The neutrophil-to-lymphocyte ratio as a marker of chronic obstructive pulmonary disease and its exacerbations: A systematic review and meta-analysis.

Published on Jul 5, 2018in European Journal of Clinical Investigation4.686
· DOI :10.1111/ECI.12984
Panagiotis Paliogiannis23
Estimated H-index: 23
(University of Sassari),
Alessandro G. Fois20
Estimated H-index: 20
(University of Sassari)
+ 5 AuthorsAngelo Zinellu33
Estimated H-index: 33
(University of Sassari)
Sources
Abstract
INTRODUCTION:The main white blood cell populations, neutrophils and lymphocytes, are involved in the pathophysiology of chronic obstructive pulmonary disease (COPD). We conducted a systematic review and meta-analysis of studies investigating the relationship between the neutrophil to lymphocyte ratio (NLR, a marker of subclinical inflammation), presence of COPD, and its exacerbations. METHODS:A comprehensive literature search was conducted in Pubmed, Web of Science and Scopus databases; two investigators independently reviewed suitable studies. RESULTS:Nine studies, from 247 initially identified, were included in the meta-analysis. Seven studies, in 775 COPD patients with stable disease and 496 healthy controls, showed a significant increase in NLR values in stable COPD (standardised mean difference, SMD, 0.773, 95% CI 0.410-1.136; P < 0.001). Furthermore, in six studies in 527 COPD patients with acute exacerbation and 620 COPD patients with stable disease, NLR values were significantly higher in patients with exacerbations (random effects SMD 0.850, 95% CI 0.549-1.151; P < 0.001). CONCLUSIONS:Our meta-analysis showed that NLR values are significantly higher in stable COPD patients when compared to healthy individuals, although the magnitude of the difference is reduced after trim and fill adjustment, and in patients with COPD exacerbations when compared to patients with stable disease. Further studies, in larger cohorts, are needed to confirm whether the NLR is a useful tool in discriminating between COPD patients with stable disease, those with acute exacerbations, and subjects without the disease.
Figures & Tables
Download
📖 Papers frequently viewed together
References42
Newest
#1Zaixing Yang (WMU: Wenzhou Medical College)H-Index: 18
#2Zhiyu Zhang ('SMMU': Second Military Medical University)H-Index: 2
Last. Yan Liang ('SMMU': Second Military Medical University)H-Index: 34
view all 7 authors...
Abstract This study was aimed to evaluate levels of neutrophil- (NLR), monocyte- (MLR), eosinophil- (ELR), and basophil-lymphocyte ratio (BLR) and their association with inflammatory markers in systemic autoimmune rheumatic diseases (SARDs). A total of 1139 SARD patients and 170 healthy individuals were enrolled. Clinical and laboratory data were extracted. NLR and MLR were significantly increased, but BLR decreased in most SARD patients (p < 0.05). ELR were significantly decreased in systemic l...
Source
#1CaoYuan Yao (CQMU: Chongqing Medical University)H-Index: 1
#2XiaoLi LiuH-Index: 1
Last. Ze Tang (CQMU: Chongqing Medical University)H-Index: 1
view all 3 authors...
BACKGROUND AND OBJECTIVES: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is one of the leading causes of hospitalization and is associated with considerable mortality, for which clinicians are seeking useful and easily obtained biomarkers for prognostic evaluation. This study aimed to determine the potential role of the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) as prognostic makers for hospital mortality in patients with AECOPD. METHODS: We incl...
Source
#1Praneel Kumar (Griffith University)H-Index: 2
#2Stephanie Law (Griffith University)H-Index: 2
Last. Krishna B. Sriram (Griffith University)H-Index: 15
view all 3 authors...
Background: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have high mortality and health care costs. The platelet to lymphocyte ratio (PLR) is a marker of inflammation and has been reported to be elevated in patients with AECOPD compared to stable state. In this study, we sought to evaluate the association of the PLR in patients with AECOPD with 90-day mortality. Methods: We conducted a retrospective cohort study of patients admitted to our institution with a primary diag...
Source
#1Mahsuk Taylan (Dicle University)H-Index: 10
#2Melike Demir (Dicle University)H-Index: 11
Last. Cengizhan Sezgi (Dicle University)H-Index: 10
view all 9 authors...
Objectives We aimed to investigate the importance of neutrophil–lymphocyte ratio (NLR) in patients with chronic obstructive pulmonary disease (COPD) for identifying the severity of inflammation and recognition of acute exacerbation. Methods We retrospectively enrolled 100 patients with a diagnosis of COPD exacerbation who were admitted to our clinic. Complete blood count (CBC), measurement of C reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were determined within 2 h of hospital...
Source
The prognostic significance of neutrophil-to-lymphocyte ratio (NLR), derived-neutrophil-to-lymphocyte ratio (d-NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) have been shown in many diseases. To the best of our knowledge, there is no published report evaluation of those parameters in acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The aims of this study are to evaluate the parameters in predicting in-hospital mortality in patients with AECO...
Source
#1Nan Chen (Sichuan University)H-Index: 8
#2Shuai Liu (Sichuan University)H-Index: 2
Last. Meng Qiu (Sichuan University)H-Index: 4
view all 8 authors...
// Nan Chen 1,* , Shuai Liu 1,* , Lin Huang 1,* , Wanling Li 1 , Wenhao Yang 1 , Tianxin Cong 1 , Lin Ding 1 and Meng Qiu 1,2 1 West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China 2 Department of Medical Oncology, Cancer Center, The State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Guoxue Alley, Chengdu, China * These authors have contributed equally to this work Correspondence to: Meng Qiu, email: // Keywords : inflammation, malignan...
Source
BACKGROUND: The major characteristic of COPD is systemic inflammation. The parameters such as neutrophil-to-lymphocyte ratio (NLR) and eosinophil-to-basophil ratio (EBR) in routine blood test (RBT) are considered to be the underlying biomarkers of inflammation. We hypothesized that the prognosis of patients with COPD can be predicted with RBT. METHODS: Patients with COPD in stable stage were enrolled. The RBT, pulmonary function testing (PFT), BODE index, C-reactive protein (CRP), procalcitonin,...
Source
#1Raymond FarahH-Index: 10
#2Rabia IbrahimH-Index: 1
Last. Elizabeth Eshel (BIU: Bar-Ilan University)H-Index: 3
view all 6 authors...
Abstract This study investigated the importance of neutrophil/lymphocyte ratio (NLR) and other new inflammatory markers including CD64 expression in patients with chronic obstructive pulmonary disease (COPD) for identifying the severity of inflammation and recognition of acute exacerbation and infection. Seventy-two patients with a diagnosis of COPD exacerbation who were admitted to the Department of Internal Medicine B, 13 with stable COPD, and control group of 15 healthy people were enrolled i...
Source
SummaryIntroductions Discriminating bacterial from nonbacterial acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is difficult, causing antibiotics overuse and bacterial resistance. Sputum cultures are of limited use because results take time. In our hospital, only leukocyte concentration and CRP are laboratory parameters evaluated in AECOPD. We evaluated additional tests to discriminate bacterial vs. nonbacterial AECOPD: 5-part leukocyte differentiation (hematology analyzer)...
Source
#1Heock Lee (Dong-a University)H-Index: 1
#2Soo Jung Um (Dong-a University)H-Index: 4
Last. Ki Suck Jung (Hallym University)H-Index: 17
view all 10 authors...
Background The ratio of neutrophils to lymphocytes (NLR) is a widely available marker of inflammation. Several types of inflammatory cells and mediators have been found to be involved in the progression of chronic obstructive pulmonary disease (COPD). We sought to evaluate the association of the NLR with severity of airflow limitation and disease exacerbations in a COPD population.
Source
Cited By12
Newest
#1Angelo ZinelluH-Index: 33
#2Claudia ColluH-Index: 3
Last. Ciriaco CarruH-Index: 39
view all 13 authors...
Variable patterns of disease progression are typically observed in patients with idiopathic pulmonary fibrosis (IPF). We sought to determine the prognostic capacity of blood cell count indexes, derived from routine complete blood cell (CBC) count, in a cohort of IPF patients. The neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (dNLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic inflammation index (SII), systemic inflammation respo...
Source
#1Yiben Huang (WMU: Wenzhou Medical College)H-Index: 1
#2Jianing Wang (WMU: Wenzhou Medical College)H-Index: 1
Last. Xiaodiao Zhang (WMU: Wenzhou Medical College)H-Index: 1
view all 12 authors...
Background We aimed to investigate the association between red cell index (RCI) and the severity of Chronic Obstructive Pulmonary Disease (COPD), and compare predictive value of RCI, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) for the severity of COPD. Methods A total of 207 participants were recruited (100 COPD patients and 107 healthy controls). COPD patients were divided into two groups according to the optimal cut-off value of RCI determined by the receiver operatin...
Source
#1Alessandro G. FoisH-Index: 20
Last. Angelo ZinelluH-Index: 33
view all 15 authors...
Background The rapid onset of a systemic pro-inflammatory state followed by acute respiratory distress syndrome is the leading cause of mortality in patients with COVID-19. We performed a retrospective observational study to explore the capacity of different complete blood cell count (CBC)-derived inflammation indexes to predict in-hospital mortality in this group. Methods The neutrophil to lymphocyte ratio (NLR), derived NLR (dNLR), platelet to lymphocyte ratio (PLR), mean platelet volume to pl...
Source
The aim of the study was to evaluate the effect of Oxyjun™ on cardiovascular fitness of overweight individuals by reducing obesity induced systemic inflammation. Male participants between the ages of 18 - 35 years and body mass index of 25 - 34.9 kg/m2 were recruited in the study. Change in neutrophil lymphocyte ratio (NLR), high density lipoprotein (HDL-c) and quality of life using 36-item Short form survey (SF-36) was assessed over a period of 8-weeks. Results demonstrated that NLR was reduced...
Source
#1Rui Guo (Capital Medical University)H-Index: 1
#2Jia Li (Capital Medical University)H-Index: 1
Last. Lei Pan (Capital Medical University)H-Index: 9
view all 4 authors...
There was inconsistent results regarding the associations of neutrophil to lymphocyte ratio (NLR) with the progression and prognosis of chronic obstructive pulmonary disease (COPD). This paper asse...
Source
#1Angelo Zinellu (University of Sassari)H-Index: 33
#2Panagiotis Paliogiannis (University of Sassari)H-Index: 23
Last. Alessandro G. Fois (University of Sassari)H-Index: 20
view all 14 authors...
PURPOSE Inflammation and immunity play a pivotal but yet unclear role in idiopathic pulmonary fibrosis (IPF), a chronic disorder characterized by progressive damage of lung parenchyma and severe loss of lung function despite optimal treatment. However, the pathophysiological and predictive role of combined blood cell count indexes of inflammation in IPF is uncertain. METHODS Seventy-three patients with IPF and 62 healthy subjects matched for age, gender and smoking status were included in this c...
Source
#1Angelo Zinellu (University of Sassari)H-Index: 33
#2Elisabetta ZinelluH-Index: 19
Last. Pietro Pirina (University of Sassari)H-Index: 26
view all 11 authors...
It is amply reported that patients with chronic obstructive pulmonary disease (COPD) have increased risk of cardiovascular disease (CVD). Recent evidence suggests that COPD patients have elevated concentrations of plasma homocysteine (Hcy), a transsulfuration pathway analyte that is commonly regarded as a CVD risk factor. We comprehensively investigated the plasma concentrations of transsulfuration pathway analytes, and their relationship with markers of oxidative stress and inflammation, to ide...
Source
#1Mario Cazzola (University of Rome Tor Vergata)H-Index: 69
#2Ermanno Puxeddu (University of Rome Tor Vergata)H-Index: 17
Last. Paola Rogliani (University of Rome Tor Vergata)H-Index: 43
view all 4 authors...
In recent years, there has been a great deal of interest in the identification and validation of blood-based biomarkers for clinical use in chronic obstructive pulmonary disease (COPD). We now have panels of blood biomarkers that potentially hold great promise as they show statistically significant associations with COPD, but biomarkers for the diagnosis of COPD remain elusive. In fact, they are yet to demonstrate sufficient accuracy to be accepted in clinical use, and many are not specific to C...
Source
#1Alexandra Nieters (University of Freiburg)H-Index: 61
#2Nadja Blagitko-Dorfs (University of Freiburg)H-Index: 9
Last. Susanne Weber (University of Freiburg)H-Index: 6
view all 4 authors...
STUDY OBJECTIVES: The immune theory of sleep suggests an important role of sleep for a functioning immune system. Insomnia has been associated with heightened risk for infections. The aim of the study was to test whether psychophysiological insomnia (PI) is associated with subsequent respiratory tract infections (RTIs) in the context of an infection-diary-based cohort study. METHODS: We recruited 674 adults from a cross-sectional survey on airway infections into the airway infection susceptibili...
Source
#1Francesca Palmacci (Sapienza University of Rome)H-Index: 1
#2Elisabetta Toti (Canadian Real Estate Association)H-Index: 15
Last. Maura Palmery (Sapienza University of Rome)H-Index: 28
view all 8 authors...
Neutrophil-to-lymphocyte ratio (NLR) has been proposed as a bone loss index in postmenopausal women and as a marker of inflammation in coeliac patients. The aims of this work were to evaluate the effect of gluten-free diet (GFD) on NLR retrospectively and study the relationship between NLR and Mediterranean diet adherence and selected food groups (fruits, vegetables, red meat, potatoes, and unrefined and refined cereals). Adult individuals (), who had been on a strict GFD by at least 6 months, w...
Source
This website uses cookies.
We use cookies to improve your online experience. By continuing to use our website we assume you agree to the placement of these cookies.
To learn more, you can find in our Privacy Policy.