Neuroimmunology Unit, Department of Neuroscience, Hospital Alemán, Buenos Aires, Argentina.
Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico.
Front Immunol. 2021 Feb 23;12:628024. doi: 10.3389/fimmu.2021.628024. eCollection 2021.
The neutrophil-to-lymphocyte ratio (NLR) has been investigated in many autoimmune conditions as a biomarker of inflammation and/or disease activity. The role of NLR in AQP4-IgG-positive neuromyelitis optica spectrum disorders (NMOSD) is far from clear. In this study, NLR was evaluated in patients with AQP4-IgG-positive NMOSD at disease onset and its prognostic impact was subsequently assessed.
In this multicenter study, we retrospectively included all recent/newly diagnosed treatment-naïve patients with AQP4-IgG-positive NMOSD (n=90) from three different countries in Latin America (LATAM): Argentina, Ecuador, and Mexico. NLR was compared between AQP4-IgG-positive NMOSD and healthy controls (HC, n = 365). Demographic, clinical, paraclinical (including imaging), and prognostic data at 12 and 24 months were also evaluated. Multivariate regression analysis was used to describe and identify independent associations between the log-transformed NLR and clinical (relapses and EDSS) and imaging (new/enlarging and/or contrast-enhancing MRI lesions) outcomes.
NLR was higher in NMOSD patients during the first attack compared with HC (2.9 ± 1.6 vs 1.8 ± 0.6; p<0.0001). Regardless of immunosuppressant's initiation at disease onset, NLR remained higher in NMOSD patients at 12 (2.8 ± 1.3; p<0.0001) and 24 (3.1 ± 1.6; p<0.0001) months. No association was found at 12 and 24 months between the log-transformed NLR and the presence of relapses, new/enlarging and/or contrast-enhancing MRI lesions, and/or physical disability.
In this cohort of LATAM patients with AQP4-IgG-positive NMOSD, NLR was abnormally high in attacks but also during follow-up. However, a high NLR was not an independent predictor of clinical or imaging outcomes in our models.
中性粒细胞与淋巴细胞比值（NLR）已在许多自身免疫性疾病中被研究为炎症和/或疾病活动的生物标志物。NLR 在水通道蛋白 4 免疫球蛋白 G 阳性视神经脊髓炎谱系疾病（NMOSD）中的作用尚不清楚。在这项研究中，我们评估了发病时 AQP4-IgG 阳性 NMOSD 患者的 NLR，并随后评估了其预后影响。
在这项多中心研究中，我们回顾性纳入了来自拉丁美洲（LATAM）三国的三个不同中心的最近/新诊断的未经治疗的 AQP4-IgG 阳性 NMOSD 患者（n=90）：阿根廷、厄瓜多尔和墨西哥。我们比较了 AQP4-IgG 阳性 NMOSD 患者与健康对照组（HC，n=365）之间的 NLR。还评估了 12 个月和 24 个月时的人口统计学、临床、临床前（包括影像学）和预后数据。使用多变量回归分析来描述和识别 NLR（对数转换）与临床（复发和 EDSS）和影像学（新/扩大和/或对比增强 MRI 病变）结局之间的独立关联。
NMOSD 患者在首次发作时的 NLR 高于 HC（2.9±1.6 比 1.8±0.6；p<0.0001）。无论在发病时是否开始免疫抑制治疗，NMOSD 患者在 12 个月（2.8±1.3；p<0.0001）和 24 个月（3.1±1.6；p<0.0001）时的 NLR 仍较高。在 12 个月和 24 个月时，NLR（对数转换）与复发、新/扩大和/或对比增强 MRI 病变以及/或身体残疾的存在之间均无关联。
在本队列中，来自 LATAM 的 AQP4-IgG 阳性 NMOSD 患者的 NLR 在发作时异常升高，但在随访期间也升高。然而，在我们的模型中，高 NLR 并不是临床或影像学结局的独立预测因子。
