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. 2022 Sep 30;12(10):1399.
doi: 10.3390/biom12101399.

Peripheral Neutrophil-to-Lymphocyte Ratio in Bronchiectasis: A Marker of Disease Severity

Miguel Ángel Martinez-García  1   2 , Casilda Olveira  3 , Rosa Girón  4 , Marta García-Clemente  5 , Luis Máiz-Carro  6 , Oriol Sibila  2   7 , Rafael Golpe  8 , Raúl Méndez  1   2 , Juan Luis Rodríguez Hermosa  9 , Esther Barreiro  10 , Concepción Prados  11 , Juan Rodríguez López  12 , David de la Rosa  13
Affiliations

Peripheral Neutrophil-to-Lymphocyte Ratio in Bronchiectasis: A Marker of Disease Severity

Miguel Ángel Martinez-García et al. Biomolecules. .

Abstract

Most patients with bronchiectasis have a predominantly neutrophilic inflammatory profile, although other cells such as lymphocytes (as controllers of bronchial inflammation) and eosinophils also play a significant pathophysiological role. Easy-to-interpret blood biomarkers with a discriminative capacity for severity or prognosis are needed. The objective of this study was to assess whether the peripheral neutrophil-to-lymphocyte ratio (NLR) is associated with different outcomes of severity in bronchiectasis. A total of 1369 patients with bronchiectasis from the Spanish Registry of Bronchiectasis were included. To compare groups, the sample was divided into increasing quartiles of NLR ratio. Correlations between quantitative variables were established using Pearson's P test. A simple linear regression (with the value of exacerbations as a quantitative variable) was used to determine the independent relationship between the number and severity of exacerbations and the NLR ratio. The area under the curve (AUC)-ROC was used to determine the predictive capacity of the NLR for severe bronchiectasis, according to the different multidimensional scores. Mean age: 69 (15) years (66.3% of women). The mean NLR was 2.92 (2.03). A higher NLR was associated with more severe bronchiectasis (with an especially significant discriminative power for severe forms) according to the commonly used scores (FACED, E-FACED and BSI), as well as with poorer quality of life (SGRQ), more comorbidities (Charlson index), infection by pathogenic microorganisms, and greater application of treatment. Furthermore, the NLR correlated better with severity scores than other parameters of systemic inflammation. Finally, it was an independent predictor of the incident number and severity of exacerbations. In conclusion, the NLR is an inexpensive and easy-to-measure marker of systemic inflammation for determining severity and predicting exacerbations (especially the most severe) in patients with bronchiectasis.

Keywords: bronchiectasis; exacerbations; lymphocyte; neutrophil; severity.

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Conflict of interest statement

RM is the recipient of a Juan Rodés grant, supported by the Instituto de Salud Carlos III (ISCIII [JR21/00051]).

Figures

Figure 1
Figure 1
Correlations between different systemic inflammation markers (including the neutrophil-to-lymphocyte ratio) and severity scales in bronchiectasis. BSI: Bronchiectasis Severity Index, NLR: neutrophil-to-lymphocyte ratio; CRP. C-reactive protein.
Figure 2
Figure 2
Prognostic capacity of the neutrophil-to-lymphocyte ratio for severe bronchiectasis, according to the Bronchiectasis Severity Index (A), E-FACED (B) and FACED (C). BSI: Bronchiectasis Severity Index, NLR: neutrophil-to-lymphocyte ratio; AUC-ROC: area under curve-ROC.
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References

    1. Flume P.A., Chalmers J.D., Olivier K.N. Advances in bronchiectasis: Endotyping, genetics, microbiome, and disease heterogeneity. Lancet. 2018;392:880–890. doi: 10.1016/S0140-6736(18)31767-7. - DOI - PMC - PubMed
    1. Martinez-Garcia M.A., Perpina-Tordera M., Soler J.J., Román P., Lloris A., Gonzalez-Molina A. Dissociation of lung function, dyspnea ratings and pulmonary extension in bronchiectasis. Respir. Med. 2007;101:2248–2253. doi: 10.1016/j.rmed.2007.06.028. - DOI - PubMed
    1. Saleh A.D., Chalmers J.D., De Soyza A., Fardon T.C., Koustas S.O., Scott J., Simpson A.J., Brown J.S., Hurst J.R. The heterogeneity of systemic inflammation in bronchiectasis. Respir. Med. 2017;127:33–39. doi: 10.1016/j.rmed.2017.04.009. - DOI - PubMed
    1. Martinez-Garcia M.A., Vendrell M., Giron R.M., Maiz L., de la Rosa D., de Gracia J., Olveira C. The Multiple Faces of Non-Cystic Fibrosis Bronchiectasis A Cluster Analysis Approach. Annu. Am. Thorac. Soc. 2016;13:1468–1475. doi: 10.1513/AnnalsATS.201510-678OC. - DOI - PubMed
    1. Sibila O., Laserna E., Shoemark A., Perea L., Bilton D., Crichton M.L., De Soyza A., Boersma W.G., Altenburg J., Chalmers J.D. Heterogeneity of treatment response in bronchiectasis clinical trials. Eur. Respir. J. 2022;59:2100777. doi: 10.1183/13993003.00777-2021. - DOI - PubMed

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