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Neutrophils-to-Lymphocyte Ratio Is Associated with Progression and Overall Survival in Amyotrophic Lateral Sclerosis

Title: Neutrophils-to-Lymphocyte Ratio Is Associated with Progression and Overall Survival in Amyotrophic Lateral Sclerosis
Authors: Leone, Maurizio A; Mandrioli, Jessica; Russo, Sergio; Cucovici, Aliona; Gianferrari, Giulia; Lisnic, Vitalie; Muresanu, Dafin Fior; Giuliani, Francesco; Copetti, Massimiliano; The Pooled Resource Open-Access Als Clinical Trials Consortium, null; Fontana, Andrea
Contributors: Leone, Maurizio A; Mandrioli, Jessica; Russo, Sergio; Cucovici, Aliona; Gianferrari, Giulia; Lisnic, Vitalie; Muresanu, Dafin Fior; Giuliani, Francesco; Copetti, Massimiliano; The Pooled Resource Open-Access Als Clinical Trials Consortium, Null; Fontana, Andrea
Publication Year: 2022
Collection: Archivio della ricerca dell'Università di Modena e Reggio Emilia (Unimore: IRIS)
Subject Terms: amyotrophic lateral sclerosi; disease progression rate; inflammation; neutrophil-to-lymphocyte ratio; prognosi; survival
Description: Background: Amyotrophic lateral sclerosis (ALS) is a devastating and untreatable motor neuron disease, with a 3-5-year survival from diagnosis. Possible prognostic serum biomarkers include albumin, C-reactive protein, ferritin, creatinine, uric acid, hemoglobin, potassium, sodium, calcium, glucose, and the neutrophil-to-lymphocyte ratio (NLR), a marker of subclinical inflammation. Objective: To ascertain the influence of NLR on ALS progression rate and survival. Methods: Cross-sectional multicenter study including 146 consecutive incident and prevalent patients (88 males), aged >18 years, diagnosed according to the El Escorial criteria. The exclusion criteria were: (1) patients with tracheostomy or receiving mechanical ventilation; (2) patients with percutaneous endoscopic gastrostomy; and (3) patients who did not sign the informed consent. The rate of disease progression (ΔFS score) represents the monthly decline of the ALSFRS-R score, and was computed as (48 - total ALSFRS-R at recruitment)/symptom duration in months. Patients were followed up to tracheotomy, death, or the end of the follow-up, whichever occurred first. To validate our findings, we used data retrieved from the Pooled Resource Open-Access ALS Clinical Trials (PRO-ACT) Database. Results: The median disease duration was 15 (range = 2-30) months. The mean ALSFRS-R score at recruitment was 35.8 ± 8.0 (range: 10-48), and the median ΔFS was 0.66 (range: 0-5.33). Age at onset, at diagnosis, and at recruitment were significantly lower in the lowest NLR tertile. NLR values positively correlated with ΔFS values (r = 0.28): the regression slope of NLR (log-values) was 0.60 (p < 0.001) before and 0.49 (p = 0.006) after adjustment for age at recruitment. The ΔFS score progressively increased from the lowest to the highest NLR tertile: 0.35 (IQR: 0.18-0.93), 0.62 (IQR: 0.25-1.09), and 0.86 (IQR: 0.53-1.92). Patients were followed for a median of 2 years. The mortality rate passed from 15.9 events per 100 person-years in patients belonging to the lowest ...
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/35203564; info:eu-repo/semantics/altIdentifier/wos/WOS:000769511300001; volume:10; issue:2; firstpage:354; lastpage:354; journal:BIOMEDICINES; https://hdl.handle.net/11380/1269178
DOI: 10.3390/biomedicines10020354
Availability: https://hdl.handle.net/11380/1269178; https://doi.org/10.3390/biomedicines10020354
Rights: info:eu-repo/semantics/openAccess ; license:[IR] creative-commons ; license uri:http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.6EE78CFB
Database: BASE