scholarly journals PCSK9 Inhibitor Induces a Transient Decrease in Neutrophil-Lymphocyte Ratio and Monocyte-Lymphocyte Ratio in Homozygous/Compound Heterozygous Familial Hypercholesterolemia Patients

Author(s):  
Fang Yuan Li ◽  
Pucong Ye ◽  
Yu Hao ◽  
Juan Du ◽  
Hang Zhang ◽  
...  

Abstract Background: Homozygous/compound heterozygous familial hypercholesterolemia (HoFH/cHeFH) is characterized by extremely elevated low-density lipoprotein-cholesterol (LDL-C) levels that have been reported to contribute to a long-term chronic systemic inflammation. The aims of this study are to describe the inflammatory profile of HoFH/cHeFH patients and explore the effect of PCSK9 inhibitor (PCSK9i) on a series of inflammatory biomarkers, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-HDL ratio (MHR), monocyte-lymphocyte ratio (MLR) and mean platelet volume-lymphocyte ratio (MPVLR). Methods: In this prospective cohort study, 21 definitive HoFH/cHeFH on high-intensity statins plus ezetimibe were placed on subcutaneous injections of PCSK9i 450mg every 4 weeks (Q4W). The biochemical parameters and inflammatory profile were analyzed at the day before PCSK9i therapy, 3 months and 6 months after PCSK9i therapy.Results: We found that HoFH/cHeFH on maximum tolerated statin dose plus ezetimibe displayed an elevated lipid and disturbed blood biomarker profile. After 3 months of add-on PCSK9i therapy, a significant reduction of LDL-C was observed. Meanwhile, percentage and count of neutrophils, monocyte counts, MPV, as well as two inflammatory biomarkers, NLR and MLR were reduced. However, at 6-month PCSK9i treatment, NLR and MLR returned to pre-PCSK9i treatment levels.Conclusions: PCSK9i induces a transient decrease in NLR and MLR in HoFH/cHeFH patients. Our results add evidence in evaluating the effects of PCSK9i on systemic inflammation.

Author(s):  
Tevfik Kalelioglu ◽  
Guler Celikel ◽  
Ozlem Devrim Balaban ◽  
Nesrin Karamustafalioglu ◽  
Jennifer Kim Penberthy

Objective: Neuroleptic malignant syndrome (NMS) is a rare but severe side effect of antipsychotic medication. Neutrophil-lymphocyte ratio (NLR) is a simple marker used to measure systemic inflammation. Method: In this case report we explore the relationship of inflammation in the etiology of NMS. In our case involving NMS, although there was no leukocytosis, the NLR was increased up to systemic infection levels. Conclusion: We hypothesized that systemic inflammation may take a role in developing NMS. If so, NLR could be a new marker of NMS that may be able to provide more sensitive results than leukocyte levels.


2013 ◽  
Vol 88 (1) ◽  
pp. 218-230 ◽  
Author(s):  
Graeme J.K. Guthrie ◽  
Kellie A. Charles ◽  
Campbell S.D. Roxburgh ◽  
Paul G. Horgan ◽  
Donald C. McMillan ◽  
...  

2019 ◽  
Vol 39 (10) ◽  
Author(s):  
Liang Xiao ◽  
Furong Zeng ◽  
Guangtong Deng

Abstract Some doubts were generated during the reading of nomograms based on inflammatory biomarkers for preoperatively predicting tumor grade and microvascular invasion in stage I/II hepatocellular carcinoma (HCC). We would like to highlight and discuss with authors. First, neutrophil-lymphocyte ratio (NLR) and derived NLR (dNLR) should not be entered into multivariate analysis simultaneously. Second, authors should clarify how the cutoffs of these variables including lymphocyte-monocyte ratio (LMR), dNLR, age and tumor size were set. We insist that the type of variables should be consistent when we carry out the analysis and establish the nomogram. Last, we have to point out that Li et al.’s (Biosci. Rep. (2018), 38) study failed to validate nomograms using an independent dataset.


2021 ◽  
Vol 38 (2) ◽  
pp. 106-110
Author(s):  
İsmail BIYIK ◽  
Fatih KESKİN ◽  
Nagihan SAZ

Endometriosis occurs in about 5-10 in 100 women of reproductive age. The pathophysiology of endometriosis is controversial. Some studies claimed an association between endometriosis and increased levels of inflammatory factors in peritoneal fluid and/or peripheral blood. Monocyte / HDL cholesterol ratio (MHR) and neutrophil/lymphocyte ratio (NLR) are inflammatory markers and are used as predictors and prognostic indicators of mortality and morbidity in many diseases. In this study, we aimed to investigate whether Monocyte / HDL cholesterol ratio (MHR) and neutrophil/lymphocyte ratio (NLR) are increased in endometriosis as in patients with chronic inflammation and cardiovascular diseases. This is a retrospective case-control study conducted with 87 women, 45 in the endometriosis group and 42 in the control group. The demographic data, biochemical, complete blood count parameters and lipid profile of the cases were recorded and compared between the groups. The mean age of the endometriosis group was 33.88 years and was older than the control group. In terms of other demographic data, there were no difference between the two groups. Although the platelet distribution width and triglyceride values of the endometriosis group were higher than controls, they were interpreted as clinically insignificant. There were no significant differences between the groups in terms of other laboratory parameters including MHR and NLR. In this study, MHR and NLR are found similar in endometriosis and control groups. Further studies are needed to investigate the relationship between increased systemic inflammation.


2021 ◽  
Author(s):  
Łukasz Zapała ◽  
Aleksander Ślusarczyk ◽  
Karolina Garbas ◽  
Łukasz Mielczarek ◽  
Cezary Ślusarczyk ◽  
...  

Abstract BackroundSeveral hematological markers of systemic inflammation were reported as prognostic in renal cell carcinoma (RCC). We aimed to re-evaluate the prognostic significance of clinicopathologic features and compare the predictive value of different inflammatory markers in RCC.MethodsFour hundred ninety-five patients treated with nephrectomy for primary localized or locally advanced RCC were included in the retrospective analysis. The median follow-up was 48 months.ResultsPatients with higher neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), neutrophil/erythrocyte ratio (NER), derived neutrophil/lymphocyte ratio (dNLR), and lower lymphocyte/monocyte ratio (LMR) and hemoglobin/platelet ratio (HPR) had worse cancer-specific survival (CSS). In the multivariate analysis tumour stage, grade, age and high SIRI constituted independent factors predicting CSS. The model including SIRI values achieved C-index 0.903. Alternative multivariate models that included SII and NLR were characterized by comparable C-indexes i.e. 0.902 and 0.890, respectively. Different inflammatory markers could not be utilized in a single model, as they show a strong correlation with one other (SII, SIRI and NLR), and seem to provide similar prognostic information. Tumour grade and diameter were independent predictors for recurrence-free survival, whereas age, tumour grade and high NER (or high SIRI/ SII in alternative models) were prognostic for overall survival.ConclusionsMarkers of systemic inflammation might provide additional prognostic information (especially SIRI, SII, NLR and NER) and further increase the predictive accuracy of already available models in localized and locally advanced renal cell carcinoma. Clinicopathological features (stage, grade and age) remain the most important prognostic factors for oncological outcomes in RCC patients treated with nephrectomy. For the first time, we show the prognostic value of neutrophil-to-erythrocyte ratio, which constitutes an independent risk factor of overall survival.Trial registrationnot applicable


2017 ◽  
Vol 22 (03) ◽  
pp. 126-126
Author(s):  
Gabriele Dobler

Kazi DS et al. Cost-effectiveness of PCSK9 Inhibitor Therapy in Patients With Heterozygous Familial Hypercholesterolemia or Atherosclerotic Cardiovascular Disease. JAMA 2016; 316: 743–753 PCSK9-Inhibitoren wurden kürzlich in den USA für Patienten mit familiärer Hypercholesterinämie (FH) oder atherosklerotischer kardiovaskulärer Erkrankung (ASCVD) zugelassen, die trotz Maximaldosen von Statinen eine weitere Senkung des LDL-Cholesterins benötigen. Langfristig könnten sie wichtig bei der ASCVD-Prophylaxe werden. Die Autoren untersuchten die langfristige Wirtschaftlichkeit und potentiellen Kosten für das US-Gesundheitssystem.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Bin Waleed ◽  
Y L Xia ◽  
L J Gao ◽  
Y Xiaomeng ◽  
G Tse ◽  
...  

Abstract Background There is increasing evidence that inflammatory biomarkers growth differentiation factor 15 (GDF-15) and neutrophil-lymphocyte ratio (NLR) appear to be associated with stroke and adverse cardiovascular events in patients with atrial fibrillation (AF). However, long-term impact of catheter ablation (CA) on GDF-15 and NLR is still unknown. Objective To evaluate the long-term change in GDF-15 and NLR after CA in paroxysmal AF patients. Methods A total of 58 paroxysmal AF patients were consecutively enrolled to perform CA. The inflammatory biomarkers GDF-15 and NLR were measured at baseline and 6-months postablation. Results All patients except one could complete 6-Months follow up. Fifty (87.7%) patients maintained sinus rhythm (SR group) and seven (12.3%) patients sustained AF recurrence (AFR group). No significant difference was noted in clinical and procedural characteristics between two groups (p>0.05), except mean fluoroscopy time (minutes 22±11.7 vs. 13±5.3, p=0.001) significantly longer in AFR than SR group. The GDF-15 (pg/ml 195±57 vs. 216±88, p=0.398), and NLR (% 1.8 (1.3–3) vs. 2.6 (1.4–3.4), p=0.395) were comparable at baseline in both SR and AFR groups respectively. At 6-months postablation, GDF-15 (pg/ml 133±41 vs. 195±57, p<0.001), and NLR (% 1.6 (1.1–2) vs. 1.8 (1.3–3), p=0.004) were significant deceased compared to baseline levels in SR group. However, GDF-15 (pg/ml 139±86 vs. 216±88, p=0.064), and NLR (% 1.6 (1.2–3) vs. 2.6 (1.4–3.4), p=0.398) biomarkers remained comparable to baseline level in AFR group (p>0.05) Conclusion Inflammatory biomarkers; GDF-15 and NLR significantly decreased at long-term on successful maintenance of sinus rhythm by CA in paroxysmal AF patients. Acknowledgement/Funding None


2021 ◽  
Vol 11 (6) ◽  
pp. 464
Author(s):  
Alexey N. Meshkov ◽  
Alexandra I. Ershova ◽  
Anna V. Kiseleva ◽  
Svetlana A. Shalnova ◽  
Oxana M. Drapkina ◽  
...  

Heterozygous familial hypercholesterolemia (HeFH) is one of the most common genetic conditions but remains substantially underdiagnosed. The aim of our study was to investigate the prevalence of HeFH in the population of 11 different regions of Russia. Individuals were selected from the Epidemiology of Cardiovascular Risk Factors and Diseases in Regions of the Russian Federation Study. All participants who had low-density lipoprotein cholesterol (LDL-C) higher than 4.9 mmol/L, or LDL-C lower than 4.9 mmol/L, but had statin therapy, were additionally examined by FH experts. FH was diagnosed using the Dutch Lipid Clinic Network criteria, incorporating genetic testing. HeFH prevalence was assessed for 18,142 participants. The prevalence of patients with definite or probable HeFH combined was 0.58% (1 in 173). A total of 16.1% of patients with definite or probable HeFH had tendon xanthomas; 36.2% had mutations in one of the three genes; 45.6% of FH patients had coronary artery disease; 63% of HeFH patients received statins; one patient received an additional PCSK9 inhibitor; no patients received ezetimibe. Only 3% of patients reached the LDL-C goal based on 2019 ESC/EAS guidelines. Underdiagnosis and undertreatment of FH in Russia underline the need for the intensification of FH detection with early and aggressive cholesterol-lowering treatment.


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