npj Parkinsons Dis: neutrophil to lymphocyte ratio predicting survival in multiple system atrophy

Multiple system atrophy (MSA) is a severe, progressive neurodegenerative disease clinically characterized by varying degrees of Parkinson's disease, cerebellar ataxia, autonomic dysfunction, and pyramidal function
.

According to the main symptoms, MSA can be divided into two subtypes: Parkinsonian (MSA-P) and cerebellar (MSA-C)

Multiple system atrophy (MSA) is a severe, progressive neurodegenerative disease clinically characterized by varying degrees of Parkinson's disease, cerebellar ataxia, autonomic dysfunction, and pyramidal function

There are currently no treatments that can alter disease progression in people with MSA

The pathological feature of MSA is abundant eosinophilic filamentous glial inclusions (GCIs), α-synuclein is the main component of GCIs, α-synucleinopathies are divided into MSA, Parkinson's disease (PD) and Dementia with Lewy bodies (DLB)

Figure 1 Title map of the paper

Figure 1 Title map of the paper

Furthermore, several hypotheses have been proposed regarding the pathogenesis of MSA
.

However, its pathogenic mechanism is not fully understood

Furthermore, several hypotheses have been proposed regarding the pathogenesis of MSA

Neuroinflammation mediated by astrocytes and microglia has been implicated in the pathophysiology of MSA

The neutrophil-to-lymphocyte ratio (NLR) in blood is an inexpensive, easy-to-apply marker that can indicate peripheral inflammation

NLR is a predictor of prognosis in cardiovascular disease, cerebrovascular disease, and amyotrophic lateral sclerosis (ALS)

To explore the prognostic significance of NLR in MSA, LingYu Zhangdg et al.

They recruited a total of 169 MSA patients and 163 matched healthy controls (HCs)

Kaplan-Meier survival analysis and Cox regression models were used to assess the effect of NLR on survival

Figure 2 Survival curves of three NLR groups

Figure 2 Survival curves of three NLR groups

In a multivariate Cox regression model, higher NLR increased the risk of death in MSA patients after adjusting for confounders (HR = 1.
922, P = 0.
035)
.

In a multivariate Cox regression model, higher NLR increased the risk of death in MSA patients after adjusting for confounders (HR = 1.
922, P = 0.
035)
.

Furthermore, higher NLR increased the risk of death in MSA dominated by cerebellar ataxia (MSA-C) (HR = 2.
398, P = 0.
033) and in males (HR = 3.
483, P = 0.
027)
.

The concordance index of the multivariate Cox regression model exceeded 0.
7 in both the primary cohort and the external validation cohort
.

Furthermore, higher NLR increased the risk of death in MSA dominated by cerebellar ataxia (MSA-C) (HR = 2.
398, P = 0.
033) and in males (HR = 3.
483, P = 0.
027)
.
The concordance index of the multivariate Cox regression model exceeded 0.
7 in both the primary cohort and the external validation cohort
.

MSA patients have higher NLR than HCs
.

MSA patients have higher NLR than HCs
.

CONCLUSIONS: High NLR increases the risk of death in MSA, especially in MSA-C and males
.

CONCLUSIONS: High NLR increases the risk of death in MSA, especially in MSA-C and males
.

Original source:
Zhang L, Cao B, Hou Y, et al.
High neutrophil-to-lymphocyte ratio predicts short survival in multiple system atrophy.
npj Parkinsons Dis.
2022;8(1):11.
doi:10.
1038/s41531-021 -00267-7

Original source:
Zhang L, Cao B, Hou Y, et al.
High neutrophil-to-lymphocyte ratio predicts short survival in multiple system atrophy.
npj Parkinsons Dis.
2022;8(1):11.
doi:10.
1038/s41531-021 -00267-7 High neutrophil-to-lymphocyte ratio predicts short survival in multiple system atrophy.
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