How NLR ration helps predicting corticosteroid response in alcoholic hepatitis?
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The Neutrophil-to-Lymphocyte Ratio (NLR) has been identified as a significant prognostic and therapeutic marker in predicting the response to corticosteroid treatment in patients with severe alcoholic hepatitis (AH). Research indicates that a baseline NLR can identify patients most likely to benefit from corticosteroids, particularly when the NLR is within the range of 5-8. Patients with an NLR within this range showed reduced mortality when treated with prednisolone compared to those with higher or lower NLR values. This suggests that NLR can serve as a useful tool in tailoring corticosteroid therapy for individual patients, potentially improving outcomes by identifying those who are more likely to respond positively to treatment. Moreover, the integration of NLR into a modified Glasgow Alcoholic Hepatitis Score (mGAHS) improved the predictive value for 28- and 90-day outcomes, indicating that NLR adds significant prognostic information to existing scoring systems. This is further supported by studies showing that other markers, such as plasma metabolomics and meta-proteomics, can stratify pre-therapy steroid response, highlighting the complexity of predicting treatment outcomes in AH. Additionally, gene expression analysis in peripheral blood mononuclear cells (PBMCs) has shown differences between steroid responders and non-responders, suggesting that molecular profiling could complement NLR in predicting corticosteroid efficacy. The prognostic ability of NLR, both as a standalone model and in conjunction with other scores like the day-4 Lille score, has been evaluated, demonstrating its utility in predicting mortality and treatment response. However, the effectiveness of corticosteroids in AH remains a subject of ongoing research, with studies exploring various prognostic models and their ability to predict outcomes in AH patients. The collective evidence underscores the potential of NLR as a key factor in guiding the management of AH, particularly in the context of corticosteroid therapy, by identifying patients who are more likely to benefit from treatment and thereby optimizing therapeutic strategies.
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| Not addressed in the paper. | |
11 Citations | Neutrophil-lymphocyte ratio (NLR) aids in predicting corticosteroid response in alcoholic hepatitis by serving as a prognostic marker, especially when combined with the day-4 Lille score for enhanced accuracy. |
24 Mar 2021 7 Citations | Not addressed in the paper. |
| Neutrophil-to-lymphocyte ratio (NLR) is not directly addressed in the paper. The study focuses on plasma urobilinogen as a predictor of corticosteroid non-response in severe alcoholic hepatitis. | |
42 Citations | Baseline NLR aids in predicting corticosteroid response in alcoholic hepatitis by identifying patients likely to benefit (NLR 5-8) and those at risk of infection and AKI. |
Related Questions
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Moreover, neutrophils contribute to cholestasis in AH by binding to integrin β1 (ITGB1) on cholangiocytes, leading to a decrease in type 3 inositol 1,4,5-trisphosphate receptor (ITPR3) expression, which is necessary for cholangiocyte secretion. This interaction triggers a cascade of events that exacerbate cholestasis, a condition that worsens the prognosis of AH. The involvement of neutrophils in SAH pathogenesis is further elucidated by the identification of two distinct histopathological phenotypes, one characterized by high intrahepatic neutrophils but low levels of CD8+ T cells. This phenotype is associated with upregulation of neutrophil cytosolic factor 1 (NCF1), which controls neutrophilic reactive oxygen species (ROS) production, promoting hepatic inflammation and disease progression.
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What is the phenotype of neutrophils in Alcoholic hepatitis.?10 answersThe phenotype of neutrophils in alcoholic hepatitis (AH) is characterized by a complex interplay of activation, infiltration, and interaction with other cell types, leading to liver injury and disease progression. In AH, neutrophils exhibit increased infiltration into the liver, a process implicated in the pathogenesis of severe alcoholic hepatitis (SAH). This infiltration is associated with two distinct histopathological phenotypes based on liver immune phenotyping, suggesting varied mechanisms of liver injury. Neutrophils in AH demonstrate a high degree of plasticity, enabling them to modulate the activity of T cells, which may contribute to the progression of liver disease.
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