Abnormal neutrophil-to-lymphocyte ratio in children with autism spectrum disorder and history of maternal immune activation.


Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
16 Dec 2023
Historique:
received: 16 06 2023
accepted: 12 12 2023
medline: 17 12 2023
pubmed: 17 12 2023
entrez: 16 12 2023
Statut: epublish

Résumé

Maternal immune activation (MIA), related to autoimmune/inflammatory diseases or acute infections, during the two first trimesters of pregnancy is a risk factor for autism spectrum disorders (ASD) in offspring. In mice, MIA has a long-term impact on offspring's immune equilibrium resulting in a pro-inflammatory phenotype. We therefore hypothesized that children with ASD and a history of MIA could display a similar phenotype specifically assessed by a higher neutrophil to lymphocyte ratio (NLR). In this study, we used a retrospective sample of 231 dyads involving children with ASD and their mothers. Among ASD patients, 12% had a history of MIA. The multivariate analysis revealed a significant association between NLR in children with ASD and maternal history of MIA (F = 2.27, p = 0.03). Using a categorical approach, we observed an abnormal NLR (over 3) in 7.4% of children with ASD MIA+ compared to 1.9% for MIA-. Our study supports the hypothesis suggesting an impact of MIA on the risk of ASD. Further studies could contribute to the development of biomarkers in MIA+ ASD and enable the development of targeted immunomodulatory therapies.

Identifiants

pubmed: 38104181
doi: 10.1038/s41598-023-49789-5
pii: 10.1038/s41598-023-49789-5
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

22424

Informations de copyright

© 2023. The Author(s).

Références

Lord, C. et al. Autism spectrum disorder. Nat. Rev. Dis. Primer 6, 5. https://doi.org/10.1038/s41572-019-0138-4 (2020).
doi: 10.1038/s41572-019-0138-4
Maenner, M. J. et al. Prevalence of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 sites, United States, 2016. Morb. Mortal Wkly. Rep. Surveill. Summ. Wash. DC 69, 1–12. https://doi.org/10.15585/mmwr.ss6904a1 (2020).
doi: 10.15585/mmwr.ss6904a1
Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed. (American Psychiatric Association, 2013).
Schaaf, C. P. et al. A framework for an evidence-based gene list relevant to autism spectrum disorder. Nat. Rev. Genet. 21, 367–376. https://doi.org/10.1038/s41576-020-0231-2 (2020).
doi: 10.1038/s41576-020-0231-2 pubmed: 32317787 pmcid: 10357004
Han, V. X., Patel, S., Jones, H. F. & Dale, R. C. Maternal immune activation and neuroinflammation in human neurodevelopmental disorders. Nat. Rev. Neurol. 17, 564–579. https://doi.org/10.1038/s41582-021-00530-8 (2021).
doi: 10.1038/s41582-021-00530-8 pubmed: 34341569
Choi, G. B. et al. The maternal interleukin-17a pathway in mice promotes autism-like phenotypes in offspring. Science 351, 933–939. https://doi.org/10.1126/science.aad0314 (2016).
doi: 10.1126/science.aad0314 pubmed: 26822608 pmcid: 4782964
Smith, S. E. P. et al. Maternal immune activation alters fetal brain development through interleukin-6. J. Neurosci. Off. J. Soc. Neurosci. 27, 10695–10702. https://doi.org/10.1523/JNEUROSCI.2178-07.2007 (2007).
doi: 10.1523/JNEUROSCI.2178-07.2007
Lim, A. I. et al. Prenatal maternal infection promotes tissue-specific immunity and inflammation in offspring. Science 373, eabf3002. https://doi.org/10.1126/science.abf3002 (2021).
doi: 10.1126/science.abf3002 pubmed: 34446580
Hsiao, E. Y. et al. Modeling an autism risk factor in mice leads to permanent immune dysregulation. Proc. Natl. Acad. Sci. U S A 109, 12776–12781. https://doi.org/10.1073/pnas.1202556109 (2012).
doi: 10.1073/pnas.1202556109 pubmed: 22802640 pmcid: 3411999
Gee, S. et al. The legacy of maternal SARS-CoV-2 infection on the immunology of the neonate. Nat. Immunol. https://doi.org/10.1038/s41590-021-01049-2 (2021).
doi: 10.1038/s41590-021-01049-2 pubmed: 34616036
Faria, S. S. et al. The neutrophil-to-lymphocyte ratio: A narrative review. Ecancermedicalscience 10, 702. https://doi.org/10.3332/ecancer.2016.702 (2016).
doi: 10.3332/ecancer.2016.702 pubmed: 28105073 pmcid: 5221645
Kim, S. et al. Association of neutrophil-to-lymphocyte ratio with mortality and cardiovascular disease in the Jackson Heart Study and modification by the Duffy antigen variant. JAMA Cardiol. 3, 455–462. https://doi.org/10.1001/jamacardio.2018.1042 (2018).
doi: 10.1001/jamacardio.2018.1042 pubmed: 29801037 pmcid: 6128503
Song, M., Graubard, B. I., Rabkin, C. S. & Engels, E. A. Neutrophil-to-lymphocyte ratio and mortality in the United States general population. Sci. Rep. 11, 464. https://doi.org/10.1038/s41598-020-79431-7 (2021).
doi: 10.1038/s41598-020-79431-7 pubmed: 33431958 pmcid: 7801737
Bulut, N. S., Yorguner, N. & Çarkaxhiu Bulut, G. The severity of inflammation in major neuropsychiatric disorders: Comparison of neutrophil-lymphocyte and platelet-lymphocyte ratios between schizophrenia, bipolar mania, bipolar depression, major depressive disorder, and obsessive compulsive disorder. Nord. J. Psychiatry https://doi.org/10.1080/08039488.2021.1919201 (2021).
doi: 10.1080/08039488.2021.1919201 pubmed: 34319861
Kulaksizoglu, B. & Kulaksizoglu, S. Relationship between neutrophil/lymphocyte ratio with oxidative stress and psychopathology in patients with schizophrenia. Neuropsychiatr. Dis. Treat. 12, 1999–2005. https://doi.org/10.2147/NDT.S110484 (2016).
doi: 10.2147/NDT.S110484 pubmed: 27574431 pmcid: 4991539
Tural Hesapcioglu, S., Kasak, M., Cıtak Kurt, A. N. & Ceylan, M. F. High monocyte level and low lymphocyte to monocyte ratio in autism spectrum disorders. Int. J. Dev. Disabil. 65, 73–81. https://doi.org/10.1080/20473869.2017.1371369 (2017).
doi: 10.1080/20473869.2017.1371369 pubmed: 34141326 pmcid: 8115457
Topal, Z. et al. Evaluation of peripheral inflammatory markers, serum B12, folate, ferritin levels and clinical correlations in children with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). Nord. J. Psychiatry https://doi.org/10.1080/08039488.2021.1946712 (2021).
doi: 10.1080/08039488.2021.1946712 pubmed: 34232109
Esnafoglu, E. & Subaşı, B. Association of low 25-OH-vitamin D levels and peripheral inflammatory markers in patients with autism spectrum disorder: Vitamin D and inflammation in Autism. Psychiatry Res. 316, 114735. https://doi.org/10.1016/j.psychres.2022.114735 (2022).
doi: 10.1016/j.psychres.2022.114735 pubmed: 35878480
Lord, C., Rutter, M. & Le Couteur, A. Autism diagnostic interview-revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. J. Autism Dev. Disord. 24, 659–685. https://doi.org/10.1007/BF02172145 (1994).
doi: 10.1007/BF02172145 pubmed: 7814313
Lord, C. et al. J. Autism Dev. Disord. 30, 205–223. https://doi.org/10.1023/A:1005592401947 (2000).
doi: 10.1023/A:1005592401947 pubmed: 11055457
Carmona, A. S., Kakkar, F. & Gantt, S. Perinatal cytomegalovirus infection. Curr. Treat. Opt. Pediatr. 8, 395–411. https://doi.org/10.1007/s40746-022-00261-y (2022).
doi: 10.1007/s40746-022-00261-y
Forget, P. et al. What is the normal value of the neutrophil-to-lymphocyte ratio?. BMC Res. Notes 10, 12. https://doi.org/10.1186/s13104-016-2335-5 (2017).
doi: 10.1186/s13104-016-2335-5 pubmed: 28057051 pmcid: 5217256
Williams, A. et al. Obstetric and neonatal complications among women with autoimmune disease. J. Autoimmun. 103, 102287. https://doi.org/10.1016/j.jaut.2019.05.015 (2019).
doi: 10.1016/j.jaut.2019.05.015 pubmed: 31147159 pmcid: 6708459
Ellul, P. et al. Regulatory T lymphocytes/Th17 lymphocytes imbalance in autism spectrum disorders: Evidence from a meta-analysis. Mol. Autism 12, 68. https://doi.org/10.1186/s13229-021-00472-4 (2021).
doi: 10.1186/s13229-021-00472-4 pubmed: 34641964 pmcid: 8507168
Nadeem, A. et al. Dysregulation in IL-6 receptors is associated with upregulated IL-17A related signaling in CD4+ T cells of children with autism. Prog. Neuropsychopharmacol. Biol. Psychiatry 97, 109783. https://doi.org/10.1016/j.pnpbp.2019.109783 (2020).
doi: 10.1016/j.pnpbp.2019.109783 pubmed: 31655158
Alves de Lima, K. et al. Meningeal γδ T cells regulate anxiety-like behavior via IL-17a signaling in neurons. Nat. Immunol. 21, 1421–1429. https://doi.org/10.1038/s41590-020-0776-4 (2020).
doi: 10.1038/s41590-020-0776-4 pubmed: 32929273
Ribeiro, M. et al. Meningeal γδ T cell-derived IL-17 controls synaptic plasticity and short-term memory. Sci. Immunol. https://doi.org/10.1126/sciimmunol.aay5199 (2019).
doi: 10.1126/sciimmunol.aay5199 pubmed: 31604844 pmcid: 6894940
Ito, M. et al. Brain regulatory T cells suppress astrogliosis and potentiate neurological recovery. Nature 565, 246–250. https://doi.org/10.1038/s41586-018-0824-5 (2019).
doi: 10.1038/s41586-018-0824-5 pubmed: 30602786
Xu, Z. et al. Rescue of maternal immune activation-induced behavioral abnormalities in adult mouse offspring by pathogen-activated maternal Treg cells. Nat. Neurosci. 24, 818–830. https://doi.org/10.1038/s41593-021-00837-1 (2021).
doi: 10.1038/s41593-021-00837-1 pubmed: 33859437
Patel, S. et al. Social impairments in autism spectrum disorder are related to maternal immune history profile. Mol. Psychiatry https://doi.org/10.1038/mp.2017.201 (2017).
doi: 10.1038/mp.2017.201 pubmed: 29731509 pmcid: 6594833
Shimizu, Y. et al. Exposure to maternal immune activation causes congenital unfolded protein response defects and increases the susceptibility to postnatal inflammatory stimulation in offspring. J. Inflamm. Res. 14, 355–365. https://doi.org/10.2147/JIR.S294238 (2021).
doi: 10.2147/JIR.S294238 pubmed: 33603435 pmcid: 7886242
Pitoiset, F. et al. Deep phenotyping of immune cell populations by optimized and standardized flow cytometry analyses. Cytom. Part. J. Int. Soc. Anal. Cytol. 93, 793–802. https://doi.org/10.1002/cyto.a.23570 (2018).
doi: 10.1002/cyto.a.23570
Collier, S. A. et al. Prevalence of self-reported infection during pregnancy among control mothers in the National Birth Defects Prevention Study. Birth Defects Res. A Clin. Mol. Teratol. 85, 193–201. https://doi.org/10.1002/bdra.20540 (2009).
doi: 10.1002/bdra.20540 pubmed: 19086018
Fest, J. et al. The neutrophil-to-lymphocyte ratio is associated with mortality in the general population: The Rotterdam study. Eur. J. Epidemiol. 34, 463–470. https://doi.org/10.1007/s10654-018-0472-y (2019).
doi: 10.1007/s10654-018-0472-y pubmed: 30569368
Bai, L. et al. Comparison of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio for the diagnosis of neonatal sepsis: A systematic review and meta-analysis. BMC Pediatr. 23, 334. https://doi.org/10.1186/s12887-023-04094-y (2023).
doi: 10.1186/s12887-023-04094-y pubmed: 37391699 pmcid: 10311819
Olasińska-Wiśniewska, A. et al. The beneficial role of simple inflammatory blood indices in pediatric cardiology. Adv. Clin. Exp. Med. 32, 1041–1048. https://doi.org/10.17219/acem/159947 (2023).
doi: 10.17219/acem/159947 pubmed: 36920265
Hajibandeh, S., Hajibandeh, S., Hobbs, N. & Mansour, M. Neutrophil-to-lymphocyte ratio predicts acute appendicitis and distinguishes between complicated and uncomplicated appendicitis: A systematic review and meta-analysis. Am. J. Surg. 219, 154–163. https://doi.org/10.1016/j.amjsurg.2019.04.018 (2020).
doi: 10.1016/j.amjsurg.2019.04.018 pubmed: 31056211
Hosseini, S. et al. The impact of neutrophil-lymphocyte ratio in febrile seizures: A systematic review and meta-analysis. BioMed. Res. Int. 2022, 1–14. https://doi.org/10.1155/2022/8472795 (2022).
doi: 10.1155/2022/8472795

Auteurs

Pierre Ellul (P)

Child and Adolescent Psychiatry Department, Robert Debre Hospital, APHP, 48 Boulevard Serurier, 75019, Paris, France. pierre.ellul@aphp.fr.
UMRS_959, Immunology-Immunopathology-Immunotherapy (i3), Sorbonne Université/INSERM, Paris, France. pierre.ellul@aphp.fr.

Anna Maruani (A)

Child and Adolescent Psychiatry Department, Robert Debre Hospital, APHP, 48 Boulevard Serurier, 75019, Paris, France.
Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France.

Hugo Peyre (H)

Child and Adolescent Psychiatry Department, Robert Debre Hospital, APHP, 48 Boulevard Serurier, 75019, Paris, France.

Valérie Vantalon (V)

Child and Adolescent Psychiatry Department, Robert Debre Hospital, APHP, 48 Boulevard Serurier, 75019, Paris, France.

Daphnée Hoareau (D)

Child and Adolescent Psychiatry Department, Robert Debre Hospital, APHP, 48 Boulevard Serurier, 75019, Paris, France.

Hugo Tiercelin (H)

Child and Adolescent Psychiatry Department, Robert Debre Hospital, APHP, 48 Boulevard Serurier, 75019, Paris, France.

Michelle Rosenzwajg (M)

UMRS_959, Immunology-Immunopathology-Immunotherapy (i3), Sorbonne Université/INSERM, Paris, France.

David Klatzmann (D)

UMRS_959, Immunology-Immunopathology-Immunotherapy (i3), Sorbonne Université/INSERM, Paris, France.

Richard Delorme (R)

Child and Adolescent Psychiatry Department, Robert Debre Hospital, APHP, 48 Boulevard Serurier, 75019, Paris, France.
Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France.

Classifications MeSH