{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T16:07:16Z","timestamp":1769270836295,"version":"3.49.0"},"reference-count":42,"publisher":"Wiley","license":[{"start":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T00:00:00Z","timestamp":1662940800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Mediators of Inflammation"],"published-print":{"date-parts":[[2022,9,12]]},"abstract":"<jats:p>In this study, we conducted a systematic review and meta-analysis regarding the role of the neutrophil to lymphocyte ratio (NLR) in Guillain Barr\u00e9 syndrome (GBS). The most recent update to the search was on July 18, 2022, through the databases of Web of Science, PubMed, Embase, and Scopus. The Newcastle-Ottawa scale was used for quality assessment of included studies. Finally, 14 studies were included in the review, and among them, ten studies were included in the meta-analysis. Our results showed that NLR levels were significantly increased in the patients with GBS compared with healthy controls (<jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mtext>SMD<\/a:mtext>\n                        <a:mo>=<\/a:mo>\n                        <a:mn>1.05<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>; <jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mn>95<\/c:mn>\n                        <c:mi>%<\/c:mi>\n                        <c:mtext>CI<\/c:mtext>\n                        <c:mo>=<\/c:mo>\n                        <c:mn>0.59<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula> to 1.50, <jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>P<\/e:mi>\n                        <e:mo>&lt;<\/e:mo>\n                        <e:mn>0.001<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula>). After treatment, NLR levels were decreased to the extent that they became similar to healthy controls (<jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mtext>SMD<\/g:mtext>\n                        <g:mo>=<\/g:mo>\n                        <g:mo>\u2212<\/g:mo>\n                        <g:mn>0.03<\/g:mn>\n                     <\/g:math>\n                  <\/jats:inline-formula>, <jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mn>95<\/i:mn>\n                        <i:mi>%<\/i:mi>\n                        <i:mtext>CI<\/i:mtext>\n                        <i:mo>=<\/i:mo>\n                        <i:mo>\u2212<\/i:mo>\n                        <i:mn>0.29<\/i:mn>\n                     <\/i:math>\n                  <\/jats:inline-formula> to 0.22, <jats:inline-formula>\n                     <k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\">\n                        <k:mi>P<\/k:mi>\n                        <k:mo>=<\/k:mo>\n                        <k:mn>0.204<\/k:mn>\n                     <\/k:math>\n                  <\/jats:inline-formula>). Moreover, NLR was a stable predictor of outcome or response to treatment in such patients (<jats:inline-formula>\n                     <m:math xmlns:m=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\">\n                        <m:mtext>SMD<\/m:mtext>\n                        <m:mo>=<\/m:mo>\n                        <m:mn>1.01<\/m:mn>\n                     <\/m:math>\n                  <\/jats:inline-formula>, <jats:inline-formula>\n                     <o:math xmlns:o=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\">\n                        <o:mn>95<\/o:mn>\n                        <o:mi>%<\/o:mi>\n                        <o:mtext>CI<\/o:mtext>\n                        <o:mo>=<\/o:mo>\n                        <o:mn>0.65<\/o:mn>\n                     <\/o:math>\n                  <\/jats:inline-formula> to 1.37, <jats:inline-formula>\n                     <q:math xmlns:q=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M9\">\n                        <q:mi>P<\/q:mi>\n                        <q:mo>&lt;<\/q:mo>\n                        <q:mn>0.001<\/q:mn>\n                     <\/q:math>\n                  <\/jats:inline-formula>); the higher the NLR, the worse the outcome. In addition, patients who underwent mechanical ventilation had higher levels of NLR compared to those who did not (<jats:inline-formula>\n                     <s:math xmlns:s=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M10\">\n                        <s:mtext>SMD<\/s:mtext>\n                        <s:mo>=<\/s:mo>\n                        <s:mn>0.93<\/s:mn>\n                     <\/s:math>\n                  <\/jats:inline-formula>, <jats:inline-formula>\n                     <u:math xmlns:u=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M11\">\n                        <u:mn>95<\/u:mn>\n                        <u:mi>%<\/u:mi>\n                        <u:mtext>CI<\/u:mtext>\n                        <u:mo>=<\/u:mo>\n                        <u:mn>0.05<\/u:mn>\n                     <\/u:math>\n                  <\/jats:inline-formula> to 1.82, <jats:inline-formula>\n                     <w:math xmlns:w=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M12\">\n                        <w:mi>P<\/w:mi>\n                        <w:mo>=<\/w:mo>\n                        <w:mn>0.03<\/w:mn>\n                     <\/w:math>\n                  <\/jats:inline-formula>). However, NLR levels were not different among distinct GBS subtypes, so it could not distinguish among them. In conclusion, our analysis indicates that the NLR levels are highly elevated in patients with GBS. Therefore, the NLR has the potential to be used as a biomarker to inform diagnosis, prognosis, or treatment responses in GBS, and future studies are warranted.<\/jats:p>","DOI":"10.1155\/2022\/3390831","type":"journal-article","created":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T22:05:10Z","timestamp":1663020310000},"page":"1-13","source":"Crossref","is-referenced-by-count":16,"title":["Role of the Neutrophil to Lymphocyte Ratio in Guillain Barr\u00e9 Syndrome: A Systematic Review and Meta-Analysis"],"prefix":"10.1155","volume":"2022","author":[{"given":"Shirin","family":"Sarejloo","sequence":"first","affiliation":[{"name":"Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shokoufeh","family":"Khanzadeh","sequence":"additional","affiliation":[{"name":"Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samaneh","family":"Hosseini","sequence":"additional","affiliation":[{"name":"Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morad Kohandel","family":"Gargari","sequence":"additional","affiliation":[{"name":"Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon","family":"Lucke-Wold","sequence":"additional","affiliation":[{"name":"University of Florida, Department of Neurosurgery, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3554-4935","authenticated-orcid":true,"given":"Seyedarad","family":"Mosalamiaghili","sequence":"additional","affiliation":[{"name":"Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pouria","family":"Azami","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3185-1249","authenticated-orcid":true,"given":"Sanaz","family":"Oftadehbalani","sequence":"additional","affiliation":[{"name":"Fatemeh Zahra Hospital, Iran University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7083-5722","authenticated-orcid":true,"given":"Shahram","family":"Sadeghvand","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Tabriz University of Medical Sciences, Tabriz, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-019-0250-9"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1016\/j.paed.2019.07.008"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-021-01117-3"},{"key":"4","doi-asserted-by":"crossref","first-page":"492","DOI":"10.3389\/fnagi.2020.613628","article-title":"The neuroimmunology of Guillain-Barr\u00e9 syndrome and the potential role of an aging immune system","volume":"12","author":"K. 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