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. 2024 Mar 26:15:1374365.
doi: 10.3389/fneur.2024.1374365. eCollection 2024.

The characteristic and prognostic role of blood inflammatory markers in patients with Huntington's disease from China

Jie-Qiang Xia #  1   2 , Yang-Fan Cheng #  1 , Si-Rui Zhang  1 , Yuan-Zheng Ma  1 , Jia-Jia Fu  1 , Tian-Mi Yang  1 , Ling-Yu Zhang  1 , Jean-Marc Burgunder  1   3 , Hui-Fang Shang  1
Affiliations

The characteristic and prognostic role of blood inflammatory markers in patients with Huntington's disease from China

Jie-Qiang Xia et al. Front Neurol. .

Abstract

Objectives: This study aims to elucidate the role of peripheral inflammation in Huntington's disease (HD) by examining the correlation of peripheral inflammatory markers with clinical manifestations and disease prognosis.

Methods: This investigation involved 92 HD patients and 92 matched healthy controls (HCs). We quantified various peripheral inflammatory markers and calculated their derived metrics including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammation index (SII). Clinical assessments spanning cognitive, motor, and disease severity were administered. Comparative analysis of inflammatory markers and clinical correlations between HD and controls was performed. Kaplan-Meier survival analysis and Cox regression model were used to assess the effect of inflammatory markers on survival.

Results: The study revealed that HD patients had significantly reduced lymphocyte counts, and LMR. Conversely, NLR, PLR, and SII were elevated compared to HCs. Lymphocyte levels inversely correlated with the age of onset and monocyte levels inversely correlated with the UHDRS-total functional capacity (TFC) scores. After adjusting for age, sex, and CAG repeat length, lymphocyte count, NLR, PLR, and SII were significantly correlated with the progression rate of TFC scores. Elevated levels of white blood cells and monocytes were associated with an increased risk of disability and mortality in the HD cohort.

Conclusion: Our findings indicate that HD patients display a distinct peripheral inflammatory profile with increased NLR, PLR, and SII levels compared to HCs. The peripheral inflammation appears to be linked with accelerated disease progression and decreased survival in HD.

Keywords: Huntington’s disease; biomarkers; peripheral inflammatory; prognosis; progression.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Inflammatory indicators in HD patients across sex and BMI groups. Male patients exhibited higher counts of RBCs, hemoglobin, WBCs, neutrophils, and monocytes compared to female patients (A–E). An elevated BMI was associated with increased WBC counts relative to patients with lower BMI (F). Specifically, *represents a p-value < 0.05; ** represents a p-value < 0.01; and **** represents a p-value < 0.0001.
Figure 2
Figure 2
Inflammatory indicators in HD patients across age of onset. Platelet levels were elevated in patients with onset <40 years of age compared to those between 40 and 50 years and those with onset >50 years (A). The level of monocytes in patients with onset <40 years and those aged 40–50 years were higher than in patients with onset >50 years (B). The NLR level of patients aged 40–50 years of onset was higher compared to that of patients younger than 40 (C). Specifically, * represents a p-value < 0.05; ** represents a p-value < 0.01.
Figure 3
Figure 3
Kaplan–Meier survival analysis of inflammatory profiles in HD patients. Variability in the duration of the loss-of-function state was significant across groups stratified by WBC counts (Breslow p = 0.010) (A). Distinct differences in the duration of the loss-of-function state were also observed among monocyte level groups (Breslow p = 0.043) (B).
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