A Case-Control Study of Neutrophil-Lymphocyte Ratio as a Biomarker of Inflammation in Adults with Epilepsy
DOI:
https://doi.org/10.30442/ahr.0902-04-197Abstract
Background: There is growing evidence that inflammation plays a specific role in the pathogenesis of epilepsy and seizures also induce inflammation. The Neutrophil/Lymphocyte ratio (NLR) is an emerging inflammatory biomarker of epilepsy.
Objectives: To determine the association between epilepsy and Neutrophil /Lymphocyte Ratio among adults.
Methods: Adults with epilepsies the attending outpatient neurology clinics at two Nigerian tertiary health facilities, were recruited. One hundred cases and one hundred age-matched, healthy controls were recruited. The total white blood cell (WBC) and its differential counts were extracted from Full Blood Count (FBC) results and NLR was calculated. The predictors of the association between WBC parameters and epilepsy were established using a linear regression model derived from WBC parameters associated with epilepsy.
Results: Out of 100 cases and controls, there was no gender-related statistical difference between the cases and controls (p = 0.777). There was no difference between the mean ages of cases and control (p = 0.058). The total mean white blood cell count among the cases was 8.80±9.84×109 cells/L compared to was 6.30±1.90 ×109 cells/L in the controls, (p = 0.013). The mean neutrophil count in the cases was 59.00±17.89 ×109 cells/L compared to 49.50±15.44 ×109 cells/L among the controls (p < 0.001). The mean NLR for the cases was 4.24±10.44 compared to 1.84±2.26 in the controls (p = 0.026). The Neutrophil/Lymphocyte Ratio (p = 0.013) and Basophil (p < 0.001) predicted epilepsy on linear regression analysis.
Conclusion: This study shows a clear difference in the TWBC and NLR with between adults with epilepsies and health controls.
References
Adeloye D. An estimate of the incidence and prevalence of stroke in Africa: a systematic review and meta-analysis. PLoS One 2014;9:e100724. https://doi.org/10.1371/journal.pone.0100724
Hosseini S, Mofrad AME, Mokarian P, Nourigheimasi S, Azarhomayoun A, Khanzadeh S, et al. Neutrophil to Lymphocyte Ratio in Epilepsy: A Systematic Review. Mediators Inflamm 2022;2022:4973996. https://doi.org/10.1155/2022/4973996.
Webster KM, Sun M, Crack P, O’Brien TJ, Shultz SR, Semple BD. Inflammation in epileptogenesis after traumatic brain injury. J Neuroinflammation 2017;14:10. https://doi.org/10.1186/s12974-016-0786-1
Zahorec R. Neutrophil-to-lymphocyte ratio, past, present and future perspectives. Bratisl Lek Listy 2021;122:474–88. https://doi.org/10.4149/BLL_2021_078
Zhang R, Wu X, Hu W, Zhao L, Zhao S, Zhang J, et al. Neutrophil-to-lymphocyte ratio predicts hemorrhagic transformation in ischemic stroke: A meta-analysis. Brain Behav 2019;9:e01382. https://doi.org/10.1002/brb3.1382
Clossen BL, Reddy DS. Novel therapeutic approaches for disease-modification of epileptogenesis for curing epilepsy. Biochim Biophys Acta Mol Basis Dis 2017;1863:1519–38. https://doi.org/10.1016/j.bbadis.2017.02.003
Beniczky S, Hirsch LJ, Kaplan PW, Pressler R, Bauer G, Aurlien H, et al. Unified EEG terminology and criteria for nonconvulsive status epilepticus. Epilepsia 2013;54(Suppl 6):28–29. https://doi.org/10.1111/epi.12270
Bentes C, Martins H, Peralta AR, Morgado C, Casimiro C, Franco AC, et al. Early EEG predicts poststroke epilepsy. Epilepsia Open 2018;3:203–212. https://doi.org/10.1002/epi4.12103
Hirsch LJ, LaRoche SM, Gaspard N, Gerard E, Svoronos A, Herman ST, et al. American Clinical Neurophysiology Society’s Standardized Critical Care EEG Terminology: 2012 version. J Clin Neurophysiol 2013;30:1–27. https://doi.org/10.1097/WNP.0b013e3182784729
Löscher W, Brandt C. Prevention or modification of epileptogenesis after brain insults: experimental approaches and translational research. Pharmacol Rev 2010;62:668–700. https://doi.org/10.1124/pr.110.003046
Tanaka T, Ihara M. Post-stroke epilepsy. Neurochem Int 2017;107:219–228. https://doi.org/10.1016/j.neuint.2017.02.002
Morkavuk G, Koc G, Leventoglu A. Is the differential diagnosis of epilepsy and psychogenic nonepileptic seizures possible by assessing the neutrophil/lymphocyte ratio? Epilepsy Behav 2021;116:Article 107736. https://doi.org/10.1016/j.yebeh.2020.107736.
Özdemir HH., Akil E, Acar A, Tamam Y, Varol S, Cevik MU, et al. Changes in serum albumin levels and neutrophil–lymphocyte ratio in patients with convulsive status epilepticus. Int J Neurosci 2017;127:417–420. https://doi.org/10.1080/00207454.2016.1187606.
Güneş M., Büyükgöl H. Relationship between generalized epileptic seizure and neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and neutrophil mediated inflammation. Int J Neurosci 2020;130:1095–1100. https://doi.org/10.1080/00207454.2020.1722662.
Barnes SE, Zera KA, Ivison GT, Buckwalter MS, Engleman EG. Brain profiling in murine colitis and human epilepsy reveals neutrophils and TNFα as mediators of neuronal hyperexcitability. J Neuroinflamm 2021;18:1–3. https://doi.org/10.1186/s12974-021-02262-4.
Rana A, Musto AE. The role of inflammation in the development of epilepsy. J Neuroinflamm 2018;15:1–2. https://doi.org/10.1186/s12974-018-1192-7.
Mete Ural Ü, Şehitoğlu İ, Bayoğlu Tekin Y, Kir ŞF. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in patients with endometrial hyperplasia and endometrial cancer. J Obstet Gynaecol Res 2015;41:445–448. https://doi.org/10.1111/jog.12536.
Cedres S, Torrejon D, Martinez A, Martinez P, Navarro A, Zamora E, et al. Neutrophil to lymphocyte ratio (NLR) as an indicator of poor prognosis in stage IV non-small cell lung cancer. Clin Trans Oncol 2012;14:864–869. https://doi.org/10.1007/s12094-012-0872-5.
Mohseni-Moghaddam P, Roghani M, Khaleghzadeh-Ahangar H, Sadr SS, Sala C. A literature overview on epilepsy and inflammasome activation. Brain Res Bull 2021;172:229–235. https://doi.org/10.1016/j.brainresbull.2021.05.001.
Terrone G, Balosso S, Pauletti A, Ravizza T, Vezzani A. Inflammation and reactive oxygen species as disease modifiers in epilepsy. (In Eng). Neuropharmacol 2020;167.Article 107742. https://doi.org/10.1016/j.neuropharm.2019.107742.
Aslan A, Cevik E. Critical Analysis of Blood Parameters in Epilepsy Patients. Ann Clin Analytical Med 2020;11:193–196. https://doi.org/10.4328/ACAM.2023.
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Annals of Health Research
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The articles and other materials published in the Annals of Health Research are protected by the Nigerian Copyright laws. The journal owns the copyright over every article, scientific and intellectual materials published in it. However, the journal grants all authors, users and researchers access to the materials published in the journal with the permission to copy, use and distribute the materials contained therein only for academic, scientific and non-commercial purposes.
