THE USEFULNESS OF NEUTROPHIL-TO-LYMPHOCYTE RATIO FROM THE BRONCHOALVEOLAR LAVAGE (BNLR) IN THE ASSESSMENT OF PATIENTS WITH INTERSTITIAL LUNG DISEASE
Keywords:
NEUTROPHIL-TO-LYMPHOCITE RATIO, BRONHCOALEVOLAR LAVAGE, INTER-STITIAL LUNG DISEASEAbstract
The present study aims to evaluate the usefulness of neutrophil-to-lymphocyte ratio from the bronchoalveolar lavage (bNLR) in the assessment of local inflammatory status in patients with the stable interstitial lung disease by comparing a group of patients with IPF versus non-IPF patients. A secondary outcome was to see if we can identify values that differentiate idiopathic pulmonary fibrosis from another interstitial lung disease. Materials and methods: 42 patients with newly diagnosed ILD (24 with IPF and 18 non-IPF) were included; physical examination, high resolution CT, bronchoscopy with lavage, spirometry, DLCO and blood tests were performed in all patients. Results: We did not find any statistically significant difference between bNLR in the two groups IPF versus non IPF. bNLR were similar 2.73 + 1.14 in the non-IPF group and 2.98 ±1.72 in IPF patients, p=0.59. bNLR in patients with chronic stable newly diagnosed interstitial lung disease does not seem to bring any additional information. Conclusions: Assessment of local lung inflammation in BAL by the bNLR variable can provide minimal differential diagnostic information with higher values in IPF and HP.
References
2. Man MA, Rajnoveanu R-M, Motoc NS, et al. Neutrophil-to-lymphocyte ratio, platelets-to-lymphocyte ratio, and eosinophils correlation with high-resolution computer tomography severity score in COVID-19 patients. PLoS ONE 2021; 16(6): e0252599.
3. Ruta VM, Man Alexescu TG, et al. Neutrophil-to-Lymphocyte Ratio and Systemic Immune-Inflammation Index-Biomarkers in Interstitial Lung Disease. Medicina 2020; 56: 381.
4. Man MA, Davidescu I, Motoc NS, et al. Diagnostic Value of the Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) in Various Respiratory Diseases: A Retrospective Analysis. Diagnostics 2022; 12: 81.
5. Motoc NS, Martinovici P, Man MA, et al. Neutrophil-to-lymphocyte ratio (NLR) and Platelets-to-lymphocyte (PLR) Ratio in Patients with Exacerbation of Bronchiectasis. Rev Chim 2019; 70: 3889-3892.
6. Motoc NS, Man MA, Urda AEC, et al. Neutrophil-to-Lymphocyte Ratio and Platelets-to-Lymphocytes Ratio in severe COPD exacerbation: The importance of obstructive sleep apnea. Eur. Respir. J 2019: 54 / doi: 10.1183/13993003.congress-2019.PA2582
7. Paliogiannis P, Fois AG, Sotgia S, et al. The neutrophil-to-lymphocyte ratio as a marker of chronic obstructive pulmonary disease and its exacerbations: A systematic review and meta-analysis. European Journal of Clinical Investigation 2018; 48(8): e12984.
8. Sun W, Luo Z, Jin J, Cao Z, Ma Y. The Neutrophil/Lymphocyte Ratio Could Predict Noninvasive Mechanical Ventilation Failure in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Retrospective Observational Study. International Journal of Chronic Obstructive Pulmonary Disease 2021; 16: 2267-2277.
9. Teng F, Ye H, Xue T. Predictive value of neutrophil to lymphocyte ratio in patients with acute exacerbation of chronic obstructive pulmonary disease. Forget P, editor. PLOS ONE 2018; 13(9): e0204377.
10. Kono M, Miyashita K, Hirama R, et al. Prognostic significance of bronchoalveolar lavage cellular analysis in patients with acute exacerbation of interstitial lung disease. Respiratory Medicine 2021; 186: 106534.
11. Graham BL, Steenbruggen I, Miller ML, et al. Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement. Am J Respir Crit Care Med 2019; 200(8): e70-e88.
12. Graham BL, Brusasco V et al. Executive Summary: 2017 ERS/ATS standards for single-breath carbon monoxide uptake in the lung. Eur Respir J 2017; 49: 16E0016.
13. D’Alessandro M, Bergantini L, et al. Neutrophil-to-lymphocyte ratio in bronchoalveolar lavage from IPF patients: a novel prognostic biomarker? Minerva Medica 2020; 113(3): 526-531.
14. Chen Y, Cai J, Zhang M, Yan X. Prognostic Role of NLR, PLR and MHR in Patients with Idiopathic Pulmonary Fibrosis. Frontiers in Immunology 2022; 28: 13.
15. Naccache J-M, Gibiot Q, Monnet I, et al. Lung cancer and interstitial lung disease: a literature review. Journal of Thoracic Disease (Internet) 2018; 10(6): 3829-3844.
16. Bergantini L, d’Alessandro M, Cameli P, et al. Integrated approach to bronchoalveolar lavage cytology to distinguish interstitial lung diseases. European Journal of Internal Medicine 2021; 89: 76-80.
17. Salonen J, Lampela H, Keskitalo E, Vähänikkilä H, Purokivi M, Kaarteenaho R. Bronchoalveolar lavage differential cell count on prognostic assessment of patients with stable or acute interstitial lung disease: A retrospective real-life study. Clinical Immunology 2020; 220: 108594.
18. Barratt SL, Creamer AW, Adamali HI, et al. Use of peripheral neutrophil to lymphocyte ratio and peripheral monocyte levels to predict survival in fibrotic hypersensitivity pneumonitis (fHP): a multicenter retrospective cohort study. BMJ Open Respiratory Research 2021; 8(1): e001063.
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