https://doi.org/10.4081/monaldi.2023.2706
Monocyte related haematological indices in acute exacerbations of COPD – a new biomarker?
Submitted: July 8, 2023
Accepted: September 14, 2023
Published: September 25, 2023
Accepted: September 14, 2023
Abstract Views: 691
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
C-reactive protein (CRP) and leukocyte count are standard tools for recognising inflammation in COPD patients. This study aimed to find if there is a pattern in monocyte related haematological indices - monocyte to neutrophil ratio (MNR) and monocyte to lymphocyte ratio (MLR) - which could be helpful in differentiating COPD patients in need for hospitalization due to acute exacerbation of COPD or differentiating frequent COPD exacerbators from non-frequent COPD exacerbators. The study included 119 patients with COPD and 35 control subjects, recruited at the Clinic for Respiratory Diseases Jordanovac, University Hospital Centre Zagreb, Croatia. Complete blood count was performed on Sysmex XN-1000, CRP on Cobas c501, and Fbg on BCS XP analyser. Data were analysed with MedCalc statistical software. The COPD patients were divided into three groups – frequent exacerbators (FE), non-frequent exacerbators (NFE), patients hospitalized for acute COPD exacerbations (HAE) and the control group were healthy smokers (HS). A statistically significant difference was found in the values of MNR while comparing these groups of patients: FE vs HAE (p<0.000), NFE vs HAE (p<0.000) and HS vs HAE (p<0.001); and for the values of MLR: FE vs HAE (p<0.022), NFE vs HAE (p<0.000) and HS vs HAE (p<0.000). As MLR and MNR have shown the statistical difference comparing the group of HAE to NFE, FE and HS, MLR and MNR could be valuable and available markers of acute COPD exacerbations and need for hospitalization.
Global Strategy for the Diagnosis, Management and Prevention of COPD. Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2018. Available from: https://goldcopd.org/wp-content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdf
GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017;390:1151-10.
DOI: https://doi.org/10.1016/S0140-6736(17)32152-9
Global Health Epidemiology Reference Group (GHERG). Global and regional estimates of COPD prevalence: Systematic review and meta-analysis. J Glob Health 2015;5:020415.
Miravitlles M, Soler-Cataluña JJ, Calle M, et al. A new approach to grading and treating COPD based on clinical phenotypes: summary of the Spanish COPD guidelines (GesEPOC). Prim Care Respir J 2013;22:117-21.
DOI: https://doi.org/10.4104/pcrj.2013.00016
Halpin DM, Decramer M, Celli B, et al. Exacerbation frequency and course of COPD. Int J Chron Obstruct Pulmon Dis 2012;7:653-61.
DOI: https://doi.org/10.2147/COPD.S34186
Hurst JR, Vestbo J, Anzueto A, et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med 2010;363:1128-38.
DOI: https://doi.org/10.1056/NEJMoa0909883
Soler-Cataluña JJ, Martínez-García MA, Sánchez PR, et al. Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease. Thorax 2005;60:925-31.
DOI: https://doi.org/10.1136/thx.2005.040527
Connors AF, Dawson NV, Thomas C, et al. Outcomes following acute exacerbation of severe chronic obstructive lung disease. Am J Respir Crit Care Med 1996;154:959-67.
DOI: https://doi.org/10.1164/ajrccm.154.4.8887592
Seneff MG, Wagner DP, Wagner RP, et al. Hospital and 1-year survival of patients admitted to intensive care units with acute exacerbation of chronic obstructive pulmonary disease. JAMA 1995;274:1852-7.
DOI: https://doi.org/10.1001/jama.274.23.1852
Halpin DMG, Decramer M, Celli B, et al. Effect of a single exacerbation on decline in lung function in COPD. Res Med 2017;128:85-91.
DOI: https://doi.org/10.1016/j.rmed.2017.04.013
Thomsen M, Truls SI, Marott JL, et al. Inflammatory biomarkers and exacerbations in chronic obstructive pulmonary disease. JAMA 2013;309:2353-61.
DOI: https://doi.org/10.1001/jama.2013.5732
Zemans RL, Jacobson S, Keene J, et al. Multiple biomarkers predict disease severity, progression and mortality in COPD. Respir Res 2017;18:117.
DOI: https://doi.org/10.1186/s12931-017-0597-7
Huang Z, Fu Z, Huang W, et al. Prognostic value of neutrophil-to-lymphocyte ratio in sepsis: A meta-analysis. Am J Emerg Med 2020;38:641-7.
DOI: https://doi.org/10.1016/j.ajem.2019.10.023
Templeton AJ, McNamara MG, Šeruga B, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst 2014;106:dju124.
DOI: https://doi.org/10.1093/jnci/dju124
Hlapčić I, Somborac-Bačura A, Popović-Grle S, et al. Platelet indices in stable chronic obstructive pulmonary disease – association with inflammatory markers, comorbidities and therapy. Biochem Med (Zagreb) 2020;30:010701.
DOI: https://doi.org/10.11613/BM.2020.010701
Paliogiannis P, Fois AG, Sotgia S, et al. Neutrophil to lymphocite ratio and clinical outcomes in COPD: recent evidence and future perspectives. Eur Res Review 2018;27:170113.
DOI: https://doi.org/10.1183/16000617.0113-2017
Aksoy E, Karakurt Z, Gungor S, et al. Neutrophil to lymphocyte ratio is a better indicator of COPD exacerbation severity in neutrophilic endotypes than eosinophilic endotypes. Int J Chron Obstruct Pulmon Dis 2018;13:2721-30.
DOI: https://doi.org/10.2147/COPD.S170353
Tan D, Fu Y, Tong W, et al. Prognostic significance of lymphocyte to monocyte ratio in colorectal cancer: A meta-analysis. Int J Surg 2018;55;128-38.
DOI: https://doi.org/10.1016/j.ijsu.2018.05.030
Mazza MG, Tringali AGM, Rosetti A, et al. Cross-sectional study of neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratios in mood disorders. Gen Hosp Psychiatry 2019;58:7-12.
DOI: https://doi.org/10.1016/j.genhosppsych.2019.02.003
Baran O, Kemerdere R, Korkmaz TS, et al. Can preoperative neutrophil to lymphocyte, lymphocyte to monocyte, or platelet to lymphocyte ratios differentiate glioblastoma from brain metastasis? Medicine (Baltimore) 2019;98:e18306.
DOI: https://doi.org/10.1097/MD.0000000000018306
Liu P, Li P, Peng Z, et al. Predictive value of the neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-neutrophil ratio, and neutrophil-to-monocyte ratio in lupus nephritis. Lupus 2020;29:1031-9.
DOI: https://doi.org/10.1177/0961203320929753
Jeon YL, Lee WI, Kang SY, et al. Neutrophil-to-monocyte-plus-lymphocyte ratio as a potential marker for discriminating pulmonary tuberculosis from nontuberculosis infectious lung diseases. Lab Med 2019;50:286-91.
DOI: https://doi.org/10.1093/labmed/lmy083
Rahimirad S, Ghaffary MR, Rahimirad MH, et al. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute exacerbation of chronic obstructive pulmonary disease. Tuberk Toraks 2017;65:25-31.
DOI: https://doi.org/10.5578/tt.27626
Lee JS, Kim NY, Na SH, et al. Reference values of neutrophil-lymphocyte ratio, lymphocyte-monocyte ratio, platelet-lymphocyte ratio, and mean platelet volume in healthy adults in South Korea. Medicine (Baltimore) 2018;97:e11138.
DOI: https://doi.org/10.1097/MD.0000000000011138
Gao K, Zhu W, Liu W, et al. Diagnostic value of the blood monocyte–lymphocyte ratio in knee osteoarthritis. J Int Med Res 2019;47:4413-21.
DOI: https://doi.org/10.1177/0300060519860686
Perera WR, Hurst JR, Wilkinson TMA, et al. Inflammatory changes, recovery and recurrence at COPD exacerbation. Eur Respir J 2007;29:527-34.
DOI: https://doi.org/10.1183/09031936.00092506
El-Gazzar AG, Kamel MH, Elbahnasy OKM, et al. Prognostic value of platelet and neutrophil to lymphocyte ratio in COPD patients. Expert Rev Respir Med 2020;14:111-6.
DOI: https://doi.org/10.1080/17476348.2019.1675517
Karadeniz G, Aktoğu S, Erer F, et al. Predictive value of platelet-to-lymphocyte ratio in exacerbation of chronic obstructive pulmonary disease. Biomark Med 2016;10:701-10.
DOI: https://doi.org/10.2217/bmm-2016-0046
Ethics Approval
The Ethics Committee of University Hospital Centre Zagreb and University of Zagreb School of Medicine (Zagreb, Croatia) approved the study in January 2013How to Cite
Dukić, Višnja, Davorka Muršić, Sanja Popović Grle, Marko Jakopović, Alen Ružić, and Andrea Vukić Dugac. 2023. “Monocyte Related Haematological Indices in Acute Exacerbations of COPD – a New Biomarker?”. Monaldi Archives for Chest Disease, September. https://doi.org/10.4081/monaldi.2023.2706.
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