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August 2016; 3 (4) ArticleOpen Access

Increased ratio of circulating neutrophils to monocytes in amyotrophic lateral sclerosis

Benjamin J. Murdock, Diane E. Bender, Samy R. Kashlan, Claudia Figueroa-Romero, Carey Backus, Brian C. Callaghan, Stephen A. Goutman, Eva L. Feldman
First published June 1, 2016, DOI: https://doi.org/10.1212/NXI.0000000000000242
Benjamin J. Murdock
From the Department of Neurology (B.J.M., D.E.B., S.R.K., C.F.-R., C.B., B.C.C., S.A.G., E.L.F.) and A. Alfred Taubman Medical Research Institute (E.L.F.), University of Michigan, Ann Arbor.
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Diane E. Bender
From the Department of Neurology (B.J.M., D.E.B., S.R.K., C.F.-R., C.B., B.C.C., S.A.G., E.L.F.) and A. Alfred Taubman Medical Research Institute (E.L.F.), University of Michigan, Ann Arbor.
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Samy R. Kashlan
From the Department of Neurology (B.J.M., D.E.B., S.R.K., C.F.-R., C.B., B.C.C., S.A.G., E.L.F.) and A. Alfred Taubman Medical Research Institute (E.L.F.), University of Michigan, Ann Arbor.
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Claudia Figueroa-Romero
From the Department of Neurology (B.J.M., D.E.B., S.R.K., C.F.-R., C.B., B.C.C., S.A.G., E.L.F.) and A. Alfred Taubman Medical Research Institute (E.L.F.), University of Michigan, Ann Arbor.
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Carey Backus
From the Department of Neurology (B.J.M., D.E.B., S.R.K., C.F.-R., C.B., B.C.C., S.A.G., E.L.F.) and A. Alfred Taubman Medical Research Institute (E.L.F.), University of Michigan, Ann Arbor.
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Brian C. Callaghan
From the Department of Neurology (B.J.M., D.E.B., S.R.K., C.F.-R., C.B., B.C.C., S.A.G., E.L.F.) and A. Alfred Taubman Medical Research Institute (E.L.F.), University of Michigan, Ann Arbor.
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Stephen A. Goutman
From the Department of Neurology (B.J.M., D.E.B., S.R.K., C.F.-R., C.B., B.C.C., S.A.G., E.L.F.) and A. Alfred Taubman Medical Research Institute (E.L.F.), University of Michigan, Ann Arbor.
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Eva L. Feldman
From the Department of Neurology (B.J.M., D.E.B., S.R.K., C.F.-R., C.B., B.C.C., S.A.G., E.L.F.) and A. Alfred Taubman Medical Research Institute (E.L.F.), University of Michigan, Ann Arbor.
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Full PDF
Citation
Increased ratio of circulating neutrophils to monocytes in amyotrophic lateral sclerosis
Benjamin J. Murdock, Diane E. Bender, Samy R. Kashlan, Claudia Figueroa-Romero, Carey Backus, Brian C. Callaghan, Stephen A. Goutman, Eva L. Feldman
Neurol Neuroimmunol Neuroinflamm Aug 2016, 3 (4) e242; DOI: 10.1212/NXI.0000000000000242

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    Figure 1. Immune cell populations are altered in the peripheral blood of patients with ALS

    (A) The total number of leukocytes and (B) the percent and total number of specific leukocyte populations are shown. Filled black circles represent individual healthy human control patients, and empty circles represent patients with ALS. Average and SEM are displayed. Asterisks above bars indicate significance (% of CD45+ cells: *p < 0.01, ***p < 0.0001; # of leukocytes: *p < 0.008). ALS = amyotrophic lateral sclerosis.

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    Figure 2. Percentage of CD16− monocytes in the blood is reduced during disease progression

    The percentage and total number of leukocytes in the blood of patients with amyotrophic lateral sclerosis are correlated with their ALSFRS-R score at the time of blood draw. Data are displayed with best-fit line and 95% confidence intervals. R2 value and p value are also shown. ALSFRS-R scores are displayed from high (A) to low (B) to illustrate disease progression. ALSFRS-R = Amyotrophic Lateral Sclerosis Functional Rating Scale–Revised.

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    Figure 3. Percentage and total number of CD16− monocytes expressing CCR3 is reduced in patients with ALS

    The percentage and total number of CD16+ and CD16− monocytes expressing CCRL2 (A) and CCR3 (B) in the peripheral blood are shown. Filled black circles represent individual healthy human control patients, and empty circles represent patients with ALS. Average and SEM are displayed. Asterisks above bars indicate significance (*p < 0.025). ALS = amyotrophic lateral sclerosis.

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    Figure 4. The N:M ratio is significantly increased in patients with ALS and correlates with disease progression

    (A) The N:M ratio in healthy control patients (filled black circles) and patients with ALS (empty circles) is shown. Average and SEM are displayed. Asterisks above bars indicate significance (***p < 0.001). (B) The N:M ratio in the blood of patients with ALS is correlated with the ALSFRS-R score at the time of blood draw. Data are displayed with best-fit line and 95% confidence intervals. R2 value and p value are also shown. ALSFRS-R scores are displayed from high (left) to low (right) to illustrate disease progression. ALS = amyotrophic lateral sclerosis; ALSFRS-R = ALS Functional Rating Scale–Revised; N:M ratio = neutrophil to CD16− monocyte ratio.

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