transplantation (SIUT), Karachi, Pakistan
| | - Wajiha Musharraf
- Sindh Institute of Urology, and Transplantation (SIUT), Karachi, Pakistan
| | - Mirza Naqi Zafar
- Sindh Institute of Urology, and Transplantation (SIUT), Karachi, Pakistan
| | - Jawahar Lal
- Sindh Institute of Urology, and Transplantation (SIUT), Karachi, Pakistan
| | - Sunil Dodani
- Sindh Institute of Urology, and Transplantation (SIUT), Karachi, Pakistan
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25
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Higashino M, Sugimoto K, Onishi S, Okabe K, Yasuda C, Tadokoro H, Kawata R. Utility of palliative prognostic index and neutrophil-to-lymphocyte ratio in predicting prognosis of end-stage squamous cell carcinoma of head and neck. Head Neck 2024; 46:23-28. [PMID: 37850401 DOI: 10.1002/hed.27549] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/23/2023] [Accepted: 10/05/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND The purpose of this study was to examine the factors influencing the prognosis of end-stage head and neck squamous cell carcinoma (HNSCC) and to develop a more useful prognostic index. PATIENTS AND METHODS This retrospective observational study included 79 patients with end-stage HNSCC. Patients were grouped by patient factors and prognostic indicators, and overall survival from the start of Best Supportive Care was compared for each group. In addition, overall survival was compared between patients with palliative prognostic index (PPI) ≥6 and neutrophil-to-lymphocyte ratio (NLR) ≥10 and patients with PPI <6 or NLR <10. RESULTS PPI ≥6 and NLR ≥10 were associated with significantly more frequent poor prognoses (p = 0.01 and p = 0.002, respectively). The median survival was 32 days in cases with PPI ≥6 and NLR ≥10, and 64 days for PPI <6 or NLR <10 (p < 0.001). CONCLUSION The combination of PPI and NLR is a useful indicator for predicting the prognosis of patients with end-stage HNSCC.
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Affiliation(s)
- Masaaki Higashino
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Kosuke Sugimoto
- School of Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Shuji Onishi
- School of Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Kohei Okabe
- School of Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Chika Yasuda
- Broad-Based Network Medical Center, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Hiroshi Tadokoro
- Broad-Based Network Medical Center, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Ryo Kawata
- Department of Otorhinolaryngology - Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan
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Xu J, Yao G, Zhang A, Gao H, Yan L. Analysis of the expression and significance of lymphocyte ratio in different stages and clinical types of COVID-19. Cell Mol Biol (Noisy-le-grand) 2023; 69:132-135. [PMID: 38279474 DOI: 10.14715/cmb/2023.69.15.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Indexed: 01/28/2024]
Abstract
This study aimed to analyze the expression of lymphocyte ratio (LY%) in different stages and clinical staging of COVID-19 and explore the relationship between peripheral blood lymphocyte (PBL) ratio and COVID-19 severity to provide reference for early intervention. For this purpose, a total of 125 patients with COVID-19 admitted to Hebei Provincial People's Hospital from February 1, 2020, to March 1, 2022, were reviewed and divided into moderate, severe, and critical groups by the severity to analyze and compare peripheral lymphocyte ratios of patients with different clinical typing. Results showed that lymphocyte count, lymphocyte percentage, CD3+ T-lymphocyte count, CD4+ T-lymphocyte count, and CD8+ T-lymphocyte count all decreased gradually with increasing severity (F = 27.84, P<0.05; F = 15.28, P<0.05; F = 46.12, P<0.05; F = 34.65, P<0.05); the absolute numbers of CD3+, CD4+ and CD8+ cells in peripheral blood were higher in the recovery phase than in the acute phase (P<0.05). In conclusion, COVID-19 may cause a decrease in the number of lymphocytes, and the decrease in the number of lymphocytes and T-lymphocyte subsets may predict the severity of the disease. The fewer lymphocytes there are, the more likely they are to progress to the severe type and the worse the prognosis.
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Affiliation(s)
- Jinwei Xu
- Respiratory Department, Hebei Provincial People's Hospital, Shijiazhuang, Hebei 050051, China.
| | - Guangyao Yao
- Respiratory Department, Hebei Provincial People's Hospital, Shijiazhuang, Hebei 050051, China.
| | - Aili Zhang
- Respiratory Department, Hebei Provincial People's Hospital, Shijiazhuang, Hebei 050051, China.
| | - Haixiang Gao
- Respiratory Department, Hebei Provincial People's Hospital, Shijiazhuang, Hebei 050051, China.
| | - Li Yan
- Respiratory Department, Hebei Provincial People's Hospital, Shijiazhuang, Hebei 050051, China.
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Qiu X, Shi Z, Tong F, Lu C, Zhu Y, Wang Q, Gu Q, Qian X, Meng F, Liu B, Du J. Biomarkers for predicting tumor response to PD-1 inhibitors in patients with advanced pancreatic cancer. Hum Vaccin Immunother 2023; 19:2178791. [PMID: 36809234 PMCID: PMC10026926 DOI: 10.1080/21645515.2023.2178791] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
Pancreatic cancer is among the most lethal malignant neoplasms, and few patients with pancreatic cancer benefit from immunotherapy. We retrospectively analyzed advanced pancreatic cancer patients who received PD-1 inhibitor-based combination therapies during 2019-2021 in our institution. The clinical characteristics and peripheral blood inflammatory markers (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], lymphocyte-to-monocyte ratio [LMR], and lactate dehydrogenase [LDH]) were collected at baseline. Chi-squared and Fisher's exact tests were used to evaluate relationships between the above parameters and tumor response. Cox regression analyses were employed to assess the effects of baseline factors on patients' survival and immune-related adverse events (irAEs). Overall, 67 patients who received at least two cycles of PD-1 inhibitor were considered evaluable. A lower NLR was independent predictor for objective response rate (38.1% vs. 15.2%, P = .037) and disease control rate (81.0% vs. 52.2%, P = .032). In our study population, patients with lower LDH had superior progression-free survival (PFS) and overall survival(OS) (mPFS, 5.4 vs. 2.8 months, P < .001; mOS, 13.3 vs. 3.6 months, P < .001). Liver metastasis was verified to be a negative prognostic factor for PFS (2.4 vs. 7.8 months, P < .001) and OS (5.7 vs. 18.0 months, P < .001). The most common irAEs were hypothyroidism (13.4%) and rash (10.5%). Our study demonstrated that the pretreatment inflammatory markers were independent predictors for tumor response, and the baseline LDH level and liver metastasis were potential prognostic markers of survival in patients with pancreatic cancer treated with PD-1 inhibitors.
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Affiliation(s)
- Xin Qiu
- The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, China
- The Comprehensive Cancer Center of Drum Tower Hospital, Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhan Shi
- The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Fan Tong
- The Comprehensive Cancer Center of Drum Tower Hospital, Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Changchang Lu
- The Comprehensive Cancer Center of Drum Tower Hospital, Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yahui Zhu
- The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Qiaoli Wang
- The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Qing Gu
- National Institute of Healthcare Data Science, Nanjing University, Nanjing, China
| | - Xiaoping Qian
- The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Fanyan Meng
- The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Baorui Liu
- The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, China
| | - Juan Du
- The Comprehensive Cancer Center of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, China
- The Comprehensive Cancer Center of Drum Tower Hospital, Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
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Li Y, Wang Y, Chen B, Guo J, Zhang D. Changes in Early T-Cell Subsets and Their Impact on Prognosis in Patients with Sepsis: A Single-Center Retrospective Study. Int J Clin Pract 2023; 2023:1688385. [PMID: 38170088 PMCID: PMC10761232 DOI: 10.1155/2023/1688385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/09/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024] Open
Abstract
Objective To analyze the early changes in CD3+, CD4+, and CD8+T-cell subset counts in patients with sepsis and their correlation with prognosis to provide a feasible basis for clinical immunomodulation in sepsis. Methods This is a single-center retrospective study. The study enrolled sepsis patients (meeting SEPSIS 3.0 definition) who were admitted to the Department of Intensive Care Unit at the First Hospital of Jilin University from July 5th, 2018 to December 5th, 2019 and were aged 18 years or above. In addition, these patients underwent cellular immune testing (CD3+, CD4+, CD8+ T lymphocyte counts, and CD4+/CD8+ ratio) within 24 hours of ICU admission. Patient's clinical data including age, gender, infection site, APACHE II score, SOFA score, length of ICU stay, mechanical ventilation time, ICU mortality, 28-day mortality, and 3-year survival status were collected. The prognostic indicators and survival of the decreased and nondecreased groups of different subsets of T lymphocyte counts and CD4+/CD8+ ratio were compared. Results A total of 206 patients were enrolled, with 76.7% having a decrease in CD3+ T lymphocyte count, 76.7% having a decrease in CD4+ T lymphocyte count, and 63.6% having a decrease in CD8+ T lymphocyte count. Furthermore, 21.8% had a lower CD4+/CD8+ ratio. Analysis showed that the CD3+ T lymphocyte count decreased group had a longer length of ICU stay [11 d (4, 21) vs. 7 d (4, 17), P=0.03], increased percentage of mechanical ventilation (67.5% vs. 51.0%, P=0.04), and extended mechanical ventilation time [144 h (48, 360) vs. 96 h (48, 144), P=0.04] compared to the nondecreased group. The 28-day mortality was higher in the decreased group of CD4+/CD8+ ratio compared to the nondecreased group (33.3% vs. 25.5%, P=0.29); however, the difference did not reach statistical significance. Logistic regression analysis revealed no significant correlation between the decrease in CD4+/CD8+ ratio and 28-day mortality (P=0.11). The 3-year follow-up revealed that the CD4+/CD8+ decreased group had a lower survival rate than the nondecreased group (33.3% vs. 53.4%, P=0.01). Conclusions In the early stage of sepsis, most patients showed a decrease in CD3+, CD4+, and CD8+T-cell subsets, as well as in the CD4+/CD8+ ratio. The decrease in CD3+ and CD4+/CD8+ was related to some poor prognosis.
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Affiliation(s)
- Yanhua Li
- Department of Critical Care Medicine, The First Hospital of Jilin University, Changchun, China
| | - Youquan Wang
- Department of Critical Care Medicine, The First Hospital of Jilin University, Changchun, China
| | - Bin Chen
- Department of Nephrology, The First Hospital of Jilin University, Changchun, China
| | - Jianxing Guo
- Department of Critical Care Medicine, The First Hospital of Jilin University, Changchun, China
| | - Dong Zhang
- Department of Critical Care Medicine, The First Hospital of Jilin University, Changchun, China
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29
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薛 燕, 尹 晶, 许 俐, 党 利, 王 朝, 崔 亚, 张 新, 李 崇. [Predictive value of peripheral blood lymphocyte subsets for children with intravenous immunoglobulin-resistant Kawasaki disease]. Zhongguo Dang Dai Er Ke Za Zhi 2023; 25:1211-1218. [PMID: 38112137 PMCID: PMC10731968 DOI: 10.7499/j.issn.1008-8830.2305067] [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] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/24/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVES Based on peripheral blood lymphocyte subsets and common laboratory test indexes, this study aimed to construct a predictive scoring system for intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD). METHODS Children hospitalized in Tianjin Children's Hospital from January 2021 to March 2023 were included in the study (185 cases of IVIG-sensitive KD and 41 cases of IVIG -resistant KD). Forty-six healthy children matched for age and gender were selected as controls. The relative percentage and absolute counts of peripheral lymphocyte subsets were measured by flow cytometry. Multivariate logistic regression was used to identify the predictive factors for IVIG-resistant KD and to construct a predictive scoring system for predicting IVIG-resistant KD. RESULTS The multivariate logistic regression analysis showed that CD4+ T cell absolute count, natural killer cell absolute count, serum sodium level, globulin level, and total bilirubin level were identified as predictive factors for IVIG-resistant KD (P<0.05). The predictive scoring system based on these factors achieved a sensitivity of 70.7% and a specificity of 83.8% in predicting IVIG-resistant KD. CONCLUSIONS Peripheral blood lymphocyte subsets can serve as predictive indicators for IVIG-resistant KD in children. The introduction of this indicator and the establishment of a scoring system based on it can provide a higher accuracy in predicting IVIG-resistant KD in children.
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Affiliation(s)
| | - 晶 尹
- 天津市儿童医院(天津大学儿童医院)风湿免疫科天津300134
| | | | | | | | | | | | - 崇巍 李
- 天津市儿童医院(天津大学儿童医院)风湿免疫科天津300134
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De la Garza Ramos R, Ryvlin J, Hamad MK, Fourman MS, Eleswarapu A, Gelfand Y, Murthy SG, Shin JH, Yassari R. The prognostic nutritional index (PNI) is independently associated with 90-day and 12-month mortality after metastatic spinal tumor surgery. Eur Spine J 2023; 32:4328-4334. [PMID: 37700182 DOI: 10.1007/s00586-023-07930-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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/25/2023] [Accepted: 08/28/2023] [Indexed: 09/14/2023]
Abstract
INTRODUCTION Estimated postoperative survival is an important consideration during the decision-making process for patients with spinal metastases. Nutritional status has been associated with poor outcomes and limited survival in the general cancer population. The objective of this study was to evaluate the predictive utility of the prognostic nutritional index (PNI) for postoperative mortality after spinal metastasis surgery. METHODS A total of 139 patients who underwent oncologic surgery for spinal metastases between April 2012 and August 2022 and had a minimum 90-day follow-up were included. PNI was calculated using preoperative serum albumin and total lymphocyte count, with PNI < 40 defined as low. The mean PNI of our cohort was 43 (standard deviation: 7.7). The primary endpoint was 90-day mortality, and the secondary endpoint was 12-month mortality. Multivariate logistic regression analyses were performed. RESULTS The 90-day mortality was 27% (37/139), and the 12-month mortality was 56% (51/91). After controlling for age, ECOG performance status, total psoas muscle cross-sectional area (TPA), and primary cancer site, the PNI was associated with 90-day mortality [odds ratio 0.86 (95% confidence interval 0.79-0.94); p = 0.001]. After controlling for ECOG performance status and primary cancer site, the PNI was associated with 12-month mortality [OR 0.89 (95% CI 0.82-0.97); p = 0.008]. Patients with a low PNI had a 50% mortality rate at 90 days and an 84% mortality rate at 12 months. CONCLUSION The PNI was independently associated with 90-day and 12-month mortality after metastatic spinal tumor surgery, independent of performance status, TPA, and primary cancer site.
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Affiliation(s)
- Rafael De la Garza Ramos
- Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, 3316 Rochambeau Avenue, 3rd Floor, Bronx, NY, 10467, USA.
- Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Jessica Ryvlin
- Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, 3316 Rochambeau Avenue, 3rd Floor, Bronx, NY, 10467, USA
| | - Mousa K Hamad
- Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, 3316 Rochambeau Avenue, 3rd Floor, Bronx, NY, 10467, USA
- Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mitchell S Fourman
- Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, 3316 Rochambeau Avenue, 3rd Floor, Bronx, NY, 10467, USA
- Department of Orthopedic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Ananth Eleswarapu
- Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, 3316 Rochambeau Avenue, 3rd Floor, Bronx, NY, 10467, USA
- Department of Orthopedic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Yaroslav Gelfand
- Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, 3316 Rochambeau Avenue, 3rd Floor, Bronx, NY, 10467, USA
- Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Saikiran G Murthy
- Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, 3316 Rochambeau Avenue, 3rd Floor, Bronx, NY, 10467, USA
- Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - John H Shin
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Reza Yassari
- Spine Research Group, Montefiore Medical Center, Albert Einstein College of Medicine, 3316 Rochambeau Avenue, 3rd Floor, Bronx, NY, 10467, USA
- Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
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Podd BS, Banks RK, Reeder R, Telford R, Holubkov R, Carcillo J, Berg RA, Wessel D, Pollack MM, Meert K, Hall M, Newth C, Lin JC, Doctor A, Shanley T, Cornell T, Harrison RE, Zuppa AF, Sward K, Dean JM, Randolph AG. Early, Persistent Lymphopenia Is Associated With Prolonged Multiple Organ Failure and Mortality in Septic Children. Crit Care Med 2023; 51:1766-1776. [PMID: 37462434 DOI: 10.1097/ccm.0000000000005993] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
OBJECTIVES Sepsis-associated immune suppression correlates with poor outcomes. Adult trials are evaluating immune support therapies. Limited data exist to support consideration of immunomodulation in pediatric sepsis. We tested the hypothesis that early, persistent lymphopenia predicts worse outcomes in pediatric severe sepsis. DESIGN Observational cohort comparing children with severe sepsis and early, persistent lymphopenia (absolute lymphocyte count < 1,000 cells/µL on 2 d between study days 0-5) to children without. The composite outcome was prolonged multiple organ dysfunction syndrome (MODS, organ dysfunction beyond day 7) or PICU mortality. SETTING Nine PICUs in the National Institutes of Health Collaborative Pediatric Critical Care Research Network between 2015 and 2017. PATIENTS Children with severe sepsis and indwelling arterial and/or central venous catheters. INTERVENTIONS Blood sampling and clinical data analysis. MEASUREMENTS AND MAIN RESULTS Among 401 pediatric patients with severe sepsis, 152 (38%) had persistent lymphopenia. These patients were older, had higher illness severity, and were more likely to have underlying comorbidities including solid organ transplant or malignancy. Persistent lymphopenia was associated with the composite outcome prolonged MODS or PICU mortality (66/152, 43% vs 45/249, 18%; p < 0.01) and its components prolonged MODS (59/152 [39%] vs 43/249 [17%]), and PICU mortality (32/152, 21% vs 12/249, 5%; p < 0.01) versus children without. After adjusting for baseline factors at enrollment, the presence of persistent lymphopenia was associated with an odds ratio of 2.98 (95% CI [1.85-4.02]; p < 0.01) for the composite outcome. Lymphocyte count trajectories showed that patients with persistent lymphopenia generally did not recover lymphocyte counts during the study, had lower nadir whole blood tumor necrosis factor-α response to lipopolysaccharide stimulation, and higher maximal inflammatory markers (C-reactive protein and ferritin) during days 0-3 ( p < 0.01). CONCLUSIONS Children with severe sepsis and persistent lymphopenia are at risk of prolonged MODS or PICU mortality. This evidence supports testing therapies for pediatric severe sepsis patients risk-stratified by early, persistent lymphopenia.
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Affiliation(s)
- Bradley S Podd
- Division of Pediatric Critical Care Medicine, Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Center for Critical Care Nephrology and Clinical Research Investigation and Systems Modeling of Acute Illness Center, University of Pittsburgh, Pittsburgh, PA
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA
| | - Russell K Banks
- Department of Pediatrics, University of Utah, Salt Lake City, UT
| | - Ron Reeder
- Department of Pediatrics, University of Utah, Salt Lake City, UT
| | - Russell Telford
- Department of Statistics, Carnegie Mellon University, Pittsburgh, PA
| | - Richard Holubkov
- Department of Pediatrics, University of Utah, Salt Lake City, UT
| | - Joseph Carcillo
- Division of Pediatric Critical Care Medicine, Department of Critical Care Medicine, Children's Hospital of Pittsburgh, Center for Critical Care Nephrology and Clinical Research Investigation and Systems Modeling of Acute Illness Center, University of Pittsburgh, Pittsburgh, PA
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, PA
| | - Robert A Berg
- Department of Anesthesiology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - David Wessel
- Division of Critical Care Medicine, Department of Pediatrics, Children's National Hospital, Washington, DC
| | - Murray M Pollack
- Division of Critical Care Medicine, Department of Pediatrics, Children's National Hospital, Washington, DC
| | - Kathleen Meert
- Division of Critical Care Medicine, Department of Pediatrics, Children's Hospital of Michigan, Detroit, MI
- Department of Pediatrics, Central Michigan University, Mt. Pleasant, MI
| | - Mark Hall
- Division of Critical Care Medicine, Department of Pediatrics, The Research Institute at Nationwide Children's Hospital Immune Surveillance Laboratory, and Nationwide Children's Hospital, Columbus, OH
| | - Christopher Newth
- Division of Pediatric Critical Care Medicine, Department of Anesthesiology and Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA
| | - John C Lin
- Division of Critical Care Medicine, Department of Pediatrics, St. Louis Children's Hospital, St. Louis, MO
| | - Allan Doctor
- Division of Critical Care Medicine, Department of Pediatrics, St. Louis Children's Hospital, St. Louis, MO
| | - Tom Shanley
- Division of Critical Care Medicine, Department of Pediatrics, C. S. Mott Children's Hospital, Ann Arbor, MI
| | - Tim Cornell
- Division of Critical Care Medicine, Department of Pediatrics, C. S. Mott Children's Hospital, Ann Arbor, MI
| | - Rick E Harrison
- Division of Critical Care Medicine, Department of Pediatrics, Mattel Children's Hospital at University of California Los Angeles, Los Angeles, CA
| | - Athena F Zuppa
- Department of Anesthesiology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Katherine Sward
- Department of Pediatrics, University of Utah, Salt Lake City, UT
| | - J Michael Dean
- Department of Pediatrics, University of Utah, Salt Lake City, UT
| | - Adrienne G Randolph
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA
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Khorasanchi Z, Rashidmayvan M, Hasanzadeh E, Moghadam MRSF, Afkhami N, Asadiyan‐Sohan P, Fard MV, Mohammadhasani K, Varaste N, Sharifan P, Ferns G, Mobarhan MG. The association of hematological inflammatory markers and psychological function in COVID-19 patients: A cross-sectional study. Physiol Rep 2023; 11:e15889. [PMID: 38123447 PMCID: PMC10733126 DOI: 10.14814/phy2.15889] [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: 08/02/2023] [Revised: 11/03/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
Mental health disorders are linked to systemic inflammation. Due to high inflammation and mental health disorders in COVID-19 patients, we aimed to investigate the relationship between blood inflammatory markers such as red cell distribution width to platelet ratio (RPR), platelet-lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR), red cell distribution width (RDW), white blood cell (WBC), and psychological function in COVID-19 patients. In the current cross-sectional study, neuro-psychological function, and a complete blood count (CBC) were measured on 120 COVID-19 patients aged >30 years from the Imam Reza Hospital in Mashhad, Iran. Our results showed that anxiety related to MCHC (mean ± SD: 32.71 ± 1.68, p < 0.05), WBC (mean ± SD: 12.23 ± 5.43, p < 0.05), and PLR (median (IQR): 28.72 (15.88-41.31), p < 0.05) significantly. In the stress subgroup, only RPR was associated with stress (p < 0.05). Linear regression between hematological parameters and psychological score indicated that RDW and PLR had a significantly positive association with depression (β = 0.086; p = 0.045 and β = 1.326; p = 0.016, respectively) and anxiety scores (β = 0.100; p = 0.038 and β = 1.356; p = 0.010, respectively). Moreover, a positive correlation was found between PLR and stress (β = 1.102; p = 0.012). This study showed a positive association between depression/anxiety/stress symptoms and levels of hematological inflammatory markers including PLR and RDW. The findings of this study provide novel insights into mental health and physiological markers, underscoring the potential influence of inflammation on mood disorders. Our findings offer exciting prospects for future research and may lead to innovative approaches in the management and treatment of depression, anxiety, and stress.
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Affiliation(s)
- Zahra Khorasanchi
- Department of Nutrition, School of MedicineMashhad University of Medical SciencesMashhadIran
- Student Research Committee, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Mohammad Rashidmayvan
- Department of Nutrition, Food Sciences and Clinical Biochemistry, School of Medicine, Social Determinants of Health Research CenterGonabad University of Medical ScienceGonabadIran
| | - Elahe Hasanzadeh
- International UNESCO Center for Health Related Basic Sciences and Human Nutrition, Department of Nutrition, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | | | - Nafise Afkhami
- Departments of Biology, Faculty of Sciences, Mashhad BranchIslamic Azad UniversityMashhadIran
| | - Parisa Asadiyan‐Sohan
- Departments of Biology, Faculty of Sciences, Mashhad BranchIslamic Azad UniversityMashhadIran
| | - Mohammad Vahedi Fard
- Department of Nutrition, Food Sciences and Clinical Biochemistry, School of Medicine, Social Determinants of Health Research CenterGonabad University of Medical ScienceGonabadIran
| | - Kimia Mohammadhasani
- Department of Nutrition, Food Sciences and Clinical Biochemistry, School of Medicine, Social Determinants of Health Research CenterGonabad University of Medical ScienceGonabadIran
| | - Naiemeh Varaste
- International UNESCO Center for Health Related Basic Sciences and Human Nutrition, Department of Nutrition, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Payam Sharifan
- Department of Nutrition, School of MedicineMashhad University of Medical SciencesMashhadIran
| | - Gordon Ferns
- Division of Medical EducationBrighton and Sussex Medical SchoolBrightonUK
| | - Majid Ghayour Mobarhan
- International UNESCO Center for Health Related Basic Sciences and Human Nutrition, Department of Nutrition, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
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Wu H, Yang L, Zhu F, Teng Y. The predictive value of FOXO3, NLR and PLR Levels in Kawasaki disease. Minerva Pediatr (Torino) 2023; 75:925-927. [PMID: 37166779 DOI: 10.23736/s2724-5276.23.07260-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- Hang Wu
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Lulu Yang
- Zhejiang Chinese Medical University, Hangzhou, China
| | - Feng Zhu
- Department of Pediatrics, The Second Hospital of Jiaxing, Jiaxing, China
| | - Yiqun Teng
- Department of Pediatrics, The Second Hospital of Jiaxing, Jiaxing, China -
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Ming Y, Yan T. Is there a relationship between NOAC and the neutrophil-to-lymphocyte ratio? Int J Cardiol 2023; 392:131308. [PMID: 37652275 DOI: 10.1016/j.ijcard.2023.131308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/29/2023] [Indexed: 09/02/2023]
Affiliation(s)
- Yang Ming
- Department of Cardiac Surgery and Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Tao Yan
- Department of Cardiac Surgery and Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
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Chu M, Zhao X, Tang L, Zhang S, Zhang S, Huang D, Wang F, Wei L. The correlation of lymphocytes with disease progression of COVID-19. Medicine (Baltimore) 2023; 102:e36244. [PMID: 38050270 PMCID: PMC10695541 DOI: 10.1097/md.0000000000036244] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 10/31/2023] [Indexed: 12/06/2023] Open
Abstract
The aim of this study is to evaluate the potential of lymphocytes as biomarkers to predict the decline of coronavirus disease 2019 (COVID-19). Lymphocytes were counted in 164 moderate COVID-19 patients in Shenzhen, China. Among the moderate infected patients, 12.2% (20/164) progressed to severe cases after admission. Compared with the stable patients, the counts of lymphocytes, both total T lymphocytes and CD4+ T lymphocytes, in the severe patients, were lower. The aggravation of moderate infected patients was significantly associated with lymphocyte count (hazard ratio [HR] = 0.91; 95% confidence interval [CI]: 0.84-0.99), total T lymphocyte count (HR = 0.91; 95% CI: 0.84-0.99), and CD4+ T lymphocyte count (HR = 0.91; 95% CI: 0.85-0.98). Total T lymphocytes and CD4+ T lymphocytes could be important biomarkers to evaluate the risk of aggravation for moderate infected COVID-19 patients. The patients with low percentages of total T lymphocytes and CD4+ T lymphocytes need more attention.
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Affiliation(s)
- Ming Chu
- Department of Neurosurgery, The Third People’s Hospital of Shenzhen, Shenzhen, China
- The Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Xiaobao Zhao
- The Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
- National Clinical Research Center for Infectious Diseases, Shenzhen, China
- Institute for Hepatology, The Third People’s Hospital of Shenzhen, Shenzhen, China
| | - Lu Tang
- The Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
- National Clinical Research Center for Infectious Diseases, Shenzhen, China
- Institute for Hepatology, The Third People’s Hospital of Shenzhen, Shenzhen, China
- Department of Microbiology, Harbin Medical University, Harbin, China
| | - Siwei Zhang
- The Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
- National Clinical Research Center for Infectious Diseases, Shenzhen, China
- Institute for Hepatology, The Third People’s Hospital of Shenzhen, Shenzhen, China
- Department of Microbiology, Harbin Medical University, Harbin, China
| | - Shengkun Zhang
- Department of Neurosurgery, The Third People’s Hospital of Shenzhen, Shenzhen, China
| | - Dongdong Huang
- Department of Neurosurgery, The Third People’s Hospital of Shenzhen, Shenzhen, China
| | - Fuxiang Wang
- The Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
- Department of Infectious Diseases, The Third People’s Hospital of Shenzhen, Shenzhen, China
| | - Lanlan Wei
- The Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
- National Clinical Research Center for Infectious Diseases, Shenzhen, China
- Institute for Hepatology, The Third People’s Hospital of Shenzhen, Shenzhen, China
- Department of Microbiology, Harbin Medical University, Harbin, China
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Qiang T, Ding X, Ling J, Fei M. Is platelet to lymphocyte ratio predictive of preeclampsia? A systematic review and meta-analysis. J OBSTET GYNAECOL 2023; 43:2286319. [PMID: 38014649 DOI: 10.1080/01443615.2023.2286319] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND To evaluate the value of the platelet-to-lymphocyte ratio (PLR) in predicting preeclampsia (PE) in pregnant women. METHODS PubMed, EMBASE and Web of Science databases were searched for observational studies (cohort, case-control or cross-sectional) that reported pre-treatment maternal PLR values in women with and without PE. The analysis was done using a random effects model. Pooled effect sizes were reported as weighted mean difference (WMD) with 95% confidence intervals (CIs). Newcastle-Ottawa Scale (NOS) was used to evaluate the risk of bias. RESULTS Twenty-five studies with 7755 patients were included in this meta-analysis. PLR was comparable in patients with PE and healthy pregnant women (WMD -2.97; 95% CI: -11.95 to 6.02; N = 16). Patients with mild (WMD -3.00; 95% CI: -17.40 to 11.41; N = 12) and severe PE (WMD -5.77; 95% CI: -25.48 to 13.94; N = 14) had statistically similar PLR, compared to healthy controls. CONCLUSIONS Our findings show similar PLR in PE and healthy pregnancies. PLR, therefore, may not be used to differentiate between PE and normal pregnancy or for assessing the severity of PE. The majority of included studies were case-control, potentially introducing bias, and we identified evidence of publication bias as well.
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Affiliation(s)
- Tianyong Qiang
- Clinical Laboratory, Huzhou Nanxun District Hospital of Traditional Chinese Medicine, Huzhou, China
| | - Xiuqin Ding
- Department of Gynaecology and Obstetrics, Huzhou Nanxun District People's Hospital, Huzhou, China
| | - Jiajia Ling
- Clinical Laboratory, Huzhou Nanxun District Hospital of Traditional Chinese Medicine, Huzhou, China
| | - Meirong Fei
- Department of Gynaecology and Obstetrics, Huzhou Nanxun District People's Hospital, Huzhou, China
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Tefferi A, Loscocco GG, Farrukh F, Szuber N, Mannelli F, Pardanani A, Hanson CA, Ketterling RP, De Stefano V, Carobbio A, Barbui T, Guglielmelli P, Gangat N, Vannucchi AM. A globally applicable "triple A" risk model for essential thrombocythemia based on Age, Absolute neutrophil count, and Absolute lymphocyte count. Am J Hematol 2023; 98:1829-1837. [PMID: 37665758 DOI: 10.1002/ajh.27079] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 09/06/2023]
Abstract
We examined the individual prognostic contribution of absolute neutrophil (ANC), lymphocyte (ALC), and monocyte (AMC) counts, on overall (OS), leukemia-free (LFS), and myelofibrosis-free (MFFS) survival in essential thrombocythemia (ET). Informative cases (N = 598; median age 59 years; females 62%) were retrospectively accrued from a Mayo Clinic database: JAK2 59%, CALR 27%, triple-negative 11%, and MPL 3%; international prognostic scoring system for ET (IPSET) risk high 21%, intermediate 42%, and low 37%; 7% (37/515) had abnormal karyotype and 10% (21/205) adverse mutations (SF3B1/SRSF2/U2AF1/TP53). At median 8.4 years, 163 (27%) deaths, 71 (12%) fibrotic, and 20 (3%) leukemic transformations were recorded. Multivariable analysis resulted in HR (95% CI) of 16.5 (9.9-27.4) for age > 70 years, 3.7 (2.3-6.0) for age 50-70 years, 2.4 (1.7-3.3) for ANC ≥8 × 109 /L, and 1.9 (1.4-2.6) for ALC <1.7 × 109 /L. The corresponding HR-based scores were 4, 2, 1, and 1, resulting in an new 4-tiered AgeAncAlc (AAA; triple A) risk model: high (5-6 points; median survival 8 years; HR 30.1, 95% CI 17.6-54), intermediate-2 (4 points; median 13.5 years; HR 12.7, 95% CI 7.1-23.0), intermediate-1 (2-3 points; median 20.7 years; HR 3.8, 95% CI 2.3-6.4) and low (0-1 points; median 47 years). The AAA model (Akaike Information Criterion [AIC] 621) performed better than IPSET (AIC 647) and was subsequently validated by an external University of Florence ET cohort (N = 485). None of the AAA variables predicted LFS while ALC <1.7 × 109 /L was associated with inferior MFFS (p = .01). Adverse mutations (p < .01) and karyotype (p < .01) displayed additional prognostic value without disqualifying the prognostic integrity of the AAA model. This study proposes a simple and globally applicable survival model for ET, which can be used as a platform for further molecular refinement. This study also suggests a potential role for immune-related biomarkers, as a prognostic tool in myeloproliferative neoplasms.
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Affiliation(s)
- Ayalew Tefferi
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Giuseppe G Loscocco
- Department of Experimental and Clinical Medicine, CRIMM, Center Research, and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Faiqa Farrukh
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Natasha Szuber
- Department of Hematology, Université de Montréal, Quebec, Canada
| | - Francesco Mannelli
- Department of Experimental and Clinical Medicine, CRIMM, Center Research, and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Animesh Pardanani
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Curtis A Hanson
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Rhett P Ketterling
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Valerio De Stefano
- Section of Hematology, Department of Radiological and Hematological Sciences, Catholic University, Rome, Italy
| | | | - Tiziano Barbui
- FROM esearch Foundation, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Paola Guglielmelli
- Department of Experimental and Clinical Medicine, CRIMM, Center Research, and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
| | - Naseema Gangat
- Divisions of Hematology and Hematopathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Alessandro M Vannucchi
- Department of Experimental and Clinical Medicine, CRIMM, Center Research, and Innovation of Myeloproliferative Neoplasms, Azienda Ospedaliera Universitaria Careggi, University of Florence, Florence, Italy
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Xiang Z, Liu W, Fu S, Hu J, Yang Y. Clinical value of lymphocyte count in autoimmune diabetic nephropathy. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2023; 48:1639-1649. [PMID: 38432854 PMCID: PMC10929952 DOI: 10.11817/j.issn.1672-7347.2023.230110] [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] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Indexed: 03/05/2024]
Abstract
OBJECTIVES In recent years, the prevalence of diabetic nephropathy (DN) has increased significantly. An increasing number of studies have shown that lymphocyte-associated inflammatory responses play a role in DN. This study aims to investigate the relationship between lymphocytes and DN in patients with autoimmune diabetes. METHODS The clinical data of 226 patients with Type 1 diabetes (T1D) and 79 patients with latent autoimmune diabetes in adults (LADA) were retrospectively studied and stratified according to the urinary albumin to creatinine ratio (ACR). Risk factors associated with DN were analyzed using correlation analysis and logistic regression. RESULTS In T1D and LADA patients, systolic blood pressure (SBP), uric acid duration, and diabetes duration in patients with normoalbuminuria were lower or shorter than those in patients with macroalbuminuria (P<0.05). The lymphocyte count of T1D patients was significantly higher than that in LADA patients (P<0.05), while the neutrophil to lymphocyte ratio (NLR) of T1D patients was significantly lower than that in LADA patients (P<0.05). The lymphocyte count in the T1D patients with normoalbuminuria was lower than that those with macroalbuminuria (P<0.05). The NLR was lower in the T1D patients with macroalbuminuria than those with microalbuminuria and normoproteinuria (all P<0.01). Based on logistic regression analysis, lymphocytes were independently associated with DN in T1D after adjusting for various known risk factors such as course of disease, age, gender, dyslipidemia, hypertension, and smoking status. Analysis of the receiver operating characteristic curve of subjects predicting lymphocytes in normoalbuminuria showed that the area under the curve was 0.601 (95% CI 0.510 to 0.693, P=0.039), and when the cutoff value of lymphocytes was 2.332, the sensitivity was 37.0%, and the specificity was 82.5%. CONCLUSIONS Lymphocyte counts in autoimmune diabetic patients are closely associated with DN, suggesting that lymphocyte-mediated inflammation may be involved in the pathogenesis of DN in autoimmune diabetic patients. This study provides a possible perspective for using lymphocytes as a potential biomarker for the early identification of individuals at risk for DN and potential therapeutic targets for DN.
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Affiliation(s)
- Zhongyuan Xiang
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha 410008.
| | - Wen'en Liu
- Department of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha 410008
| | - Sangya Fu
- Department of Laboratory Medicine, Second Xiangya Hospital, Central South University, Changsha 410011
| | - Jingyi Hu
- Department of Endocrinology, Second Xiangya Hospital, Central South University, Changsha 410011
| | - Yanyi Yang
- Hunan Provincial Clinical Medicine Research Center for Intelligent Management of Chronic Disease, Changsha 410011.
- Health Management Center, Second Xiangya Hospital, Central South University, Changsha 410011, China.
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Hung KC, Liu CC, Wu JY, Ho CN, Lin MC, Hsing CH, Chen IW. Association between the neutrophil-to-lymphocyte ratio and cognitive impairment: a meta-analysis of observational studies. Front Endocrinol (Lausanne) 2023; 14:1265637. [PMID: 38089627 PMCID: PMC10715314 DOI: 10.3389/fendo.2023.1265637] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
Background Systemic inflammation is one of the underlying mechanisms of cognitive impairment. The neutrophil-to-lymphocyte ratio (NLR) has emerged as a systemic inflammation indicator. This meta-analysis aimed to evaluate the association between high NLR and cognitive impairment (CI) risk. Method A comprehensive systematic search was conducted to identify eligible studies published until May 30, 2023. The reference group comprised patients with the lowest NLR level, whereas the exposure group comprised those with the highest NLR level. The main outcome was to examine the relationship between NLR and CI risk. The secondary outcome included the association between patient characteristics or comorbidities and CI risk. Results This meta-analysis included 11 studies published between 2018 and 2023, involving 10,357 patients. Patients with CI had a higher NLR than those without (mean difference=0.35, 95% confidence interval [CI]: 0.26-0.44, p < 00001, I2 = 86%). Consistently, pooled results revealed an association between high NLR and CI risk (odds ratio [OR]=2.53, 95% CI:1.67-3.82, p<0.0001, I2 = 84%). Furthermore, aging (mean difference =4.31 years, 95% CI:2.83-5.8, p < 0.00001, I2 = 92%), diabetes (OR=1.59, 95% CI:1.35-1.88, p < 0.00001, I2 = 66%), and hypertension (OR=1.36, 95% CI:1.19-1.57, p < 0.00001, I2 = 0%) were significant risk factors for CI. However, no significant associations were observed between CI and male gender (OR = 0.84, 95% CI:0.64-1.11, p = 0.22, I2 = 81%), body mass index (mean = -0.32 kg/m2, 95% CI: -0.82, 0.18, p = 0.2, I2 = 82%), alcohol consumption (OR = 1.11, 95% CI:0.95-1.3, p = 1.35, I2 = 0%), and smoking (OR = 0.99, 95% CI:0.87-1.13, p = 0.86, I2 = 0%). Meta-regression found that diabetes and hypertension, but not age, significantly moderated the association between NLR and CI. Conclusion This meta-analysis showed a significant association between high NLR and increased CI risk. Moreover, meta-regression identified diabetes and hypertension, but not age, as significant moderating factors in the relationship between NLR and CI. To validate and strengthen these findings, further large-scale studies are required. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023430384, identifier CRD42023430384.
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Affiliation(s)
- Kuo-Chuan Hung
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
| | - Chien-Cheng Liu
- Department of Anesthesiology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
- Department of Nursing, College of Medicine, I-Shou University, Kaohsiung, Taiwan
- School of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Jheng-Yan Wu
- Department of Nutrition, Chi Mei Medical Center, Tainan, Taiwan
| | - Chun-Ning Ho
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
| | - Ming-Chung Lin
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
| | - Chung-Hsi Hsing
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
- Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
| | - I-Wen Chen
- Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan, Taiwan
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Ma M, Li G, Zhou B, Li K, Wu Z, Kong L, Liu M, Liu M, Zhang C, Yu H, Wang S, Huang Z, Zong K. Comprehensive analysis of the association between inflammation indexes and complications in patients undergoing pancreaticoduodenectomy. Front Immunol 2023; 14:1303283. [PMID: 38077320 PMCID: PMC10702568 DOI: 10.3389/fimmu.2023.1303283] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/07/2023] [Indexed: 12/18/2023] Open
Abstract
Background During clinical practice, routine blood tests are commonly performed following pancreaticoduodenectomy (PD). However, the relationship between blood cell counts, inflammation-related indices, and postoperative complications remains unclear. Method We conducted a retrospective study, including patients who underwent PD from October 2018 to July 2023 at the First Hospital of Chongqing Medical University, and compared baseline characteristics and clinical outcomes among different groups. Neutrophil count (NC), platelet count (PLT), lymphocyte count (LC), systemic immune-inflammation index (SII), platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and the product of platelet count and neutrophil count (PPN) were derived from postoperative blood test results. We investigated the association between these indicators and outcomes using multivariable logistic regression and restricted cubic spline analysis. The predictive performance of these indicators was assessed by the area under the curve (AUC) of the receiver operating characteristic (ROC) curve and decision curve analysis (DCA). Result A total of 232 patients were included in this study. Multivariate logistic regression and restricted cubic spline analysis showed that all indicators, except for PLT, were associated with clinical postoperative pancreatic fistula (POPF). SII, NLR, and NC were linked to surgical site infection (SSI), while SII, NLR, and PLR were correlated with CD3 complication. PLT levels were related to postoperative hemorrhage. SII (AUC: 0.729), NLR (AUC: 0.713), and NC (AUC: 0.706) effectively predicted clinical POPF. Conclusion In patients undergoing PD, postoperative inflammation-related indices and blood cell counts are associated with various complications. NLR and PLT can serve as primary indicators post-surgery for monitoring complications.
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Affiliation(s)
- Minghua Ma
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Medical University, Chongqing, China
| | - Guo Li
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Baoyong Zhou
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Kaili Li
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Medical University, Chongqing, China
| | - Zhongjun Wu
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lingwang Kong
- Chongqing University Cancer Hospital, Chongqing, China
| | - Maoyun Liu
- Chongqing University Cancer Hospital, Chongqing, China
| | - Miao Liu
- Chongqing University Cancer Hospital, Chongqing, China
| | - Cheng Zhang
- Chongqing University Cancer Hospital, Chongqing, China
| | - Huarong Yu
- Chongqing Medical University, Chongqing, China
| | - Shuaiqi Wang
- Chongqing Medical University, Chongqing, China
- Chongqing University Cancer Hospital, Chongqing, China
| | - Zuotian Huang
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Medical University, Chongqing, China
- Chongqing University Cancer Hospital, Chongqing, China
| | - Kezhen Zong
- Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Qi X, Chen J, Wei S, Ni J, Song L, Jin C, Yang L, Zhang X. Prognostic significance of platelet-to-lymphocyte ratio (PLR) in patients with breast cancer treated with neoadjuvant chemotherapy: a meta-analysis. BMJ Open 2023; 13:e074874. [PMID: 37996220 PMCID: PMC10668253 DOI: 10.1136/bmjopen-2023-074874] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
OBJECTIVE Platelet-to-lymphocyte ratio (PLR), known as a key systemic inflammatory parameter, has been proved to be associated with response to neoadjuvant therapy in breast cancer (BC); however, the results remain controversial. This meta-analysis was carried out to evaluate the prognostic values of PLR in patients with BC treated with neoadjuvant chemotherapy (NACT). DESIGN Meta-analysis. DATA SOURCES Relevant literature published on the following databases: PubMed, Embase, Web of Science databases and the Cochrane Library. ELIGIBILITY CRITERIA All studies involving patients with BC treated with NACT and peripheral blood pretreatment PLR recorded were included. DATA EXTRACTION AND SYNTHESIS Two researchers independently extracted and evaluated HR/OR and its 95% CI of survival outcomes, pathological complete response (pCR) rate and clinicopathological parameters. RESULTS The last search was updated to 31 December 2022. A total of 22 studies with 5533 patients with BC treated with NACT were enrolled in the final meta-analysis. Our results demonstrate that elevated PLR value appears to correlate with low pCR rate (HR 0.77, 95% CI 0.67 to 0.88, p<0.001, I2=75.80%, Ph<0.001) and poor prognosis, including overall survival (OS) (HR 1.90, 95% CI 1.39 to 2.59, p<0.001; I2=7.40%, Ph=0.365) and disease-free survival (HR 1.97, 95% CI 1.56 to 2.50, p<0.001; I2=0.0%, Ph=0.460). Furthermore, PLR level was associated with age (OR 0.86, 95% CI 0.79 to 0.93, p<0.001, I2=40.60%, Ph=0.096), menopausal status (OR 0.83, 95% CI 0.76 to 0.90, p<0.001, I2=50.80%, Ph=0.087) and T stage (OR 1.05, 95% CI 1.00 to 1.11, p=0.035; I2=70.30%, Ph=0.005) of patients with BC. CONCLUSIONS This meta-analysis demonstrated that high PLR was significantly related to the low pCR rate, poor OS and disease-free survival (DFS) of patients with BC treated with NACT. Therefore, PLR can be used as a potential predictor biomarker for the efficacy of NACT in BC.
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Affiliation(s)
- Xue Qi
- Department of Oncology, Nantong Liangchun Hospital of Traditional Chinese Medicine, Nantong, Jiangsu, China
| | - Jia Chen
- Department of Oncology, Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu, China
| | - Sheng Wei
- Department of Radiotherapy, Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu, China
| | - Jingyi Ni
- Department of Oncology, Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu, China
| | - Li Song
- Department of Oncology, Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu, China
| | - Conghui Jin
- Department of Oncology, Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu, China
| | - Lei Yang
- Department of Oncology, Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu, China
| | - Xunlei Zhang
- Department of Oncology, Affiliated Tumor Hospital of Nantong University, Nantong, Jiangsu, China
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Chen G, Zhao X, Chen X, Liu C. Early decrease in blood lymphocyte count is associated with poor prognosis in COVID-19 patients: a retrospective cohort study. BMC Pulm Med 2023; 23:453. [PMID: 37986163 PMCID: PMC10662697 DOI: 10.1186/s12890-023-02767-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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/16/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Previous studies have declared that baseline lymphocyte count is associated with COVID-19-related death. However, whether dynamic lymphocyte change over time affects prognosis in COVID-19 patients is unknown. This study aims to investigate the significance of lymphocyte count during the progression of the disease in COVID-19 patients. METHODS The retrospective cohort study recruited COVID-19 patients at the First People's Hospital of Jiangxia District in Wuhan from January 7, 2020, to February 28, 2020. The demographics, medical histories, results of the blood routine test, and patients' outcomes were collected. We utilized a generalized additive mixed model to compare trends in lymphocyte count over time among survivors and non-survivors, with an adjustment for potential confounders. The statistical analysis used R software and EmpowerStats. Significance was determined at a P-value of less than 0.05 (two-sided). RESULTS A total of 532 patients were included in the study. Overall, there were 29/532 in-hospital deaths (5.45%). Lymphocytes declined over time in the non-survivor group and increased in the survivor group in the first 10 days of hospitalization. Within 10 days after admission, lymphocyte count increased in the survivor group and decreased in the non-survivor group. The difference in lymphocyte counts between survivors and non-survivors increased by an average of 0.0732 × 109/L daily. After adjusting for several covariables, the increasing value remained at 0.0731 × 109/L per day. CONCLUSION In the early stage, lymphocyte count can dynamically reflect the pathophysiological changes in COVID-19 patients. An early decrease in lymphocyte count is associated with mortality in COVID-19 patients.
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Affiliation(s)
- Gong Chen
- Department of Anesthesiology, the Third Xiangya Hospital, Central South University, Changsha, China
| | - Xiaofang Zhao
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinglin Chen
- Department of Epidemiology and Biostatistics, Empower U, X&Y Solutions Inc., Boston, MA, USA
| | - Chengyun Liu
- Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
- The First People's Hospital of Jiangxia District, Wuhan City & Union Jiangnan Hospital, Huazhong University of Science and Technology, Wuhan, China.
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Balakrishnan P, Saravanan S, Vignesh R, Shankar EM. Recent advances in HIV diagnostics: Point-of-care CD4 + T-cell count & viral load assays. Indian J Med Res 2023; 158:447-450. [PMID: 38063301 PMCID: PMC10878476 DOI: 10.4103/ijmr.ijmr_1616_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Indexed: 01/25/2024] Open
Affiliation(s)
- Pachamuthu Balakrishnan
- Centre for Infectious Diseases, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, Tamil Nadu, India
| | - Shanmugam Saravanan
- Centre for Infectious Diseases, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai, Tamil Nadu, India
| | - Ramachandran Vignesh
- Pre-Clinical Department, Faculty of Medicine, Royal College of Medicine Perak, Universiti Kuala Lumpur, Ipoh, Malaysia
| | - Esaki M. Shankar
- Infection & Inflammation, Department of Biotechnology, Central University of Tamil Nadu, Thiruvarur, Tamil Nadu, India
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Goldschmidt JH, Chou L, Chan PK, Chen L, Robert N, Kinsey J, Pitts K, Nestor M, Rock EP, Lazarus HM. Real-world outcomes of 18,186 metastatic solid tumor outpatients: Baseline blood cell counts correlate with survival after immune checkpoint inhibitor therapy. Cancer Med 2023; 12:20783-20797. [PMID: 37962239 PMCID: PMC10709745 DOI: 10.1002/cam4.6645] [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: 04/18/2023] [Revised: 09/27/2023] [Accepted: 10/16/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Patient survival in advanced/metastatic melanoma, non-small cell lung cancer (NSCLC), and renal cell carcinoma (RCC) has improved with immune checkpoint inhibitors (ICI). Biomarkers' role in prognosis and treatment has been limited by conflicting trial results. METHODS This retrospective, observational study analyzed baseline demographic, clinical, laboratory, and treatment data versus outcomes of The US Oncology Network adult outpatients. Patients with advanced/metastatic melanoma, NSCLC, or RCC treated between January 1, 2015 and November 30, 2020 were given ICI monotherapy or combination therapy with ipilimumab, pembrolizumab, nivolumab, or atezolizumab. Treatment outcomes (overall survival [OS], time to treatment discontinuation, time to next treatment) were followed longitudinally until May 31, 2021, last patient record, or date of death. Baseline blood cell counts, including absolute monocyte count (AMC), absolute lymphocyte count (ALC), monocyte-to-lymphocyte ratio (MLR), absolute neutrophil count (ANC), and eosinophil count, were subdivided into quintiles for univariate and multivariable Cox regression analyses. RESULTS Data from 18,186 patients with advanced/metastatic melanoma (n = 3314), NSCLC (n = 12,416), and RCC (n = 2456) were analyzed. Better OS correlated with increased baseline serum albumin concentration, increased eosinophil and lymphocyte counts, and Western United States physician practice location. Decreased OS correlated with increased AMC, MLR, ANC, age, and worse Eastern Cooperative Oncology Group performance status. CONCLUSIONS To our knowledge, this study is the largest to date to associate baseline survival indicators and outcomes in outpatients with advanced/metastatic melanoma, NSCLC, or RCC and receiving ICIs. Results may inform disease-specific prognostic models and help providers identify patients most likely to benefit from ICI therapy.
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Affiliation(s)
| | | | | | | | | | - Joyce Kinsey
- Partner Therapeutics, IncLexingtonMassachusettsUSA
| | | | - Matt Nestor
- Partner Therapeutics, IncLexingtonMassachusettsUSA
| | | | - Hillard M. Lazarus
- Department of Medicine, Division of Hematology and OncologyCase Western Reserve UniversityClevelandOhioUSA
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Tavakolian A, Farhanji M, Shapouran F, Zal A, Taheri Z, Ghobadi T, Moghaddam VF, Mahdavi N, Talkhi N. Investigating the association of acute kidney injury (AKI) with COVID-19 mortality using data-mining scheme. Diagn Microbiol Infect Dis 2023; 107:116026. [PMID: 37598593 DOI: 10.1016/j.diagmicrobio.2023.116026] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/27/2023] [Accepted: 07/09/2023] [Indexed: 08/22/2023]
Abstract
COVID-19 has caused significant challenges in kidney research and disease management. Data mining techniques such as logistic regression (LR) and decision tree (DT) were used to model data. All analyses were performed using SPSS 25 and Python 3. The incidence of acute kidney injury (AKI) was 14.1% and the overall mortality risk was 13% among COVID-19 patients. The mortality was associated with, AKI, age, marital status, smoking status, heart failure, chronic obstructive pulmonary disease, malignancy, and SPO2 level using LR. The accuracy, sensitivity, specificity, and area under the curve of the DT (and LR) classifier were 70% (85%), 73% (75%), 78% (79%), and 77% (81%), respectively. Based on the DT model, the variable most significantly associated with COVID-19 mortality was AKI followed by age, high WBC count, BMI, and lymphocyte count. It was concluded that the incidence of AKI was high, and AKI was identified as one of the important factors that played an effective role in mortality due to COVID-19.
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Affiliation(s)
- Ayoub Tavakolian
- Emergency Medicine Department, Deputy of Treatment, Faculty of Medicine, Mashhad University of Medical Science, Mashed, Iran
| | - Mahdieh Farhanji
- Department of Nursing, Faculty of Nursing and Midwifery, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran
| | - Farhang Shapouran
- Medical Student Research Committee, Sabzevar University of Medical Science, Sabzevar, Iran
| | - Arghavan Zal
- Medical Student Research Committee, Sabzevar University of Medical Science, Sabzevar, Iran
| | - Zahra Taheri
- Medical Student Research Committee, Sabzevar University of Medical Science, Sabzevar, Iran
| | - Tina Ghobadi
- Medical Student Research Committee, Sabzevar University of Medical Science, Sabzevar, Iran
| | | | - Neda Mahdavi
- Department of Epidemiology & Biostatistics, School of public health, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Talkhi
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran; International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
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Yang H, Zhuang Y. The deviations of CD4 + T cells during peripheral blood and peritoneal fluid of endometriosis: a systematic review and meta-analysis. Arch Gynecol Obstet 2023; 308:1431-1446. [PMID: 36840769 DOI: 10.1007/s00404-023-06964-3] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/01/2023] [Indexed: 02/26/2023]
Abstract
OBJECTIVE To assess whether endometriosis (EMs) was related to systematic and/or local deviations of cluster of differentiation (CD)4 + T cells. METHODS Until November 2022, we enrolled a total of 1363 EMs and 1564 healthy women from 32 studies who met the inclusion criteria. RESULTS After systematically retrieving the literature, we identified 1086 citations and 32 case-control studies were enrolled. Cumulative results suggested that there were insignificant deviations of CD4 + T cells during peripheral blood (PB) between EMs and healthy women (RR: - 0.83, I2 = 99%, p = 0.65), also no statistically significant difference was found between mild and severe EMs (RR: 3.19, I2 = 94%, p = 0.19). We also found insignificant deviations of CD4 + /CD8 + during PB between EMs and healthy women (RR: 0.09, I2 = 99%, p = 0.39), and between mild and severe EMs (RR: - 0.16, I2 = 99%, p = 0.29). The results might suggest that there was no significant correlation between EMs and systematic deviations of CD4 + T cells. When it came to local deviation during peritoneal fluid (PF), the polled results suggested that the frequency of CD4 + T cells during EMs was significantly lower than healthy women (RR: - 5.38, I2 = 93%, p = 0.01), and the ratio of CD4 + /CD8 + during EMs was significantly lower than healthy women (RR: - 0.13, I2 = 0%, p < 0.0001). However, there were insignificant deviations of CD4 + during PF between mild and severe EMs (RR: 1.65, I2 = 53%, p = 0.15), also there was an insignificant difference of CD4 + /CD8 + between mild and severe EMs (RR: - 0.09, I2 = 14%, p = 0.19). EMs might be closely related to local deviations of CD4 + T cells. CONCLUSION There was no obvious correlation between EMs and systematic deviations of CD4 + T cells, EMs might be closely related to local deviations of CD4 + T cells. Further study on the functional deviations and subpopulation distribution of CD4 + T cells is urgently needed.
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Affiliation(s)
- Hua Yang
- Department of Gynecology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, 519000, China
| | - Yuan Zhuang
- Department of Gynecology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, 519000, China.
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Ren FP, Chen Q, Yao SS, Feng L, Xue XY, Zhao WC, Wang D, Zhao ZL, Gu SW, Li T, Shen YW, Gao L, Zang XL, Bao XY, Tong ZH. Characteristics and prognostic implications of peripheral blood lymphocyte subsets in patients with anti-MDA5 antibody positive dermatomyositis-interstitial lung disease. BMC Pulm Med 2023; 23:411. [PMID: 37898737 PMCID: PMC10612305 DOI: 10.1186/s12890-023-02706-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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/11/2023] [Indexed: 10/30/2023] Open
Abstract
OBJECTIVES To examine the characteristics of blood lymphocyte subsets in dermatomyositis-interstitial lung disease (DM-ILD) inflicted patients with positive anti-melanoma differentiation-associated gene 5 (anti-MDA5), as well as its prognosis value in this set of patients. METHODS Data were retrospectively collected from 253 DM-ILD patients from three hospitals in China between January 2016 to January 2021. Patients were grouped into anti-MDA5 antibody positive group (MDA5+ DM-ILD) and anti-MDA5 antibody negative group (MDA5- DM-ILD) based on myositis-specific autoantibody test results. Demographic characteristics, lymphocyte subsets patterns and other clinical features were compared between the two groups. The association of lymphocyte subsets with 180-day mortality was investigated using survival analysis in MDA5+ DM-ILD. RESULTS Out of 253 eligible patients with DM-ILD, 59 patients were anti-MDA5+ and 194 were anti-MDA5-. Peripheral blood lymphocyte count, CD3+ count, percentage of CD3+, CD3+CD4+ count, and CD3+CD8+ count was lower in MDA5+ DM-ILD than in MDA5- DM-ILD- (all P < 0.001) as well as CD3-CD19+ count (P = 0.04). In MDA5+ DM-ILD, CD3+CD8+ count ≤ 49.22 cell/μL (HR = 3.81, 95%CI [1.20,12.14]) and CD3-CD19+ count ≤ 137.64 cell/μL (HR = 3.43, 95%CI [1.15,10.24]) were independent predictors of mortality. CD3+CD8+ count ≤ 31.38 cell/μL was associated with a higher mortality risk in all DM-ILD patients (HR = 8.6, 95%CI [2.12,31.44]) after adjusting for anti-MDA5 and other clinical characteristics. CONCLUSION Significant lymphocytes decrease was observed in MDA5+ DM-ILD patients. CD3+CD8+ cell count was associated with worse prognosis in both MDA5+ DM-ILD and all DM-ILD patients.
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Affiliation(s)
- Fang-Ping Ren
- Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Qi Chen
- Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | | | - Lin Feng
- Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xin-Ying Xue
- Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Wei-Chao Zhao
- PLA Strategic Support Force Medical Center, Beijing, China
| | - Dong Wang
- Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Zhi-Ling Zhao
- Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Si-Wei Gu
- Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ting Li
- Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Ya-Wen Shen
- Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Lan Gao
- Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Xue-Lei Zang
- Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | | | - Zhao-Hui Tong
- Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
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de Morais IRB, Barbosa DDO, de Almeida GB, da Costa RR, da Silva BO, de Oliveira LA, Arantes JP, Leite LOC, Rossato L, Ribeiro MB, Marchioro SB, Freire SM, Nascimento RJM, Simionatto S, Torres AJL. Determining reference ranges for immunological cells of healthy indigenous individuals from a region in Brazil. Einstein (Sao Paulo) 2023; 21:eAO0291. [PMID: 37878969 PMCID: PMC10567104 DOI: 10.31744/einstein_journal/2023ao0291] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 04/16/2023] [Indexed: 10/27/2023] Open
Abstract
Morais et al. conducted a pioneering study with Brazilian indigenous populations to determine reference values for immunologic cells from healthy adult individuals. The main findings included a higher relative median for T lymphocyte subsets in females than males, and T CD3+, T CD4+, and T CD8+ relative values were statistically different when compared with Brazilian populations from other Brazilian regions. The relative medians of CD3+, CD4+, and CD8+ T cells were significantly higher in women than in men in a healthy indigenous population. Demographic and ethnic diversity of the Brazilian population can be associated with quantitative modifications in the immunologic cells of healthy individuals. OBJECTIVE The establishment of reference values for a subset of leukocytes is common in clinical practice, and ethnic variations are strongly associated with disease development. In Brazil, indigenous people are vulnerable to infections, and few studies have described the health and disease conditions of this population. This study aimed to provide reference values for immunological cell subsets in indigenous Brazilians living in the state of Mato Grosso do Sul. METHODS Flow cytometry and 4-color combinations of monoclonal antibodies were used to characterize cells. A total of 115 healthy adults, mostly females (72%), were included in the study. The results are presented as mean and median (2.5%-97.5% percentiles) for T and B lymphocytes, CD4+ T cells, CD8+ T cells, Natural Killer cells, monocytes, and dendritic cells, providing an average immunological profile for the population in question. RESULTS The relative medians of CD3+, CD4+, and CD8+ T cells were significantly higher in women than in men in a healthy indigenous population. CONCLUSION To our knowledge, cell reference data from indigenous Brazilians are unknown in the literature. The immune cell results presented in this pioneering study will contribute to the clinical and laboratory evaluation of the Brazilian indigenous population, especially given the important differences when compared with other Brazilian ethnic groups.
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Affiliation(s)
- Isa Rita Brito de Morais
- Universidade Federal da BahiaSalvadorBABrazil Universidade Federal da Bahia , Salvador , BA , Brazil .
| | | | | | - Regina Rossoni da Costa
- Universidade Federal da Grande DouradosDouradosMSBrazil Universidade Federal da Grande Dourados , Dourados , MS , Brazil .
| | - Bruna Oliveira da Silva
- Universidade Federal da Grande DouradosDouradosMSBrazil Universidade Federal da Grande Dourados , Dourados , MS , Brazil .
| | - Laís Albuquerque de Oliveira
- Universidade Federal da Grande DouradosDouradosMSBrazil Universidade Federal da Grande Dourados , Dourados , MS , Brazil .
| | - Julia Pimentel Arantes
- Universidade Federal da Grande DouradosDouradosMSBrazil Universidade Federal da Grande Dourados , Dourados , MS , Brazil .
| | - Layla Oliveira Campos Leite
- Universidade Federal da Grande DouradosDouradosMSBrazil Universidade Federal da Grande Dourados , Dourados , MS , Brazil .
| | - Luana Rossato
- Universidade Federal da Grande DouradosDouradosMSBrazil Universidade Federal da Grande Dourados , Dourados , MS , Brazil .
| | - Marcos Borges Ribeiro
- Universidade Federal da BahiaSalvadorBABrazil Universidade Federal da Bahia , Salvador , BA , Brazil .
| | | | - Songelí Menezes Freire
- Universidade Federal da BahiaSalvadorBABrazil Universidade Federal da Bahia , Salvador , BA , Brazil .
| | | | - Simone Simionatto
- Universidade Federal da BahiaSalvadorBABrazil Universidade Federal da Bahia , Salvador , BA , Brazil .
| | - Alex José Leite Torres
- Universidade Federal da BahiaSalvadorBABrazil Universidade Federal da Bahia , Salvador , BA , Brazil .
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Sun C, Li X, Qian H, Liang G, Xiang R, Zhao C, Li Z, Li S, Jing K, Wang Y, Zhang H, Feng S. Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are positively correlated with disease activity of bullous pemphigoid. Arch Dermatol Res 2023; 315:2383-2391. [PMID: 37204459 DOI: 10.1007/s00403-023-02639-w] [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: 11/15/2022] [Revised: 02/21/2023] [Accepted: 05/09/2023] [Indexed: 05/20/2023]
Abstract
Bullous pemphigoid (BP) is a complex inflammatory process with elevated levels of autoantibodies, eosinophils, neutrophils, and various cytokines. Hematological inflammatory biomarkers can reflect inflammatory state in various diseases. Up to now, the correlations of hematological inflammatory biomarkers and disease activity of BP remain unknown. The purpose of this study was to clarify the associations between hematological inflammatory biomarkers and disease activity of BP. The levels of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), platelet-to-neutrophil ratio (PNR) and mean platelet volume (MPV) of 36 untreated BP patients and 45 age and gender matched healthy controls were detected by routine blood tests. The correlations between hematological inflammatory markers and clinical characteristics of BP were statistically analyzed. The Bullous Pemphigoid Disease Area Index (BPDAI) was used to measure disease activity of BP. The mean levels of NLR, PLR, PNR and MPV in 36 untreated BP patients were 3.9, 157.9, 45.7 and 9.4 fl, respectively. Increased NLR (p < 0.001), PLR (p < 0.01), and MPV (p < 0.001) but decreased PNR (p < 0.001) were observed in BP patients when compared with healthy controls. In BP patients, the levels of NLR were positively correlated to BPDAI Erosion/Blister Scores (p < 0.01); and the levels of NLR and PLR were both positively correlated to BPDAI without Damage Score (both p < 0.05) and BPDAI Total Score (both p < 0.05). No correlation was found in other statistical analyses between hematological inflammatory markers and clinical characteristics in BP patients involved in the present study. Therefore, NLR and PLR are positively correlated with disease activity of BP.
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Affiliation(s)
- Chao Sun
- Department of Dermatology, Institute of Dermatology and Hospital of Skin Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiang Wangmiao Street, Nanjing, 210042, Jiangsu, China
| | - Xiaoguang Li
- Department of Laboratory Medicine, Chronic Disease Research Center, Medical College, Dalian University, Dalian, China
| | - Hua Qian
- Department of Laboratory Medicine, Chronic Disease Research Center, Medical College, Dalian University, Dalian, China
| | - Guirong Liang
- Department of Dermatology, Institute of Dermatology and Hospital of Skin Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiang Wangmiao Street, Nanjing, 210042, Jiangsu, China
| | - Ruiyu Xiang
- Department of Dermatology, Institute of Dermatology and Hospital of Skin Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiang Wangmiao Street, Nanjing, 210042, Jiangsu, China
| | - Chenjing Zhao
- Department of Dermatology, Institute of Dermatology and Hospital of Skin Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiang Wangmiao Street, Nanjing, 210042, Jiangsu, China
| | - Zhiliang Li
- Department of Dermatology, Institute of Dermatology and Hospital of Skin Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiang Wangmiao Street, Nanjing, 210042, Jiangsu, China
| | - Suo Li
- Department of Dermatology, Institute of Dermatology and Hospital of Skin Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiang Wangmiao Street, Nanjing, 210042, Jiangsu, China
| | - Ke Jing
- Department of Dermatology, Institute of Dermatology and Hospital of Skin Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiang Wangmiao Street, Nanjing, 210042, Jiangsu, China
| | - Yuan Wang
- Department of Dermatology, Institute of Dermatology and Hospital of Skin Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiang Wangmiao Street, Nanjing, 210042, Jiangsu, China
| | - Hanmei Zhang
- Department of Dermatology, Institute of Dermatology and Hospital of Skin Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiang Wangmiao Street, Nanjing, 210042, Jiangsu, China
| | - Suying Feng
- Department of Dermatology, Institute of Dermatology and Hospital of Skin Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 12 Jiang Wangmiao Street, Nanjing, 210042, Jiangsu, China.
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Balshi A, Saart E, Pandeya S, Dempsey J, Baber U, Sloane JA. High CD4+:CD8+ ratios with herpes zoster infections in patients with multiple sclerosis on dimethyl fumarate. Mult Scler 2023; 29:1465-1470. [PMID: 37572049 DOI: 10.1177/13524585231189641] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/14/2023]
Abstract
BACKGROUND Dimethyl fumarate (DMF) depletes CD8+ and CD4+ T cells, and cases of herpes zoster (HZ) in patients with multiple sclerosis (MS) on DMF have been documented. OBJECTIVES To evaluate lymphocyte subsets in patients with MS who developed HZ on DMF (Tecfidera) compared to matched controls who did not develop HZ. METHODS We used linear mixed-effects models to test for differences in white blood cell count, lymphocyte percentage, absolute lymphocyte count, CD3+ percentage, absolute CD3+ count, CD4+ percentage, absolute CD4+ count, CD8+ percentage, absolute CD8+ count, and CD4+:CD8+ ratio over time in HZ and non-HZ groups. RESULTS Eighteen patients developed HZ while on DMF. The linear mixed-effects model for CD4+:CD8+ ratio showed a significant difference between the HZ and non-HZ groups (p = 0.033). CD4+:CD8+ ratio decreased over time in the HZ group and increased over time in the non-HZ group. CONCLUSION Patients with MS who develop HZ while on DMF have high CD4+:CD8+ ratios, suggesting an imbalance of CD4+ and CD8+ cells that may put a patient at risk for developing HZ while on DMF. This result emphasizes the need for lymphocyte subset monitoring (including CD4+:CD8+ ratios) on DMF, as well as vaccination prior to DMF initiation.
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Affiliation(s)
- Alexandra Balshi
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Emma Saart
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, NY, USA
| | - Sarbesh Pandeya
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - John Dempsey
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Ursela Baber
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Jacob A Sloane
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
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