中性粒细胞与淋巴细胞比值升高作为检测1型发作性睡病患者神经炎症的一种可能标志物。
Increased neutrophil-to-lymphocyte ratio as a possible marker to detect neuroinflammation in patients with narcolepsy type 1.
作者信息
Conti Matteo, Cirillo Flavia, Maio Silvia, Fernandes Mariana, Bovenzi Roberta, Placidi Fabio, Izzi Francesca, Mercuri Nicola Biagio, Liguori Claudio
机构信息
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Sleep Medicine Centre, Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy.
出版信息
J Clin Sleep Med. 2025 Jan 1;21(1):101-107. doi: 10.5664/jcsm.11368.
STUDY OBJECTIVES
Narcolepsy type 1 (NT1) is an autoimmune disease caused by the selective immune attack against orexin-producing neurons. However, the pathophysiology of narcolepsy type 2 (NT2) and idiopathic hypersomnia (IH) remains controversial. The neutrophil-to-lymphocyte ratio (NLR) is an easily calculated parameter from the white blood cell count, which has already been extensively used as an inflammatory marker in immunological disorders. In this study, we examined the white blood cell count of patients with NT1, NT2, and IH compared to healthy controls (HC) and evaluated the NLR to test the possibility of identifying an easy biofluid marker for detecting inflammation and distinguishing patients from HC.
METHODS
White blood cell count and NLR were compared between 28 patients with NT1, 17 with NT2, 11 with IH, and 21 sex/age-matched HC. These parameters were correlated with cerebrospinal fluid levels of orexin-A, the cerebrospinal fluid/serum albumin ratio (as a marker of blood-brain barrier integrity), and polysomnographic parameters.
RESULTS
Patients with NT1 (NLR 2.01 ± 0.44) showed significantly higher NLR than those with NT2 (NLR 1.59 ± 0.53) or IH (NLR 1.48 ± 0.37) and HC (NLR 1.48 ± 0.43). Correlation analysis did not document significant associations between NLR and the other biological markers in each group of patients. The receiver operating characteristic curve analysis detected an optimal cutoff value to discriminate patients with NT1 from those with NT2, IH, and HC for values of NLR ≥ 1.60, 1.62, and 1.59, respectively.
CONCLUSIONS
Patients with NT1 showed a higher NLR than those with NT2, IH, and HC, possibly reflecting lymphocyte migration within the central nervous system, supporting the hypothesis of a neuroinflammatory attack of lymphocytes against orexin-producing neurons. Considering its sensitivity, this easily obtainable biofluid marker could help to screen patients with NT1.
CITATION
Conti M, Cirillo F, Maio S, et al. Increased neutrophil-to-lymphocyte ratio as a possible marker to detect neuroinflammation in patients with narcolepsy type 1. 2025;21(1):101-107.
研究目的
1型发作性睡病（NT1）是一种自身免疫性疾病，由针对产生食欲素的神经元的选择性免疫攻击引起。然而，2型发作性睡病（NT2）和特发性嗜睡症（IH）的病理生理学仍存在争议。中性粒细胞与淋巴细胞比值（NLR）是一个根据白细胞计数容易计算得出的参数，已被广泛用作免疫性疾病中的炎症标志物。在本研究中，我们检查了NT1、NT2和IH患者与健康对照（HC）的白细胞计数，并评估了NLR，以测试是否有可能确定一种易于检测的生物标志物，用于检测炎症并区分患者与HC。
方法
比较了28例NT1患者、17例NT2患者、11例IH患者和21例性别/年龄匹配的HC的白细胞计数和NLR。这些参数与脑脊液中食欲素-A水平、脑脊液/血清白蛋白比值（作为血脑屏障完整性的标志物）和多导睡眠图参数相关。
结果
NT1患者（NLR 2.01±0.44）的NLR显著高于NT2患者（NLR 1.59±0.53）、IH患者（NLR 1.48±0.37）和HC（NLR 1.48±0.43）。相关性分析未发现每组患者中NLR与其他生物标志物之间存在显著关联。受试者工作特征曲线分析检测到，将NT1患者与NT2患者、IH患者和HC区分开来的NLR最佳截断值分别为≥1.60、1.62和1.59。
结论
NT1患者的NLR高于NT2患者、IH患者和HC，这可能反映了淋巴细胞在中枢神经系统内的迁移，支持淋巴细胞对产生食欲素的神经元进行神经炎症攻击的假说。考虑到其敏感性，这种易于获得的生物标志物可能有助于筛查NT1患者。
引用
Conti M, Cirillo F, Maio S,等。中性粒细胞与淋巴细胞比值升高作为检测1型发作性睡病患者神经炎症的可能标志物。2025；21(1):101-107。
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