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Published in: Neurological Sciences 3/2022

01-03-2022 | Alzheimer's Disease | Original Article

Investigation of the peripheral inflammation (neutrophil–lymphocyte ratio) in two neurodegenerative diseases of the central nervous system

Authors: Sonat Pınar Kara, Bengü Altunan, Aysun Unal

Published in: Neurological Sciences | Issue 3/2022

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Abstract

Introduction

Alzheimer’s disease (AD), and idiopathic Parkinson’s disease (IPD) are the neurodegenerative diseases of the central nervous system (CNS). Cognitive impairment is on the forefront in AD. However, IPD is a movement disorder. Inflammation was suggested to have an effect in the pathophysiology of these two diseases. Neutrophil–lymphocyte ratio (NLR) was shown to be a possible marker showing the peripheral inflammation. We aimed to investigate the NLR of patiens with the diagnosis of AD, and IPD, and individuals with no neurodegenerative disease.

Materials and methods

A total of 100 patients with the diagnosis of IPD, and 94 with diagnosis of AD, and 61 healthy controls were included into the study. All the demographic, clinical, and laboratory data were retrospectively obtained from the hospital automated database system.

Results

The NLR in the IPD group was found statistically significantly higher compared with the control group and the AD group (p < 0.001, p = 0.04, respectively). The age-adjusted values were statistically analyzed because of age difference. No statistically significant difference was detected between AD and control groups in terms of NLR (p = 0.6). The age-adjusted NLR value in the Parkinson’s group was found significantly higher compared to the control group (p = 0.02) and Alzheimer’s group (p = 0.03).

Discussion

Chronic inflammation has an important role in the emergence and progression of the chronic neurodegenerative diseases of the CNS. Our results show that the inflammation in the peripheral blood in IPD was more significant compared with the inflammation in AD.
Literature
2.
go back to reference Avila J, Lucas JJ, Perez M et al (2004) Role of tau protein in both physiological and pathological conditions. Physiol Rev 84:361–384PubMedCrossRef Avila J, Lucas JJ, Perez M et al (2004) Role of tau protein in both physiological and pathological conditions. Physiol Rev 84:361–384PubMedCrossRef
3.
go back to reference Alonso AC, Grundke-Iqbal I, Iqbal K (1996) Alzheimer’s disease hyperphosphorylated tau sequesters normal tau into tangles of filaments and disassembles microtubules. Nat Med 2:783–787PubMedCrossRef Alonso AC, Grundke-Iqbal I, Iqbal K (1996) Alzheimer’s disease hyperphosphorylated tau sequesters normal tau into tangles of filaments and disassembles microtubules. Nat Med 2:783–787PubMedCrossRef
4.
go back to reference Kinney JW, Bemiller SM, Murtishaw AS et al (2018) Inflammation as a central mechanism in Alzheimer’s disease. Alzheimers Dement (N Y) 4:575–590CrossRef Kinney JW, Bemiller SM, Murtishaw AS et al (2018) Inflammation as a central mechanism in Alzheimer’s disease. Alzheimers Dement (N Y) 4:575–590CrossRef
5.
go back to reference Wyss-Coray T, Mucke L (2002) Inflammation in neurodegenerative disease–a double-edged sword. Neuron 35:419–432PubMedCrossRef Wyss-Coray T, Mucke L (2002) Inflammation in neurodegenerative disease–a double-edged sword. Neuron 35:419–432PubMedCrossRef
6.
go back to reference Simard AR, Rivest S (2006) Neuroprotective properties of the innate immune system and bone marrow stem cells in Alzheimer’s disease. Mol Psychiatry 11:327–335PubMedCrossRef Simard AR, Rivest S (2006) Neuroprotective properties of the innate immune system and bone marrow stem cells in Alzheimer’s disease. Mol Psychiatry 11:327–335PubMedCrossRef
7.
go back to reference Stalder AK, Ermini F, Bondolfi L et al (2005) Invasion of hematopoietic cells into the brain of amyloid precursor protein transgenic mice. J Neurosci 25:11125–11132PubMedPubMedCentralCrossRef Stalder AK, Ermini F, Bondolfi L et al (2005) Invasion of hematopoietic cells into the brain of amyloid precursor protein transgenic mice. J Neurosci 25:11125–11132PubMedPubMedCentralCrossRef
8.
go back to reference Bradburn S, Murgatroyd C, Ray N (2019) Neuroinflammation in mild cognitive impairment and Alzheimer’s disease: a meta-analysis. Ageing Res Rev 50:1–8PubMedCrossRef Bradburn S, Murgatroyd C, Ray N (2019) Neuroinflammation in mild cognitive impairment and Alzheimer’s disease: a meta-analysis. Ageing Res Rev 50:1–8PubMedCrossRef
9.
go back to reference Sayed A, Bahbah EI, Kamel S et al (2020) The neutrophil-to-lymphocyte ratio in Alzheimer’s disease: current understanding and potential applications. J Neuroimmunol 349:577398PubMedCrossRef Sayed A, Bahbah EI, Kamel S et al (2020) The neutrophil-to-lymphocyte ratio in Alzheimer’s disease: current understanding and potential applications. J Neuroimmunol 349:577398PubMedCrossRef
10.
go back to reference Akıl E, Bulut A, Kaplan İ et al (2015) The increase of carcinoembryonic antigen (CEA), high-sensitivity C-reactive protein, and neutrophil/lymphocyte ratio in Parkinson’s disease. Neurol Sci 36:423–428PubMedCrossRef Akıl E, Bulut A, Kaplan İ et al (2015) The increase of carcinoembryonic antigen (CEA), high-sensitivity C-reactive protein, and neutrophil/lymphocyte ratio in Parkinson’s disease. Neurol Sci 36:423–428PubMedCrossRef
11.
go back to reference Alexander GE (2004) Biology of Parkinson’s disease: pathogenesis and pathophysiology of a multisystem neurodegenerative disorder. Dialogues Clin Neurosci 6:259–280PubMedPubMedCentralCrossRef Alexander GE (2004) Biology of Parkinson’s disease: pathogenesis and pathophysiology of a multisystem neurodegenerative disorder. Dialogues Clin Neurosci 6:259–280PubMedPubMedCentralCrossRef
12.
go back to reference Djaldetti R, Lev N, Melamed E (2009) Lesions outside the CNS in Parkinson’s disease. Mov Disord 24:793–800PubMedCrossRef Djaldetti R, Lev N, Melamed E (2009) Lesions outside the CNS in Parkinson’s disease. Mov Disord 24:793–800PubMedCrossRef
13.
go back to reference Hannoodee S, Nasuruddin DN (2020) Acute ınflammatory response. In: StatPearls [Internet] Treasure Island (FL): StatPearls Publishing Hannoodee S, Nasuruddin DN (2020) Acute ınflammatory response. In: StatPearls [Internet] Treasure Island (FL): StatPearls Publishing
14.
go back to reference Pahwa R, Goyal A, Bansal P, Jialal I (2020) Chronic inflammation. In: StatPearls [Internet] Treasure Island (FL): StatPearls Publishing Pahwa R, Goyal A, Bansal P, Jialal I (2020) Chronic inflammation. In: StatPearls [Internet] Treasure Island (FL): StatPearls Publishing
15.
go back to reference Petrone AB, Eisenman RD, Steele KN et al (2019) Temporal dynamics of peripheral neutrophil and lymphocytes following acute ischemic stroke. Neurol Sci 40:1877–1885PubMedPubMedCentralCrossRef Petrone AB, Eisenman RD, Steele KN et al (2019) Temporal dynamics of peripheral neutrophil and lymphocytes following acute ischemic stroke. Neurol Sci 40:1877–1885PubMedPubMedCentralCrossRef
16.
go back to reference Uçar CA, Çokal BG, Artık HAÜ et al (2017) Comparison of neutrophil-lymphocyte ratio (NLR) in Parkinson’s disease subtypes. Neurol Sci 38:287–293CrossRef Uçar CA, Çokal BG, Artık HAÜ et al (2017) Comparison of neutrophil-lymphocyte ratio (NLR) in Parkinson’s disease subtypes. Neurol Sci 38:287–293CrossRef
17.
go back to reference İmtiaz F, Shafique K, Mirza SS et al (2012) Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. IntArchMed 5:2 İmtiaz F, Shafique K, Mirza SS et al (2012) Neutrophil lymphocyte ratio as a measure of systemic inflammation in prevalent chronic diseases in Asian population. IntArchMed 5:2
18.
go back to reference McKhann GM, Knopman DS, Chertkow H et al (2011) The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 7:263–269PubMedPubMedCentralCrossRef McKhann GM, Knopman DS, Chertkow H et al (2011) The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 7:263–269PubMedPubMedCentralCrossRef
19.
go back to reference Morris JC (1993) The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology 43:2412–2414PubMedCrossRef Morris JC (1993) The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology 43:2412–2414PubMedCrossRef
20.
go back to reference Hughes AJ, Daniel SE, Kilford L et al (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 55:181–184PubMedPubMedCentralCrossRef Hughes AJ, Daniel SE, Kilford L et al (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 55:181–184PubMedPubMedCentralCrossRef
23.
go back to reference Rubio-Perez JM, Morillas-Ruiz JM (2012) A review: inflammatory process in Alzheimer’s disease, role of cytokines. Sci World J 2012:756357CrossRef Rubio-Perez JM, Morillas-Ruiz JM (2012) A review: inflammatory process in Alzheimer’s disease, role of cytokines. Sci World J 2012:756357CrossRef
25.
go back to reference Cappellano G, Carecchio M, Fleetwood T et al (2013) Immunity and inflammation in neurodegenerative diseases. Am J Neurodegener Dis 2:89–107PubMedPubMedCentral Cappellano G, Carecchio M, Fleetwood T et al (2013) Immunity and inflammation in neurodegenerative diseases. Am J Neurodegener Dis 2:89–107PubMedPubMedCentral
27.
28.
go back to reference Ferretti MT, Cuello AC (2011) Does a pro-inflammatory process precede Alzheimer’s disease and mild cognitive impairment? Curr Alzheimer Res 8:164–174PubMedCrossRef Ferretti MT, Cuello AC (2011) Does a pro-inflammatory process precede Alzheimer’s disease and mild cognitive impairment? Curr Alzheimer Res 8:164–174PubMedCrossRef
29.
go back to reference Strang F, Scheichl A, Chen YC et al (2012) Amyloid plaques dissociate pentameric to monomeric C-reactive protein: a novel pathomechanism driving cortical inflammation in Alzheimer’s disease? Brain Pathol 22:337–346PubMedCrossRef Strang F, Scheichl A, Chen YC et al (2012) Amyloid plaques dissociate pentameric to monomeric C-reactive protein: a novel pathomechanism driving cortical inflammation in Alzheimer’s disease? Brain Pathol 22:337–346PubMedCrossRef
31.
go back to reference McColl BW, Rothwell NJ, Allan SM (2007) Systemic inflammatory stimulus potentiates the acute phase and CXC chemokine responses to experimental stroke and exacerbates brain damage via interleukin-1- and neutrophil-dependent mechanisms. J Neurosci 27:4403–4412PubMedPubMedCentralCrossRef McColl BW, Rothwell NJ, Allan SM (2007) Systemic inflammatory stimulus potentiates the acute phase and CXC chemokine responses to experimental stroke and exacerbates brain damage via interleukin-1- and neutrophil-dependent mechanisms. J Neurosci 27:4403–4412PubMedPubMedCentralCrossRef
32.
go back to reference Heppner F, Ransohoff R, Becher B (2015) Immune attack: the role of inflammation in Alzheimer disease. Nat Rev Neurosci 16:358–372PubMedCrossRef Heppner F, Ransohoff R, Becher B (2015) Immune attack: the role of inflammation in Alzheimer disease. Nat Rev Neurosci 16:358–372PubMedCrossRef
33.
go back to reference Zotova E, Nicoll JA, Kalaria R, Holmes C et al (2010) Inflammation in Alzheimer’s disease: relevance to pathogenesis and therapy. Alzheimers Res Ther 2:1PubMedPubMedCentralCrossRef Zotova E, Nicoll JA, Kalaria R, Holmes C et al (2010) Inflammation in Alzheimer’s disease: relevance to pathogenesis and therapy. Alzheimers Res Ther 2:1PubMedPubMedCentralCrossRef
34.
go back to reference Sultana R, Baglioni M, Cecchetti R et al (2013) Lymphocyte mitochondria: toward identification of peripheral biomarkers in the progression of Alzheimer disease. Free Radic Biol Med 65:595–606PubMedCrossRef Sultana R, Baglioni M, Cecchetti R et al (2013) Lymphocyte mitochondria: toward identification of peripheral biomarkers in the progression of Alzheimer disease. Free Radic Biol Med 65:595–606PubMedCrossRef
36.
go back to reference Llanos-Gonzalez E, Henares-Chavarino AA, Pedrero-Prieto CM et al (2019) Interplay between mitochondrial oxidative disorders and proteostasis in Alzheimer’s disease. Front Neurosci 13:1444PubMedCrossRef Llanos-Gonzalez E, Henares-Chavarino AA, Pedrero-Prieto CM et al (2019) Interplay between mitochondrial oxidative disorders and proteostasis in Alzheimer’s disease. Front Neurosci 13:1444PubMedCrossRef
37.
go back to reference Miller VM, Lawrence DA, Mondal TK et al (2009) Reduced glutathione is highly expressed in white matter and neurons in the unperturbed mouse brain—implications for oxidative stress associated with neurodegeneration. Brain Res 1276:22–30PubMedPubMedCentralCrossRef Miller VM, Lawrence DA, Mondal TK et al (2009) Reduced glutathione is highly expressed in white matter and neurons in the unperturbed mouse brain—implications for oxidative stress associated with neurodegeneration. Brain Res 1276:22–30PubMedPubMedCentralCrossRef
38.
go back to reference Wilkinson BL, Landreth GE (2006) The microglial NADPH oxidase complex as a source of oxidative stress in Alzheimer’s disease. J Neuroinflammation 3:30PubMedPubMedCentralCrossRef Wilkinson BL, Landreth GE (2006) The microglial NADPH oxidase complex as a source of oxidative stress in Alzheimer’s disease. J Neuroinflammation 3:30PubMedPubMedCentralCrossRef
39.
go back to reference Kuyumcu ME, Yesil Y, Oztürk ZA et al (2012) The evaluation of neutrophil-lymphocyte ratio in Alzheimer’s disease. Dement Geriatr Cogn Disord 34:69–74PubMedCrossRef Kuyumcu ME, Yesil Y, Oztürk ZA et al (2012) The evaluation of neutrophil-lymphocyte ratio in Alzheimer’s disease. Dement Geriatr Cogn Disord 34:69–74PubMedCrossRef
40.
go back to reference Shad KF, Aghazadeh Y, Ahmad S et al (2013) Peripheral markers of Alzheimer’s disease: surveillance of white blood cells. Synapse 67:541–543PubMedCrossRef Shad KF, Aghazadeh Y, Ahmad S et al (2013) Peripheral markers of Alzheimer’s disease: surveillance of white blood cells. Synapse 67:541–543PubMedCrossRef
41.
go back to reference Rembach A, Watt AD, Wilson WJ et al (2014) An increased neutrophil-lymphocyte ratio in Alzheimer’s disease is a function of age and is weakly correlated with neocortical amyloid accumulation. J Neuroimmunol 273:65–71PubMedCrossRef Rembach A, Watt AD, Wilson WJ et al (2014) An increased neutrophil-lymphocyte ratio in Alzheimer’s disease is a function of age and is weakly correlated with neocortical amyloid accumulation. J Neuroimmunol 273:65–71PubMedCrossRef
43.
44.
45.
go back to reference Liu B, Gao HM, Hong JS (2003) Parkinson’s disease and exposure to ınfectious agents and pesticides and the occurrence of brain ınjuries: role of neuroinflammation. Environ Health Perspect 111:1065–1073PubMedPubMedCentralCrossRef Liu B, Gao HM, Hong JS (2003) Parkinson’s disease and exposure to ınfectious agents and pesticides and the occurrence of brain ınjuries: role of neuroinflammation. Environ Health Perspect 111:1065–1073PubMedPubMedCentralCrossRef
46.
go back to reference Martin-Bastida A, Tilley BS, Bansal S et al (2021) Iron and inflammation: in vivo and post-mortem studies in Parkinson’s disease. J Neural Transm 128:15–25PubMedCrossRef Martin-Bastida A, Tilley BS, Bansal S et al (2021) Iron and inflammation: in vivo and post-mortem studies in Parkinson’s disease. J Neural Transm 128:15–25PubMedCrossRef
47.
go back to reference Ramsey CP, Tansey MG (2014) A survey from 2012 of evidence for the role of neuroinflammation in neurotoxin animal models of Parkinson’s disease and potential molecular targets. Exp Neurol 256:126–132PubMedCrossRef Ramsey CP, Tansey MG (2014) A survey from 2012 of evidence for the role of neuroinflammation in neurotoxin animal models of Parkinson’s disease and potential molecular targets. Exp Neurol 256:126–132PubMedCrossRef
48.
go back to reference Collins LM, Toulouse A, Connor TJ et al (2012) Contributions of central and systemic inflammation to the pathophysiology of Parkinson’s disease. Neuropharmacology 62:2154–2168PubMedCrossRef Collins LM, Toulouse A, Connor TJ et al (2012) Contributions of central and systemic inflammation to the pathophysiology of Parkinson’s disease. Neuropharmacology 62:2154–2168PubMedCrossRef
49.
go back to reference Herrera A, Muñoz P, Steinbusch H et al (2017) Are dopamine oxidation metabolites involved in the loss of dopaminergic neurons in the nigrostriatal system in Parkinson’s disease? ACS Chem Neurosci 8:702–711PubMedCrossRef Herrera A, Muñoz P, Steinbusch H et al (2017) Are dopamine oxidation metabolites involved in the loss of dopaminergic neurons in the nigrostriatal system in Parkinson’s disease? ACS Chem Neurosci 8:702–711PubMedCrossRef
50.
go back to reference Lotharius J, Brundin P (2002) Pathogenesis of Parkinson’s disease: dopamine, vesicles and alpha-synuclein. Nat Rev Neurosci 3:932–942PubMedCrossRef Lotharius J, Brundin P (2002) Pathogenesis of Parkinson’s disease: dopamine, vesicles and alpha-synuclein. Nat Rev Neurosci 3:932–942PubMedCrossRef
51.
go back to reference Song IU, Kim YD, Cho HJ (2013) Is neuroinflammation involved in the development of dementia in patients with Parkinson’s disease? Intern Med 52:1787–1792PubMedCrossRef Song IU, Kim YD, Cho HJ (2013) Is neuroinflammation involved in the development of dementia in patients with Parkinson’s disease? Intern Med 52:1787–1792PubMedCrossRef
52.
go back to reference Singh A, Tripathi P, Singh S (2021) Neuroinflammatory responses in Parkinson’s disease: relevance of Ibuprofen in therapeutics. Inflammopharmacology 29:5–14PubMedCrossRef Singh A, Tripathi P, Singh S (2021) Neuroinflammatory responses in Parkinson’s disease: relevance of Ibuprofen in therapeutics. Inflammopharmacology 29:5–14PubMedCrossRef
53.
54.
go back to reference Solmaz V, Pekdaş EG, Aksoy D et al (2018) Serum neutrophil-lymphocyte ratios, C-reactive protein and sedimentation levels in Parkinson’s disease. Cukurova Med J 43:305–311CrossRef Solmaz V, Pekdaş EG, Aksoy D et al (2018) Serum neutrophil-lymphocyte ratios, C-reactive protein and sedimentation levels in Parkinson’s disease. Cukurova Med J 43:305–311CrossRef
55.
go back to reference Jin H, Gu HY, Mao CJ et al (2020) Association of inflammatory factors and aging in Parkinson’s disease. Neurosci Lett 736:135259PubMedCrossRef Jin H, Gu HY, Mao CJ et al (2020) Association of inflammatory factors and aging in Parkinson’s disease. Neurosci Lett 736:135259PubMedCrossRef
56.
go back to reference Moghaddam HS, Sherbaf FG, Zadeh MM et al (2018) Association between peripheral inflammation and DATSCAN data of the striatal nuclei in different motor subtypes of Parkinson disease. Front Neurol 9:234CrossRef Moghaddam HS, Sherbaf FG, Zadeh MM et al (2018) Association between peripheral inflammation and DATSCAN data of the striatal nuclei in different motor subtypes of Parkinson disease. Front Neurol 9:234CrossRef
57.
go back to reference Karuppagounder SS, Madathil SK, Pandey M et al (2013) Quercetin up-regulates mitochondrial complex-I activity to protect against programmed cell death in rotenone model of Parkinson’s disease in rats. Neuroscience 236:136–148PubMedCrossRef Karuppagounder SS, Madathil SK, Pandey M et al (2013) Quercetin up-regulates mitochondrial complex-I activity to protect against programmed cell death in rotenone model of Parkinson’s disease in rats. Neuroscience 236:136–148PubMedCrossRef
58.
go back to reference Ahn TB, Jeon BS (2015) The role of quercetin on the survival of neuron-like PC12 cells and the expression of α-synuclein. Neural Regen Res 10:1113–1119PubMedPubMedCentralCrossRef Ahn TB, Jeon BS (2015) The role of quercetin on the survival of neuron-like PC12 cells and the expression of α-synuclein. Neural Regen Res 10:1113–1119PubMedPubMedCentralCrossRef
59.
go back to reference Wang J, Song Y, Chen Z et al (2018) Connection between systemic ınflammation and neuroinflammation underlies neuroprotective mechanism of several phytochemicals in neurodegenerative diseases. Oxid Med Cell Longev 2018:1972714PubMedPubMedCentralCrossRef Wang J, Song Y, Chen Z et al (2018) Connection between systemic ınflammation and neuroinflammation underlies neuroprotective mechanism of several phytochemicals in neurodegenerative diseases. Oxid Med Cell Longev 2018:1972714PubMedPubMedCentralCrossRef
60.
go back to reference Parlar A, Annac E, Arslan SO et al (2021) Pretreatment with glabridin prevents carrageenan-ınduced ınflammation: the roles for cytokines and oxidative stress production. Farmacia 69:135–141CrossRef Parlar A, Annac E, Arslan SO et al (2021) Pretreatment with glabridin prevents carrageenan-ınduced ınflammation: the roles for cytokines and oxidative stress production. Farmacia 69:135–141CrossRef
61.
go back to reference Mandegary A, Saeedi A, Eftekhari A et al (2013) Hepatoprotective effect of silyamarin in individuals chronically exposed to hydrogen sulfide; modulating influence of TNF-α cytokine genetic polymorphism. Daru 21:28PubMedPubMedCentralCrossRef Mandegary A, Saeedi A, Eftekhari A et al (2013) Hepatoprotective effect of silyamarin in individuals chronically exposed to hydrogen sulfide; modulating influence of TNF-α cytokine genetic polymorphism. Daru 21:28PubMedPubMedCentralCrossRef
Metadata
Title
Investigation of the peripheral inflammation (neutrophil–lymphocyte ratio) in two neurodegenerative diseases of the central nervous system
Authors
Sonat Pınar Kara
Bengü Altunan
Aysun Unal
Publication date
01-03-2022
Publisher
Springer International Publishing
Published in
Neurological Sciences / Issue 3/2022
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-021-05507-5

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