Low-grade systemic inflammation in patients with amyotrophic lateral sclerosis

• Published in: Acta neurologica Scandinavica Vol. 119; no. 6; pp. 383 - 389
• Main Authors: Keizman, D., Rogowski, O., Berliner, S., Ish-Shalom, M., Maimon, N., Nefussy, B., Artamonov, I., Drory, V. E.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.06.2009; Blackwell
• Subjects: Adult; Aged; Aged, 80 and over; amyotrophic lateral sclerosis; Amyotrophic Lateral Sclerosis - blood; Amyotrophic Lateral Sclerosis - complications; Amyotrophic Lateral Sclerosis - physiopathology; Biological and medical sciences; Biomarkers - blood; Blood Sedimentation; C-reactive protein; C-Reactive Protein - analysis; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Disease Progression; Female; Fibrinogen - analysis; Humans; Inflammation - blood; Inflammation - etiology; Inflammation - physiopathology; Leukocyte Count; Male; Medical sciences; Middle Aged; motor neuron disease; Neurology; Prognosis; systemic low-grade inflammation; Human; Nervous system diseases; C-reactive protein; Central nervous system disease; Motor neuron disease; Amyotrophic lateral sclerosis; Degenerative disease; Inflammation; systemic low-grade inflammation; Spinal cord disease; Protein
• ISSN: 0001-6314; 1600-0404
• DOI: 10.1111/j.1600-0404.2008.01112.x

Objective –  To prospectively determine the intensity of systemic low‐grade inflammation in patients with amyotrophic lateral sclerosis (ALS). Patients and methods –  Patients with ALS and matched healthy controls underwent blood tests for inflammation‐sensitive biomarkers: erythrocyte sedimentation rate (ESR), quantitative fibrinogen, wide‐range C‐reactive protein (wrCRP) concentrations, leukocyte count and neutrophil‐to‐lymphocyte ratio (NLR). The correlation between these inflammatory biomarkers and disability status of the patients, expressed by the ALS Functional Rating Scale (ALSFRS‐R), was evaluated. Results –  Eighty patients with ALS and 80 matched controls were included. wrCRP, fibrinogen, ESR and NLR values were significantly elevated in patients compared with controls. There was a significant correlation between the ALSFRS‐R score and wrCRP, ESR and fibrinogen levels. This correlation persisted on sequential examinations. Conclusions –  A systemic low‐grade inflammation was detected in patients with ALS and correlated with their degree of disability. A heightened systemic inflammatory state is apparently associated with a negative prognosis in ALS.