Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
J Neuroimmunol. 2020 Dec 15;349:577398. doi: 10.1016/j.jneuroim.2020.577398. Epub 2020 Sep 18.
Alzheimer's disease (AD) is a chronic neurodegenerative disorder affecting millions of people, and its prevalence is expected to continue to grow in the older age population. It is characterized by cognitive impairment and dementia on the long term leading to a wide spectrum of social and financial burdens. Due to these burdens, there is a need to have a better understanding of the disease pathophysiology as well as to come up with more readily available and cost-effective screening tools to provide an acceptable estimate of the disease risk/diagnosis in the early years of the disease before dementia develops as it is in these early years that lifestyle modifications can be more effective in protecting against and delaying the frank cognitive impairment associated with AD. Recently, there has been a more detailed, yet incomplete, comprehension of the inflammatory component of the AD pathophysiology. The inflammatory response in AD entails hyperactivation of neutrophils with noticeable changes in their subsets and increased migration of lymphocytes into the central nervous system (CNS) across the compromised blood-brain barrier (BBB). These changes in the counts of the different immune cells in AD allowed for pursuing a new cost-effective, and more widely accessible diagnostic tool, which is the neutrophil-to-lymphocyte ratio (NLR). In this review, we aimed to discuss the inflammatory response in AD, and how this response is reflected in the counts of different immune cells, mainly neutrophils and lymphocytes which can be implemented in the utility of NLR as a diagnostic tool in AD patients.
阿尔茨海默病（AD）是一种慢性神经退行性疾病，影响着数以百万计的人，其患病率预计在老年人口中继续增长。它的特征是长期认知障碍和痴呆，导致广泛的社会和经济负担。由于这些负担，需要更好地了解疾病的病理生理学，以及开发更易于获得和更具成本效益的筛查工具，以便在痴呆发生之前，对疾病风险/诊断进行可接受的早期估计，因为在这些早期阶段，生活方式的改变可以更有效地预防和延缓与 AD 相关的明显认知障碍。最近，人们对 AD 病理生理学的炎症成分有了更详细但不完整的理解。AD 中的炎症反应涉及中性粒细胞的过度激活，其亚群发生明显变化，淋巴细胞穿过受损的血脑屏障（BBB）向中枢神经系统（CNS）迁移增加。AD 中不同免疫细胞数量的这些变化使得可以开发一种新的具有成本效益且更广泛应用的诊断工具，即中性粒细胞与淋巴细胞比值（NLR）。在这篇综述中，我们旨在讨论 AD 中的炎症反应，以及这种反应如何反映在不同免疫细胞的数量上，主要是中性粒细胞和淋巴细胞，这些细胞可用于 NLR 在 AD 患者中的诊断工具。
