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Kastamonu Medical Journal

Kastamonu Medical Journal regularly publishes internationally qualified issues in the field of Medicine in the light of up-to-date information.

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Original Article
Evaluation of hematological markers and disease activity in relapsing-remitting multiple sclerosis
Abstract
Aims: Multiple sclerosis (MS) is an immune-mediated chronic disease of the central nervous system that causes demyelination and neuroaxonal damage. Systemic inflammation is thought to cause chronic neurodegeneration. It plays an essential role in the pathogenesis of MS. This study aims to compare the inflammatory parameters such as neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio, platelet-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII) and systemic inflammatory response index (SIRI) in relapsing-remitting multiple sclerosis (RRMS) patients during relapse and remission periods with the healthy control group and to investigate the relationship between these parameters and disease activity in MS patients.
Methods: This study involved one hundred four patients between the ages of 18 and 47 who applied to Kastamonu Training and Research Hospital with an MS attack and were diagnosed with RRMS according to the 2017 McDonald criteria were included in the study. The patients’ hemogram results were compared in the relapse and remission periods. In addition, the hemogram results in the relapse and remission periods were compared with the hemogram results of the healthy control group.
Results: A total of 104 MS patients and 64 healthy controls were included in the study. 70 (67%) of MS patients were female, and 24 (33%) were male. The average disease duration of the patients was calculated as 4.7±3.7, and the average Expanded Disability Status Scale score was 2.17. NLR, PLR, SIRI, and SII were significantly higher during the attack period compared to the healthy group. Also, NLR, PLR, SII, and SIRI were significantly higher in the remission period compared to the healthy control group. However, there was no significant difference in NLR, PLR, SII, and SIRI levels in MS patients between the attack and remission phases.
Conclusion: Elevated inflammatory markers in MS patients compared to healthy controls suggest inflammation’s role in the disease. Notably, similar levels during relapse and remission periods may indicate possible chronic inflammation. Larger prospective studies are needed to confirm these findings.

Keywords : Multiple sclerosis, inflammation, NLR, SII, SIRI

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1. Olsson A, Gustavsen S, Gisselø Lauridsen K, et al. Neutrophil-to-lymphocyte ratio and CRP as biomarkers in multiple sclerosis: a systematic review. Acta Neurol Scand. 2021;143(6):577-586.
2. Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17(2):162-173.
3. Fahmi RM, Ramadan BM, Salah H, Elsaid AF, Shehta N. Neutrophil-lymphocyte ratio as a marker for disability and activity in multiple sclerosis. Mult Scler Relat Disord. 2021;51:102921.
4. Yang J, Hamade M, Wu Q, et al. Current and future biomarkers in multiple sclerosis. Int J Mol Sci. 2022;23(11):5877.
5. Hemond CC, Glanz BI, Bakshi R, Chitnis T, Healy BC. The neutrophilto-lymphocyte and monocyte-to-lymphocyte ratios are independently associated with neurological disability and brain atrophy in multiple sclerosis. BMC Neurol. 2019;19:23.
6. Mouchli M, Reddy S, Gerrard M, Boardman L, Rubio M. Usefulness of neutrophil-to-lymphocyte ratio (NLR) as a prognostic predictor after treatment of hepatocellular carcinoma. Review article. Ann Hepatol. 2021; 22:100249.
7. Wang L, Wang C, Jia X, Yang M, Yu J. Relationship between neutrophil-to-lymphocyte ratio and systemic lupus erythematosus: a meta-analysis. Clinics (Sao Paulo). 2020;75:e1450.
8. Dziedzic A, Bijak M. Interactions between platelets and leukocytes in pathogenesis of multiple sclerosis. Adv Clin Exp Med. 2019;28:277-285.
9. Gokce SF, Bolayır A, Cigdem B, Yildiz B. The role of systemic immune inflammatory ındex in showing active lesion ın patients with multiple sclerosis : SII and other inflamatuar biomarker in radiological active multiple sclerosis patients. BMC Neurol. 2023;23(1):64.
10. Saçmacı H, Aktürk T, Tanık N. The predictive value of the systemic immune-inflammation index as a new prognostic marker for disability in patients with multiple sclerosis. Turk J Neurol. 2021;27(2):133-139.
11. Lin KB, Fan FH, Cai MQ, et al. Systemic immune inflammation index and system inflammation response index are potential biomarkers of atrial fibrillation among the patients presenting with ischemic stroke. Eur J Med Res. 2022;27(1):106.
12. Kocaturk I, Gokmuharremmoglu OO. A comprehensive look at inflammation in RLS: assessing NLR, MLR, PLR, SII, SIRI, and microR. JHSM. 2024;7(2):219-223.
13. Petrone AB, Eisenman RD, Steele KN, Mosmiller LT, Urhie O, Zdilla MJ. Temporal dynamics of peripheral neutrophil and lymphocytes following acute ischemic stroke. Neurol Sci. 2019;40(9):1877-1885.
14. Sayed A, Bahbah EI, Kamel S, Barreto GE, Ashraf GM, Elfil M. The neutrophil-to-lymphocyte ratio in Alzheimer’s disease: current understanding and potential applications. J Neuroimmunol. 2020;349: 577398.
15. Demirci S, Demirci S, Kutluhan S, Koyuncuoglu HR, Yurekli VA. The clinical significance of the neutrophil-to-lymphocyte ratio in multiple sclerosis. Int J Neurosci. 2016;126(8):700-706.
16. Hasselbalch IC, Søndergaard HB, Koch-Henriksen N, et al. The neutrophil-to-lymphocyte ratio is associated with multiple sclerosis. Mult Scler J Exp Transl Clin. 2018;4(4):2055217318813183.
17. D’Amico E, Zanghì A, Romano A, Sciandra M, Palumbo GAM, Patti F. The neutrophil-to-lymphocyte ratio is related to disease activity in relapsing remitting multiple sclerosis. Cells. 2019;8(10):1114.
18. Guzel I, Mungan S, Oztekin ZN, Ak F. Is there an association between the Expanded Disability Status Scale and inflammatory markers in multiple sclerosis?. J Chin Med Assoc. 2016;79(2):54-57.
19. Yetkin MF, Mirza M. Neutrophil to-lymphocyte ratio as a possible predictor of prognosis in recently diagnosed multiple sclerosis patients. J Neuroimmunol. 2020;346:577307.
20. Gelibter S, Pisa M, Croese T, et al. Neutrophil-to-lymphocyte ratio: a marker of neuro-inflammation in multiple sclerosis?. J Neurol. 2021; 268(2):717-723.
21. Haase S, Linker RA. Inflammation in multiple sclerosis. Ther Adv Neurol Disord. 2021;14:17562864211007687.
22. Sharma D, Bhaskar SMM. Prognostic role of the platelet-lymphocyte ratio in acute ischemic stroke patients undergoing reperfusion therapy: a meta-analysis. J Cent Nerv Syst Dis. 2022;14:11795735221110373.
23. Tak AZA, Şengül Y. Evaluation of ınflammation with neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in restless legs syndrome. Turk J Neurol. 2018;24:259-263.
24. Fathy SE, Abdallah AM, Helal RY. Neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as predictors of MS severity: a retrospective cohort study. Egyptian J Neurol Psychiatry Neurosurg. 2024;60(1):40.
25. Saçmaci H, Akturk T, Tanık N. The predictive value of the systemic immune-inflammation index as a new prognostic marker for disability in patients with multiple sclerosis. Turk J Neurol. 2021;27:133-139.
26. Huang YW, Yin XS, Li ZP. Association of the systemic immune-inflammation index (SII) and clinical outcomes in patients with stroke: a systematic review and meta-analysis. Front Immunol. 2022;13:1090305.
27. Weng Y, Zeng T, Huang H, et al. Systemic immune-inflammation index predicts 3-month functional outcome in acute ischemic stroke patients treated with intravenous thrombolysis. Clin Interv Aging. 2021;16:877-886.
28. Trifan G, Testai FD. Systemic immune-inflammation (SII) index predicts poor outcome after spontaneous supratentorial intracerebral hemorrhage. J Stroke Cerebrovasc Dis. 2020;29(9):105057.
29. Vural N, Duyan M, Saridas A, Ertas E, Kalkan A. The predictive value of inflammatory biomarkers in the detection of multiple sclerosis attacks. Emergency Care J. 2023;19(2).
30. Bunul SD, Alagoz AN, Piri Cinar B, Bunul F, Erdogan S, Efendi H. A preliminary study on the meaning of inflammatory indexes in MS: a neda-based approach. J Pers Med. 2023;13(11):1537.
31. Rodríguez Murúa S, Farez MF, Quintana FJ. The immune response in multiple sclerosis. Annu Rev Pathol. 2022;17:121-139.
32. Han J, Yang L, Lou Z, Zhu Y. Association between systemic immune-inflammation index and systemic inflammation response index and outcomes of acute ischemic stroke: a systematic review and meta-analysis. Ann Indian Acad Neurol. 2023;26(5):655-662.
33. Li J, Yuan Y, Liao X, Yu Z, Li H, Zheng J. Prognostic significance of admission systemic inflammation response index in patients with spontaneous intracerebral hemorrhage: a propensity score matching analysis. Front Neurol. 2021;12:718032.
Article available in :
Volume 4, Issue 3, 2024
Page : 119-123
https://doi.org/10.51271/KMJ-0156
Article Information
Received : 13 Tem 2024
Accepted : 06 Ağu 2024
Published : 01 Eyl 2024
Corresponding Author :

İdris Kocatürk: Department of Neurology, Faculty of Medicine, Kastamonu University, Kastamonu, Turkiye

[email protected]
Citation : Kocatürk İ, Bildirici MA. Evaluation of hematological markers and disease activity in relapsing-remitting multiple sclerosis. Kastamonu Med J. 2024;4(3):119-123.

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