Does increased neutrophil-lymphocyte ratio predict autism spectrum disorder?

Objective: Although autism spectrum disorder (ASD) is one of the most studied neurodevelopmental disorders, itsetiology has not been fully elucidated. A growing body of evidence suggest the role of neuroinflammation in theetiology of ASD. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are markers of systemicinflammation. In this study, we aimed to evaluate NLR and PLR in children with ASD comparison to healthy controls.Methods: We reviewed the medical files of children with ASD in the ages of 2 to 5. The ASD group were consistedof drug-naïve 64 children who had complete blood count within a month of assessment. Age and sex matched 64healthy children without any psychiatric disorders were recruited from the healthy child outpatient unit of the hospital.Results: NLRs were significantly higher in ASD. Children with ASD had significantly higher neutrophil counts butlower platelet and lymphocyte counts compared to those of healthy controls. NLR was found to be a predictor ofASD. Conclusions: Increased NLRs support the hypothesis of the involvement of neuroinflammation in the under-lying physiopathology of ASD. Even though recent evidence is not enough to suggest that in young childrenincreased NLR levels may be used as screening and early intervention predictor, it should be kept in mind and mayinspire new studies. Further longitudinal studies with larger sample size and homogeneous groups regarding theage and subtypes may clarify the inflammatory involvement in ASD. (Anatolian Journal of Psychiatry 2018;19(6):607-614)

Yüksek nötrofil-lenfosit oranı otizm spektrum bozukluğunu öngörebilir mi?

Amaç: Otizm spektrum bozukluğu (OSB), üzerinde en çok çalışılan nörogelişimsel bozukluklardan biri olmasına rağmen, etiyolojisi tam olarak aydınlatılamamıştır. OSB’nin altta yatan patofizyolojisinde nöroinflamasyonun rol oynadığına ilişkin çalışmalar ve bulgular giderek artmaktadır. Nötrofil-Lenfosit oranı (NLO) ve trombosit-lenfosit oranı (TLO) sistemik inflamasyonun göstergeleridir. Bu çalışmada, OSB’li çocuklarda sağlıklı kontrollere göre NLO ve TLO'yu değerlendirmeyi amaçladık. Yöntem: Bu çalışmada OSB tanısı olan 2-5 yaşları arasındaki çocukların tıbbi dosyaları gözden geçirilmiştir. Hasta grubu, daha öncesinde ilaç kullanımı olmayan ve tanı konulduğu bir ay içinde tam kan sayımı yapılan 64 çocuktan oluşmaktadır. Sağlam çocuk polikliniğinden psikiyatrik bozukluğu olmayan, yaş ve cinsiyetleri benzer 64 çocuk sağlıklı kontrol olarak çalışmaya alınmıştır. Sonuç: OSB’li çocuklarda, NLO anlamlı olarak yüksek bulunmuştur. Olgu grubunda, sağlıklı kontrollere kıyasla nötrofil sayısı daha yüksek, lenfosit ve trombosit sayısı daha düşük bulunmuştur. NLO değerlerinin OSB’yi yordadığı saptanmıştır. Tartışma:NLR yüksekliği OSB’nin etiyolojisinde nöroinflamasyon rolü olduğunu hipotezini desteklemektedir. Yeterli kanıt olmamakla birlikte küçük yaş döneminde yükselmiş NLR düzeylerinin OSB’de tarama ve erken müdahalede yorda- yıcı olabileceği görüşü yeni araştırmalara konu olabilir. Yaş ve alt grup dağılımı açısından benzer çocukları içeren daha büyük örneklemli uzun izlem çalışmaları OSB’nin etiyolojisinde inflamasyonun katkısını açıklayabilir. (Ana- dolu Psikiyatri Derg 2018; 19(6):607-614)

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