Department of Clinical Pathology, South Egypt Cancer Institute, Assiut, Egypt.
Faculty of Medicine, Department of Clinical Pathology, Assiut University, Assiut, Egypt.
Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029619895111. doi: 10.1177/1076029619895111.
Neutrophil-to-lymphocyte ratio (NLR) was introduced as a potential inflammatory marker in sickle cell disease (SCD). This study aimed to evaluate the impact of hydroxyurea (HU) treatment on the value of NLR and some inflammatory mediators in SCD.
The hematological parameters and clinical events were analyzed in 35 children with SCD under HU treatment and followed up for 1 year and in 20 healthy controls. Enzyme-linked immunosorbent assay was performed for the evaluation of proinflammatory cytokines, including interleukin (IL) 6, IL-8, high-sensitivity C-reactive protein (hs-CRP), and tumor necrosis factor α (TNF-α).
Hydroxyurea significantly improves most of the hematological parameters in children with SCD. The percentages of hemoglobin fraction S, serum levels of TNF-α and IL-6 were significantly decreased when compared to baseline value but did not reach the value of the healthy control. The HU treatment led to a significant decrease in NLR compared to the baseline values and reached healthy control values. Neutrophil-to-lymphocyte ratio was positively correlated with hs-CRP, TNF-α, and IL-8 serum levels and negatively correlated with percentage of fetal hemoglobin and hematocrit values. The cutoff value of NLR to expect a response to HU among SCD was 3.0, with 76% specificity and 85% sensitivity (area under the curve: 0.85, < .0001). In conclusion, hydroxyurea induced a decrease in NLR and inflammatory cytokines, which represent a biomarker of inflammation in SCD. The calculation of NLR is a straightforward and cheap method for SCD outcome prediction in young children.
中性粒细胞与淋巴细胞比值（NLR）被引入镰状细胞病（SCD）作为一种潜在的炎症标志物。本研究旨在评估羟脲（HU）治疗对 SCD 中 NLR 和一些炎症介质值的影响。
对 35 名接受 HU 治疗并随访 1 年的 SCD 儿童和 20 名健康对照者的血液学参数和临床事件进行分析。采用酶联免疫吸附试验评估促炎细胞因子，包括白细胞介素（IL）6、IL-8、高敏 C 反应蛋白（hs-CRP）和肿瘤坏死因子α（TNF-α）。
HU 显著改善了 SCD 儿童的大多数血液学参数。与基线值相比，血红蛋白 S 百分比、血清 TNF-α和 IL-6 水平显著降低，但未达到健康对照组的水平。与基线值相比，HU 治疗导致 NLR 显著下降，并达到健康对照组的水平。NLR 与 hs-CRP、TNF-α 和 IL-8 血清水平呈正相关，与胎儿血红蛋白百分比和血细胞比容值呈负相关。SCD 患者对 HU 反应的 NLR 截断值为 3.0，特异性为 76%，敏感性为 85%（曲线下面积：0.85，<.0001）。总之，HU 诱导 NLR 和炎症细胞因子下降，这是 SCD 炎症的生物标志物。NLR 的计算是预测 SCD 年幼患儿结局的一种简单而廉价的方法。
