Neutrophil-to-lymphocyte ratio: a marker of neuro-inflammation in multiple sclerosis?

: Background: The role of the neutrophil-to-lymphocyte ratio (NLR) of peripheral blood has been investigated in relation to several autoimmune diseases. Limited studies have addressed the significance of the NLR in terms of being a marker of disease activity in multiple sclerosis (MS). Methods: This is a retrospective study in relapsing–remitting MS patients (RRMS) admitted to the tertiary MS center of Catania, Italy during the period of 1 January to 31 December 2018. The aim of the present study was to investigate the significance of the NLR in reflecting the disease activity in a cohort of early diagnosed RRMS patients. Results: Among a total sample of 132 patients diagnosed with RRMS, 84 were enrolled in the present study. In the association analysis, a relation between the NLR value and disease activity at onset was found (V-Cramer 0.271, p = 0.013). In the logistic regression model, the variable NLR (p = 0.03 ExpB 3.5, CI 95% 1.089–11.4) was related to disease activity at onset. Conclusion: An elevated NLR is associated with disease activity at onset in RRMS patients. More large-scale studies with a longer follow-up are needed.

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High-intensity interval training reduces neutrophil-to-lymphocyte ratio in persons with multiple sclerosis during inpatient rehabilitation

Multiple Sclerosis Journal ◽

10.1177/1352458520951382 ◽

2020 ◽

pp. 135245852095138

Author(s):

Niklas Joisten ◽

Sebastian Proschinger ◽

Annette Rademacher ◽

Alexander Schenk ◽

Wilhelm Bloch ◽

...

Keyword(s):

Multiple Sclerosis ◽

High Intensity ◽

Controlled Trial ◽

Interval Training ◽

Inpatient Rehabilitation ◽

Neutrophil To Lymphocyte Ratio ◽

High Intensity Interval Training ◽

Continuous Training ◽

Lymphocyte Ratio ◽

High Intensity Interval

In persons with multiple sclerosis (PwMS), the neutrophil-to-lymphocyte ratio (NLR) is associated with disability status, symptomatology and disease activity. High-intensity interval training (HIIT) improves many symptoms in PwMS and may positively influence disease progression. Here, we present results from a randomized controlled trial during inpatient rehabilitation on immediate (single bout) and training (3-week intervention) effects of HIIT versus moderate continuous training on NLR and related cellular inflammation markers. Only HIIT reduced the NLR over the 3-week intervention period. These training effects might be due to repetitive inflammatory states with compensatory anti-inflammatory counterbalancing after each HIIT session.

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The neutrophil-to-lymphocyte ratio is associated with multiple sclerosis

Multiple Sclerosis Journal - Experimental Translational and Clinical ◽

10.1177/2055217318813183 ◽

2018 ◽

Vol 4 (4) ◽

pp. 205521731881318 ◽

Cited By ~ 4

Author(s):

IC Hasselbalch ◽

HB Søndergaard ◽

N Koch-Henriksen ◽

A Olsson ◽

H Ullum ◽

...

Keyword(s):

Multiple Sclerosis ◽

Propensity Score ◽

Clinical Information ◽

Neutrophil To Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Cell Counts ◽

Unit Increase ◽

White Blood Cell Counts ◽

Treatment Register ◽

Multiple Sclerosis Treatment

Background Subtypes of white blood cell counts are known biomarkers of systemic inflammation and a high neutrophil-to-lymphocyte ratio (NLR) has been associated with several autoimmune diseases. Few studies have investigated the NLR in multiple sclerosis (MS). Objective To examine the association between NLR, MS and disability measured by the MS severity score (MSSS). Methods Patients were included from the Danish Multiple Sclerosis Biobank. Information on patient NLR was obtained just before their first treatment and clinical information was provided by the Danish Multiple Sclerosis Treatment Register. Information on NLR from controls was collected from the Danish Blood Donor Study. Patients and controls were 1:2 propensity score matched by baseline confounders. Results Propensity score matching left 740 of 743 MS patients and 1420 of 4691 controls for further analyses. Odds-ratio (OR) was 3.64 (95% confidence interval 2.87–4.60, p < 0.001) for MS disease per unit increase of logarithmically transformed NLR (ln-NLR), corresponding to an OR of 2.68 for each doubling of NLR. Mean NLR was 2.12 for patients and 1.72 for controls ( p < 0.001). Ln-NLR correlated weakly with patient MSSS ( R2 = 0.019, p = 0.008). Conclusion Patients with early MS had increased levels of NLR compared to healthy controls and NLR was weakly correlated with MSSS.

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