Monocyte to high-density lipoprotein ratio and neutrophil to lymphocyte ratio in trigeminal neuralgia patients: A retrospective cohort study

MHR and NLR in trigeminal neuralgia

Authors

Keywords:

Inflammation, neutrophil-lymphocyte ratio, monocytes-high density lipoprotein ratio, trigeminal neuralgia

Abstract

Background/Aim: Trigeminal neuralgia (TN) is a prevalent cranial nerve disorder. While inflammation has been implicated in neuropathic pain in numerous recent studies, its role in TN has remained uncertain. Given the increasing significance of neuroinflammation, this study aims to explore the association between inflammation and TN and to assess whether there are disparities in the monocyte to high-density lipoprotein ratio (MHR) and neutrophil to lymphocyte ratio (NLR) values between TN patients and healthy individuals. There is a dearth of literature concerning the link with MHR, a parameter extensively studied in cardiac research but unexplored in the context of TN.

Methods: This retrospective cohort study encompassed 48 patients diagnosed with classical TN and 40 healthy controls treated at the neurology and pain clinic of Dokuz Eylül University. Demographic and clinical variables, such as age and gender, along with monocyte, neutrophil, lymphocyte, and high-density lipoprotein (HDL) levels, were retrospectively retrieved from medical records. Inflammation markers, namely MHR and NLR, were calculated. Nonparametric tests were employed to compare these markers between TN patients and healthy controls.

Results: Regarding sociodemographic data, the average age of the patient group was 59.8, while that of the healthy group was 47.4. A significant age difference was observed between the patient and healthy groups (P<0.001). However, no significant differences between the groups regarding MHR or NLR values were detected.

Conclusions: These findings may suggest the presence of an inflammatory process characterized by local neurogenic inflammation in the pathophysiology of TN. Further comprehensive studies are required to assess the utility of MHR as a readily applicable marker in neurological disorders with neuroinflammatory and neuropathic pain etiologies.

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References

Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018 Jan;38(1):1-211. doi: 10.1177/0333102417738202. PMID: 29368949. DOI: https://doi.org/10.1177/0333102417738202

Maarbjerg S, Di Stefano G, Bendtsen L, Cruccu G. Trigeminal neuralgia - diagnosis and treatment. Cephalalgia. 2017 Jun;37(7):648-57. doi: 10.1177/0333102416687280. Epub 2017 11 January. PMID: 28076964. DOI: https://doi.org/10.1177/0333102416687280

Kiguchi N, Kobayashi Y, Kishioka S. Chemokines and cytokines in neuroinflammation leading to neuropathic pain. Curr Opin Pharmacol. 2012 Feb;12(1):55-61. doi: 10.1016/j.coph.2011.10.007. Epub 2011 21 October. PMID: 22019566. DOI: https://doi.org/10.1016/j.coph.2011.10.007

Calvo M, Dawes JM, Bennett DL. The role of the immune system in the generation of neuropathic pain. Lancet Neurol. 2012 Jul;11(7):629-42. doi: 10.1016/S1474-4422(12)70134-5. PMID: 22710756. DOI: https://doi.org/10.1016/S1474-4422(12)70134-5

Carniglia L, Ramírez D, Durand D, Saba J, Turati J, Caruso C, et al. Neuropeptides and Microglial Activation in Inflammation, Pain, and Neurodegenerative Diseases. Mediators Inflamm. 2017;2017:5048616. doi: 10.1155/2017/5048616. Epub 2017 5 January. PMID: 28154473; PMCID: PMC5244030. DOI: https://doi.org/10.1155/2017/5048616

Bilal N, Sarıca S, Orhan I, Aktas Samur A. Analysis and Prognostic Significance of Hematological Parameters in Patients with Tinnitus. Kocaeli Medical J. 2016;5(2):1-7.

Zipp F, Aktas O. The brain as a target of inflammation: common pathways link inflammatory and neurodegenerative diseases. Trends Neurosci. 2006 Sep;29(9):518-27. doi: 10.1016/j.tins.2006.07.006. Epub 2006 1 August. PMID: 16879881. DOI: https://doi.org/10.1016/j.tins.2006.07.006

Dawes JM, Andersson DA, Bennett DLH, Stuart B, McMahon SB. Inflammatory mediators and modulators of pain. Wall and Melzack’s Textbook of Pain, 2013. 6: p. 48-67.

You S, Zhong C, Zheng D, Xu J, Zhang X, Liu H, et al. Monocyte to HDL cholesterol ratio is associated with discharge and 3-month outcome in patients with acute intracerebral hemorrhage. J Neurol Sci. 2017 Jan 15;372:157-61. doi: 10.1016/j.jns.2016.11.022. Epub 2016 12 November. PMID: 28017204. DOI: https://doi.org/10.1016/j.jns.2016.11.022

Inci I, Kusbeci OY, Eskut N. The neutrophil-to-lymphocyte ratio as a marker of peripheral inflammation in progressive supranuclear palsy: a retrospective study. Neurol Sci. 2020 May;41(5):1233-7. doi: 10.1007/s10072-019-04208-4. Epub 2020 4 January. PMID: 31901125. DOI: https://doi.org/10.1007/s10072-019-04208-4

Rembach A, Watt AD, Wilson WJ, Rainey-Smith S, Ellis KA, Rowe CC, et al. AIBL Research Group. An increased neutrophil-lymphocyte ratio in Alzheimer’s disease is a function of age and is weakly correlated with neocortical amyloid accumulation. J Neuroimmunol. 2014 Aug 15;273(1-2):65-71. doi: 10.1016/j.jneuroim.2014.05.005. Epub 2014 20 May. PMID: 24907904. DOI: https://doi.org/10.1016/j.jneuroim.2014.05.005

Nam KW, Kwon HM, Jeong HY, Park JH, Kim SH, Jeong SM. High neutrophil to lymphocyte ratios predict intracranial atherosclerosis in a healthy population. Atherosclerosis. 2018 Feb;269:117-21. doi: 10.1016/j.atherosclerosis.2017.12.035. Epub 2018 5 January. PMID: 29353226. DOI: https://doi.org/10.1016/j.atherosclerosis.2017.12.035

Huh Y, Ji RR, Chen G. Neuroinflammation, Bone Marrow Stem Cells, and Chronic Pain. Front Immunol. 2017 21 August;8:1014. doi: 10.3389/fimmu.2017.01014. PMID: 28871264; PMCID: PMC5567062. DOI: https://doi.org/10.3389/fimmu.2017.01014

Erre GL, Paliogiannis P, Castagna F, Mangoni AA, Carru C, Passiu G, et al. Meta-analysis of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio in rheumatoid arthritis. Eur J Clin Invest. 2019 Jan;49(1):e13037. doi: 10.1111/eci.13037. Epub 2018 6 November. PMID: 30316204. DOI: https://doi.org/10.1111/eci.13037

Ethier JL, Desautels D, Templeton A, Shah PS, Amir E. Prognostic role of neutrophil-to-lymphocyte ratio in breast cancer: a systematic review and meta-analysis. Breast Cancer Res. 2017 5 January;19(1):2. doi: 10.1186/s13058-016-0794-1. PMID: 28057046; PMCID: PMC5217326. DOI: https://doi.org/10.1186/s13058-016-0794-1

Walsh SR, Cook EJ, Goulder F, Justin TA, Keeling NJ. Neutrophil-lymphocyte ratio as a prognostic factor in colorectal cancer. J Surg Oncol. 2005 Sep 1;91(3):181-4. doi: 10.1002/jso.20329. PMID: 16118772. DOI: https://doi.org/10.1002/jso.20329

Núñez J, Núñez E, Bodí V, Sanchis J, Miñana G, Mainar L, et al. Usefulness of the neutrophil to lymphocyte ratio in predicting long-term mortality in ST segment elevation myocardial infarction. Am J Cardiol. 2008 Mar 15;101(6):747-52. doi: 10.1016/j.amjcard.2007.11.004. Epub 2008 21 February. PMID: 18328833. DOI: https://doi.org/10.1016/j.amjcard.2007.11.004

Simcox R, Sin WT, Seed PT, Briley A, Shennan AH. Prophylactic antibiotics for the prevention of preterm birth in women at risk: a meta-analysis. Aust N Z J Obstet Gynaecol. 2007 Oct;47(5):368-77. doi: 10.1111/j.1479-828X.2007.00759.x. PMID: 17877593. DOI: https://doi.org/10.1111/j.1479-828X.2007.00759.x

Riley JK, Nelson DM. Toll-like receptors in pregnancy disorders and placental dysfunction. Clin Rev Allergy Immunol. 2010 Dec;39(3):185-93. doi: 10.1007/s12016-009-8178-2. PMID: 19866377. DOI: https://doi.org/10.1007/s12016-009-8178-2

Semerano A, Strambo D, Martino G, Comi G, Filippi M, Roveri L, et al. Leukocyte Counts and Ratios Are Predictive of Stroke Outcome and Hemorrhagic Complications Independently of Infections. Front Neurol. 2020 Apr 3;11:201. doi: 10.3389/fneur.2020.00201. PMID: 32308640; PMCID: PMC7145963. DOI: https://doi.org/10.3389/fneur.2020.00201

Goyal N, Tsivgoulis G, Chang JJ, Malhotra K, Pandhi A, Ishfaq MF, et al. Admission Neutrophil-to-Lymphocyte Ratio as a Prognostic Biomarker of Outcomes in Large Vessel Occlusion Strokes. Stroke. 2018 Aug;49(8):1985-7. doi: 10.1161/STROKEAHA.118.021477. PMID: 30002151. DOI: https://doi.org/10.1161/STROKEAHA.118.021477

Hasselbalch IC, Søndergaard HB, Koch-Henriksen N, Olsson A, Ullum H, Sellebjerg F, et al. The neutrophil-to-lymphocyte ratio is associated with multiple sclerosis. Mult Scler J Exp Transl Clin. 2018 Nov 28;4(4):2055217318813183. doi: 10.1177/2055217318813183. PMID: 30515298; PMCID: PMC6262498. DOI: https://doi.org/10.1177/2055217318813183

Bisgaard AK, Pihl-Jensen G, Frederiksen JL. The neutrophil-to-lymphocyte ratio as disease actvity marker in multiple sclerosis and optic neuritis. Mult Scler Relat Disord. 2017 Nov;18:213-7. doi: 10.1016/j.msard.2017.10.009. Epub 2017 13 October. PMID: 29141813. DOI: https://doi.org/10.1016/j.msard.2017.10.009

Demirci S, Demirci S, Kutluhan S, Koyuncuoglu HR, Yurekli VA. The clinical significance of the neutrophil-to-lymphocyte ratio in multiple sclerosis. Int J Neurosci. 2016 Aug;126(8):700-6. doi: 10.3109/00207454.2015.1050492. Epub 2015 22 May. PMID: 26000934. DOI: https://doi.org/10.3109/00207454.2015.1050492

Al-Hussain F, Alfallaj MM, Alahmari AN, Almazyad AN, Alsaeed TK, Abdurrahman AA, et al. Relationship between Neutrophil-to-Lymphocyte Ratio and Stress in Multiple Sclerosis Patients. J Clin Diagn Res. 2017 May;11(5):CC01-4. doi: 10.7860/JCDR/2017/24388.9764. Epub 2017 1 May. PMID: 28658752; PMCID: PMC5483654.

D’Amico E, Zanghì A, Romano A, Sciandra M, Palumbo GAM, Patti F. The Neutrophil-to-Lymphocyte Ratio is Related to Disease Activity in Relapsing Remitting Multiple Sclerosis. Cells. 2019 Sep 20;8(10):1114. doi: 10.3390/cells8101114. PMID: 31547008; PMCID: PMC6830321. DOI: https://doi.org/10.3390/cells8101114

Hemond CC, Glanz BI, Bakshi R, Chitnis T, Healy BC. The neutrophil-to-lymphocyte and monocyte-to-lymphocyte ratios are independently associated with neurological disability and brain atrophy in multiple sclerosis. BMC Neurol. 2019 12 February;19(1):23. doi: 10.1186/s12883-019-1245-2. PMID: 30755165; PMCID: PMC6371437. DOI: https://doi.org/10.1186/s12883-019-1245-2

Templeton AJ, McNamara MG, Šeruga B, Vera-Badillo FE, Aneja P, Ocaña A, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst. 2014 May 29;106(6):dju124. doi: 10.1093/jnci/dju124. PMID: 24875653. DOI: https://doi.org/10.1093/jnci/dju124

Tokgoz S, Keskin S, Kayrak M, Seyithanoglu A, Ogmegul A. Is neutrophil/lymphocyte ratio predict to short-term mortality in acute cerebral infarct independently from infarct volume? J Stroke Cerebrovasc Dis. 2014 Sep;23(8):2163-8. doi: 10.1016/j.jstrokecerebrovasdis.2014.04.007. Epub 2014 6 August. PMID: 25106834. DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.04.007

Celikbilek A, Ismailogullari S, Zararsiz G. Neutrophil to lymphocyte ratio predicts poor prognosis in ischemic cerebrovascular disease. J Clin Lab Anal. 2014 Jan;28(1):27-31. doi: 10.1002/jcla.21639. Epub 2013 27 December. PMID: 24375839; PMCID: PMC6807633. DOI: https://doi.org/10.1002/jcla.21639

Mayer FJ, Gruenberger D, Schillinger M, Mannhalter C, Minar E, Koppensteiner R, et al. Prognostic value of neutrophils in patients with asymptomatic carotid artery disease. Atherosclerosis. 2013 Dec;231(2):274-80. doi: 10.1016/j.atherosclerosis.2013.10.002. Epub 2013 11 October. PMID: 24267239. DOI: https://doi.org/10.1016/j.atherosclerosis.2013.10.002

Hyun S, Kwon S, Cho S, Park S, Jung W, Moon S, et al. Can the Neutrophil-to-Lymphocyte Ratio Appropriately Predict Carotid Artery Stenosis in Patients with Ischemic Stroke?-A Retrospective Study. J Stroke Cerebrovasc Dis. 2015 Nov;24(11):2646-51. doi: 10.1016/j.jstrokecerebrovasdis.2015.07.024. Epub 2015 24 August. PMID: 26316355. DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.07.024

Gary T, Pichler M, Belaj K, Hafner F, Gerger A, Froehlich H, et al. Neutrophil-to-lymphocyte ratio and its association with critical limb ischemia in PAOD patients. PLoS One. 2013;8(2):e56745. doi: 10.1371/journal.pone.0056745. Epub 2013 15 February. PMID: 23457609; PMCID: PMC3574103. DOI: https://doi.org/10.1371/journal.pone.0056745

Tamhane UU, Aneja S, Montgomery D, Rogers EK, Eagle KA, Gurm HS. Association between admission neutrophil to lymphocyte ratio and outcomes in patients with acute coronary syndrome. Am J Cardiol. 2008 Sep 15;102(6):653-7. doi: 10.1016/j.amjcard.2008.05.006. Epub 2008 26 June. PMID: 18773982. DOI: https://doi.org/10.1016/j.amjcard.2008.05.006

Köklü E, Yüksel IO, Arslan S, Bayar N, Çağırcı G, Gencer ES, et al. Is Elevated Neutrophil-to-Lymphocyte Ratio a Predictor of Stroke in Patients with Intermediate Carotid Artery Stenosis? J Stroke Cerebrovasc Dis. 2016 Mar;25(3):578-84. doi: 10.1016/j.jstrokecerebrovasdis.2015.10.031. Epub 2015 17 December. PMID: 26706445. DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.10.031

Yao Y, Chang B, Li S. Relationship of Inflammation With Trigeminal Neuralgia. J Craniofac Surg. 2020 Mar/Apr;31(2):e110-3. doi: 10.1097/SCS.0000000000005879. PMID: 31609955. DOI: https://doi.org/10.1097/SCS.0000000000005879

Dietschy JM. Central nervous system: cholesterol turnover, brain development and neurodegeneration. Biol Chem. 2009 Apr;390(4):287-93. doi: 10.1515/BC.2009.035. PMID: 19166320; PMCID: PMC3066069. DOI: https://doi.org/10.1515/BC.2009.035

Hayashi H. Lipid metabolism and glial lipoproteins in the central nervous system. Biol Pharm Bull. 2011;34(4):453-61. doi: 10.1248/bpb.34.453. PMID: 21467629. DOI: https://doi.org/10.1248/bpb.34.453

Björkhem I, Meaney S. Brain cholesterol: long secret life behind a barrier. Arterioscler Thromb Vasc Biol. 2004 May;24(5):806-15. doi: 10.1161/01.ATV.0000120374.59826.1b. Epub 2004 5 February. PMID: 14764421. DOI: https://doi.org/10.1161/01.ATV.0000120374.59826.1b

Salemi G, Gueli MC, Vitale F, Battaglieri F, Guglielmini E, Ragonese P, et al. Blood lipids, homocysteine, stress factors, and vitamins in clinically stable multiple sclerosis patients. Lipids Health Dis. 2010 18 February;9:19. doi: 10.1186/1476-511X-9-19. PMID: 20163740; PMCID: PMC2834681. DOI: https://doi.org/10.1186/1476-511X-9-19

Weinstock-Guttman B, Zivadinov R, Mahfooz N, Carl E, Drake A, Schneider J, et al. Serum lipid profiles are associated with disability and MRI outcomes in multiple sclerosis. J Neuroinflammation. 2011 Oct 4;8:127. doi: 10.1186/1742-2094-8-127. PMID: 21970791; PMCID: PMC3228782. DOI: https://doi.org/10.1186/1742-2094-8-127

Jamroz-Wisniewska A, Beltowski J, Stelmasiak Z, Bartosik-Psujek H. Paraoxonase 1 activity in different types of multiple sclerosis. Mult Scler. 2009 Mar;15(3):399-402. doi: 10.1177/1352458508098371. Epub 2008 9 October. PMID: 18845659. DOI: https://doi.org/10.1177/1352458508098371

Calabresi L, Gomaraschi M, Franceschini G. Endothelial protection by high-density lipoproteins: from bench to bedside. Arterioscler Thromb Vasc Biol. 2003 Oct 1;23(10):1724-31. doi: 10.1161/01.ATV.0000094961.74697.54. Epub 2003 11 September. PMID: 12969988. DOI: https://doi.org/10.1161/01.ATV.0000094961.74697.54

Nobrega C, Capela C, Gorjon A, Lurdes P, Roque R, Sousa A, et al. Plasma lipoproteins and intrathecal immunoglobulin synthesis in multiple sclerosis. J Neurol 2011;258:202–3.

Burger D, Dayer JM. High-density lipoprotein-associated apolipoprotein A-I: the missing link between infection and chronic inflammation? Autoimmun Rev. 2002 Feb;1(1-2):111-7. doi: 10.1016/s1568-9972(01)00018-0. PMID: 12849067. DOI: https://doi.org/10.1016/S1568-9972(01)00018-0

Mitchell AJ, Vancampfort D, Sweers K, van Winkel R, Yu W, De Hert M. Prevalence of metabolic syndrome and metabolic abnormalities in schizophrenia and related disorders--a systematic review and meta-analysis. Schizophr Bull. 2013 Mar;39(2):306-18. doi: 10.1093/schbul/sbr148. Epub 2011 29 December. PMID: 22207632; PMCID: PMC3576174. DOI: https://doi.org/10.1093/schbul/sbr148

Kanbay M, Solak Y, Unal HU, Kurt YG, Gok M, Cetinkaya H, et al. Monocyte count/HDL cholesterol ratio and cardiovascular events in patients with chronic kidney disease. Int Urol Nephrol. 2014 Aug;46(8):1619-25. doi: 10.1007/s11255-014-0730-1. Epub 2014 23 May. PMID: 24853998. DOI: https://doi.org/10.1007/s11255-014-0730-1

Canpolat U, Aytemir K, Yorgun H, Şahiner L, Kaya EB, Çay S, et al. The role of preprocedural monocyte-to-high-density lipoprotein ratio in prediction of atrial fibrillation recurrence after cryoballoon-based catheter ablation. Europace. 2015 Dec;17(12):1807-15. doi: 10.1093/europace/euu291. Epub 2015 19 May. PMID: 25995388. DOI: https://doi.org/10.1093/europace/euu291

Karataş MB, Çanga Y, Ozcan KS, İpek G, Güngör B, Onuk T, et al. Monocyte to high-density lipoprotein ratio as a new prognostic marker in patients with STEMI undergoing primary percutaneous coronary intervention. Am J Emerg Med. 2016 Feb;34(2):240-4. doi: 10.1016/j.ajem.2015.10.049. Epub 2015 27 October. PMID: 26585199. DOI: https://doi.org/10.1016/j.ajem.2015.10.049

Zhang Y, Li S, Guo YL, Wu NQ, Zhu CG, Gao Y, et al. Is monocyte to HDL ratio superior to monocyte count in predicting the cardiovascular outcomes: evidence from a large cohort of Chinese patients undergoing coronary angiography. Ann Med. 2016 Aug;48(5):305-12. doi: 10.3109/07853890.2016.1168935. Epub 2016 17 April. PMID: 27087382. DOI: https://doi.org/10.3109/07853890.2016.1168935

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2023-09-10

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1.
Tuncer Z, Akbulut N, Ekmekçi UC, Gürsoy Çirkinoğlu G, Öztürk V, Erkin Y. Monocyte to high-density lipoprotein ratio and neutrophil to lymphocyte ratio in trigeminal neuralgia patients: A retrospective cohort study: MHR and NLR in trigeminal neuralgia. J Surg Med [Internet]. 2023 Sep. 10 [cited 2024 Jul. 3];7(9):568-73. Available from: https://jsurgmed.com/article/view/7884