Clinical value of the systemic immune-inflammation index in moyamoya disease

Erheng Liu; Chengyuan Liu; Lide Jin; Hu Zhou; Xueyi Tan; Guibo Zhang; Weihua Tao; Xiang Gao; Heng Zhao; Chao Luo; Xuehua Li; Shuaifeng Yang

doi:10.3389/fneur.2023.1123951

Clinical value of the systemic immune-inflammation index in moyamoya disease

Front Neurol. 2023 Apr 20:14:1123951. doi: 10.3389/fneur.2023.1123951. eCollection 2023.

Authors

Erheng Liu^#^{1

2}, Chengyuan Liu^#^{1

2}, Lide Jin^#², Hu Zhou^#², Xueyi Tan^{1

2}, Guibo Zhang^{1

2}, Weihua Tao², Xiang Gao², Heng Zhao², Chao Luo², Xuehua Li³, Shuaifeng Yang²

Affiliations

¹ Department of Neurosurgery, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.
² Department of Neurosurgery, The First People's Hospital of Yunnan Province, Kunming, China.
³ Department of AIDS/STDs Prevention and Control, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China.

^# Contributed equally.

Abstract

Background: Moyamoya disease (MMD) is a rare cerebrovascular disorder with unknown etiology. The underlying pathophysiological mechanism of moyamoya disease remains to be elucidated, but recent studies have increasingly highlighted that abnormal immune response may be a potential trigger for MMD. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) are inflammatory markers that can reflect the immune-inflammation state of the disease.

Objective: The purpose of this study was to investigate SII, NLR, and PLR in patients with moyamoya disease.

Methods: A total of 154 patients with moyamoya disease (MMD group) and 321 age- and sex-matched healthy subjects (control group) were included in this retrospective case-control study. Complete blood count parameters were assayed to calculate the SII, NLR, and PLR values.

Results: The SII, NLR, and PLR values in the moyamoya disease group were significantly higher than those in the control group [754 ± 499 vs. 411 ± 205 (P < 0.001), 2.83 ± 1.98 vs. 1.81 ± 0.72 (P < 0.001), and 152 ± 64 vs. 120 ± 42 (P < 0.001), respectively]. The SII in the medium-moyamoya vessels of moyamoya disease was higher than that in the high-moyamoya vessels and low-moyamoya vessels (P = 0.005). Using the receiver operating characteristic (ROC) curve analysis to predict MMD, the highest area under the curve (AUC) was determined for SII (0.76 for SII, 0.69 for NLR, and 0.66 for PLR).

Conclusion: Based on the results of this study, patients with moyamoya disease admitted for inpatient care due to acute or chronic stroke have significantly higher SII, NLR, and PLR when compared to blood samples drawn from completely healthy controls in a non-emergent outpatient setting. While the findings may suggest that inflammation plays a role in moyamoya disease, further studies are warranted to corroborate such an association. In the middle stage of moyamoya disease, there may be a more intense imbalance of immune inflammation. Further studies are needed to determine whether the SII index contributes to the diagnosis or serves as a potential marker of an inflammatory response in patients with moyamoya disease.

Keywords: immune; inflammation; moyamoya disease; neutrophil/lymphocyte ratio; platelet/lymphocyte ratio; systemic immune-inflammation index.

Grants and funding

This work was supported by Joint Project of Yunnan Science and Technology Department and Kunming Medical University [Grant No. 2019FE001(-160)], Yunnan Fundamental Research Projects (Grant No. 202201AT070014), the Joint Special Project for Applied Basic Research of Yunnan Provincial Science and Technology Department Kunming Medical University (Grant No. 202101AY070001-254), and Open Project of the Clinical Medical Center of the First People's Hospital of Yunnan Province (Grant Nos. 2021LCZXXF-SJ04 and 2022LCZXKF-SJ03).