Could a simple biomarker as neutrophil-to-lymphocyte ratio reflect complex processes orchestrated by neutrophils?

IF 4.7 Q2 IMMUNOLOGY Journal of Translational Autoimmunity Pub Date : 2023-01-01 DOI:10.1016/j.jtauto.2022.100159
María Kourilovitch, Claudio Galarza–Maldonado
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引用次数: 6

Abstract

The complex pathological mechanisms of autoimmune diseases have now been discovered and described, including interactions between innate and adaptive immunity, the principal cells of which are neutrophils and lymphocytes. Neutrophil-to–lymphocyte ratio (NLR) was proposed as a biomarker for inflammation that reflects the balance between these aspects of the immune system. NLR is widely studied as a prognostic or screening parameter in quantity diseases with important inflammatory components such as malignancies, trauma, sepsis, critical care pathology, etc. Although there are still no consensually accepted normal values for this parameter, there is a proposal to consider an interval of 1–2 as a normal value, an interval of 2–3 as a grey area indicating subclinical inflammation and values above 3 as inflammation.

On the other hand, several studies have been published indicating that a particular morphological type of neutrophils, low-density neutrophils (LDNs), play a pathological role in autoimmune diseases. Probably, the LDNs detected in patients with different autoimmune diseases, mostly than normal density neutrophils, are involved in the suppression of lymphocytes through different pathways: inducing of lymphopenia through neutrophil depending overproduction of type I interferon (IFN)-α/β and direct suppression by a hydrogen-peroxide-dependent mechanism. Their functional features involvement in IFN production is of particular interest. IFN is one of the critical cytokines in the pathogenesis of many autoimmune diseases, primarily systemic lupus erythematosus (SLE). An interesting and important feature of IFN involvement in the pathogenesis of SLE is not only to be directly related to lymphopenia but also its role in the inhibition of the production of C-reactive protein (CRP) by hepatocytes. The CRP is the primary acute phase reactant, which in SLE often does not correlate with the extent of inflammation. NLR in such a case can be an important biomarker of inflammation. The study of NLR as a biomarker of inflammation also deserves attention in other diseases with established interferon pathways, as well as in hepatopathies, when CRP does not reflect the proper inflammation activity. Also, it may be interesting to study its role as a predictor of relapses in autoimmune diseases.

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中性粒细胞与淋巴细胞比率这样一个简单的生物标志物能否反映由中性粒细胞策划的复杂过程?
自身免疫性疾病的复杂病理机制现已被发现和描述,包括先天免疫和适应性免疫之间的相互作用,其主要细胞是中性粒细胞和淋巴细胞。中性粒细胞与淋巴细胞比率(NLR)被认为是炎症的生物标志物,反映了免疫系统这些方面之间的平衡。NLR在恶性肿瘤、创伤、败血症、重症病理等具有重要炎症成分的疾病中作为预后或筛查参数被广泛研究。尽管对于该参数仍没有共识接受的正常值,但有人建议将1-2区间视为正常值,2-3区间为灰色区域,表明亚临床炎症,3以上的值为炎症。另一方面,一些已发表的研究表明,中性粒细胞的一种特殊形态类型,低密度中性粒细胞(ldn),在自身免疫性疾病中起病理作用。可能,在不同自身免疫性疾病患者中检测到的ldn,大多比正常密度的中性粒细胞,通过不同的途径参与淋巴细胞的抑制:通过中性粒细胞依赖I型干扰素(IFN)-α/β的过量产生诱导淋巴细胞减少,以及通过过氧化氢依赖机制直接抑制。它们的功能特征与干扰素产生的关系特别令人感兴趣。IFN是许多自身免疫性疾病发病机制中的关键细胞因子之一,主要是系统性红斑狼疮(SLE)。IFN参与SLE发病机制的一个有趣而重要的特征是,它不仅与淋巴细胞减少症直接相关,而且还能抑制肝细胞产生c反应蛋白(CRP)。CRP是主要的急性期反应物,在SLE中通常与炎症程度无关。在这种情况下,NLR可能是炎症的重要生物标志物。NLR作为炎症的生物标志物的研究也值得关注在其他有干扰素通路的疾病中,以及在CRP不能正确反映炎症活性的肝病中。此外,研究其作为自身免疫性疾病复发预测因子的作用可能会很有趣。
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来源期刊
Journal of Translational Autoimmunity
Journal of Translational Autoimmunity Medicine-Immunology and Allergy
CiteScore
7.80
自引率
2.60%
发文量
33
审稿时长
55 days
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