Neutrophil/lymphocyte and monocyte/lymphocyte indexes as potential predictors of relapse at 1 year after diagnosis of pediatric multiple sclerosis: a single-center, exploratory and proof-of-concept study
IntroductionEarly identification of patients with a more unfavorable outcome in Multiple Sclerosis (MS) is crucial to optimize individualized treatment. Neutrophil-lymphocyte index (NLI) and monocyte-lymphocyte index (MLI) have been considered as potential biomarkers for disease prognosis. Our study...
| 主要な著者: | , , , , , , , , |
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| フォーマット: | 論文 |
| 言語: | English |
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Frontiers Media S.A.
2024-01-01
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| シリーズ: | Frontiers in Neuroscience |
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| オンライン･アクセス: | https://www.frontiersin.org/articles/10.3389/fnins.2023.1305176/full |
| _version_ | 1827381826377744384 |
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| author | Filipe Palavra Filipe Palavra Filipe Palavra Leonor Geria André Jorge Margarida Marques Constança Soares dos Santos Joana Amaral Joana Afonso Ribeiro Cristina Pereira Conceição Robalo |
| author_facet | Filipe Palavra Filipe Palavra Filipe Palavra Leonor Geria André Jorge Margarida Marques Constança Soares dos Santos Joana Amaral Joana Afonso Ribeiro Cristina Pereira Conceição Robalo |
| author_sort | Filipe Palavra |
| collection | DOAJ |
| description | IntroductionEarly identification of patients with a more unfavorable outcome in Multiple Sclerosis (MS) is crucial to optimize individualized treatment. Neutrophil-lymphocyte index (NLI) and monocyte-lymphocyte index (MLI) have been considered as potential biomarkers for disease prognosis. Our study aims to investigate the usefulness of NLI and MLI as predictors of relapse, disability progression, and lesion accumulation on magnetic resonance imaging (MRI) 1 year after diagnosis and treatment initiation, in pediatric-onset MS.MethodsA retrospective single-center study was conducted, including patients with diagnosis of MS established in pediatric age (<18 years old), at least 1-year of follow-up, and a complete blood count (CBC) performed at diagnosis. We collected the nearest-to-diagnosis NLI and MLI, as well as clinical and imaging variables, at diagnosis and 12 months later. Our cohort was further dichotomized into two groups, based on the presence of relapses. Statistical significance was considered for p < 0.05.ResultsEighteen patients (n = 18) were included. The relapsing group had higher mean, minimum, and maximum values for both NLI (5.17 ± 5.85, range: 1.57–11.92) and MLI (0.35 ± 0.22, range: 0.19–0.59), compared to the non-relapsing group (2.19 ± 1.63, range: 1.12–7.32 for NLI, and 0.24 ± 0.09, range: 0.14–0.44 for MLI). A higher percentage of patients in the relapsing group had increased NLI (>1.89, 66.7%) and MLI (>0.21, 66.7%) values than those in the non-relapsing group (46.7%). Patients who presented new T2-hyperintense lesions on MRI after 1 year of follow-up also had higher mean, minimum, and maximum values of both biomarkers. Patients who did not achieve No Evidence of Disease Activity-3 (NEDA-3) state exhibited higher values for both ratios. However, in our sample, no statistically significant correlations were found between MLI and NLI values and the clinical and imaging variables considered.ConclusionThe ease of obtaining NLI and MLI from routine blood tests renders them useful biomarkers as a screening tool in longitudinal follow-up. Our study was based on a very small sample size, but it allowed us to verify the feasibility of the protocol used. It is intended to involve other centers in the next phase of this work, testing the possible usefulness of the indices under analysis on a larger sample. |
| first_indexed | 2024-03-08T14:09:33Z |
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| last_indexed | 2024-03-08T14:09:33Z |
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| series | Frontiers in Neuroscience |
| spelling | doaj.art-f898b6ea234949e2836ae4e89f8060d92024-01-15T04:15:56ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2024-01-011710.3389/fnins.2023.13051761305176Neutrophil/lymphocyte and monocyte/lymphocyte indexes as potential predictors of relapse at 1 year after diagnosis of pediatric multiple sclerosis: a single-center, exploratory and proof-of-concept studyFilipe Palavra0Filipe Palavra1Filipe Palavra2Leonor Geria3André Jorge4Margarida Marques5Constança Soares dos Santos6Joana Amaral7Joana Afonso Ribeiro8Cristina Pereira9Conceição Robalo10Center for Child Development–Neuropediatrics Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, PortugalLaboratory of Pharmacology and Experimental Therapeutics, Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, PortugalClinical Academic Center of Coimbra, Coimbra, PortugalFaculty of Medicine, University of Coimbra, Coimbra, PortugalDepartment of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, PortugalBiostatistics and Medical Informatics Laboratory, Faculty of Medicine, University of Coimbra, Coimbra, PortugalCenter for Child Development–Neuropediatrics Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, PortugalCenter for Child Development–Neuropediatrics Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, PortugalCenter for Child Development–Neuropediatrics Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, PortugalCenter for Child Development–Neuropediatrics Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, PortugalCenter for Child Development–Neuropediatrics Unit, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, PortugalIntroductionEarly identification of patients with a more unfavorable outcome in Multiple Sclerosis (MS) is crucial to optimize individualized treatment. Neutrophil-lymphocyte index (NLI) and monocyte-lymphocyte index (MLI) have been considered as potential biomarkers for disease prognosis. Our study aims to investigate the usefulness of NLI and MLI as predictors of relapse, disability progression, and lesion accumulation on magnetic resonance imaging (MRI) 1 year after diagnosis and treatment initiation, in pediatric-onset MS.MethodsA retrospective single-center study was conducted, including patients with diagnosis of MS established in pediatric age (<18 years old), at least 1-year of follow-up, and a complete blood count (CBC) performed at diagnosis. We collected the nearest-to-diagnosis NLI and MLI, as well as clinical and imaging variables, at diagnosis and 12 months later. Our cohort was further dichotomized into two groups, based on the presence of relapses. Statistical significance was considered for p < 0.05.ResultsEighteen patients (n = 18) were included. The relapsing group had higher mean, minimum, and maximum values for both NLI (5.17 ± 5.85, range: 1.57–11.92) and MLI (0.35 ± 0.22, range: 0.19–0.59), compared to the non-relapsing group (2.19 ± 1.63, range: 1.12–7.32 for NLI, and 0.24 ± 0.09, range: 0.14–0.44 for MLI). A higher percentage of patients in the relapsing group had increased NLI (>1.89, 66.7%) and MLI (>0.21, 66.7%) values than those in the non-relapsing group (46.7%). Patients who presented new T2-hyperintense lesions on MRI after 1 year of follow-up also had higher mean, minimum, and maximum values of both biomarkers. Patients who did not achieve No Evidence of Disease Activity-3 (NEDA-3) state exhibited higher values for both ratios. However, in our sample, no statistically significant correlations were found between MLI and NLI values and the clinical and imaging variables considered.ConclusionThe ease of obtaining NLI and MLI from routine blood tests renders them useful biomarkers as a screening tool in longitudinal follow-up. Our study was based on a very small sample size, but it allowed us to verify the feasibility of the protocol used. It is intended to involve other centers in the next phase of this work, testing the possible usefulness of the indices under analysis on a larger sample.https://www.frontiersin.org/articles/10.3389/fnins.2023.1305176/fullmultiple sclerosischildrenadolescentsneutrophil-lymphocyte indexmonocyte-lymphocyte index |
| spellingShingle | Filipe Palavra Filipe Palavra Filipe Palavra Leonor Geria André Jorge Margarida Marques Constança Soares dos Santos Joana Amaral Joana Afonso Ribeiro Cristina Pereira Conceição Robalo Neutrophil/lymphocyte and monocyte/lymphocyte indexes as potential predictors of relapse at 1 year after diagnosis of pediatric multiple sclerosis: a single-center, exploratory and proof-of-concept study Frontiers in Neuroscience multiple sclerosis children adolescents neutrophil-lymphocyte index monocyte-lymphocyte index |
| title | Neutrophil/lymphocyte and monocyte/lymphocyte indexes as potential predictors of relapse at 1 year after diagnosis of pediatric multiple sclerosis: a single-center, exploratory and proof-of-concept study |
| title_full | Neutrophil/lymphocyte and monocyte/lymphocyte indexes as potential predictors of relapse at 1 year after diagnosis of pediatric multiple sclerosis: a single-center, exploratory and proof-of-concept study |
| title_fullStr | Neutrophil/lymphocyte and monocyte/lymphocyte indexes as potential predictors of relapse at 1 year after diagnosis of pediatric multiple sclerosis: a single-center, exploratory and proof-of-concept study |
| title_full_unstemmed | Neutrophil/lymphocyte and monocyte/lymphocyte indexes as potential predictors of relapse at 1 year after diagnosis of pediatric multiple sclerosis: a single-center, exploratory and proof-of-concept study |
| title_short | Neutrophil/lymphocyte and monocyte/lymphocyte indexes as potential predictors of relapse at 1 year after diagnosis of pediatric multiple sclerosis: a single-center, exploratory and proof-of-concept study |
| title_sort | neutrophil lymphocyte and monocyte lymphocyte indexes as potential predictors of relapse at 1 year after diagnosis of pediatric multiple sclerosis a single center exploratory and proof of concept study |
| topic | multiple sclerosis children adolescents neutrophil-lymphocyte index monocyte-lymphocyte index |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2023.1305176/full |
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