White blood cell count profiles in multiple sclerosis during attacks before the initiation of acute and chronic treatments

Tetsuya Akaishi,Naoki Nakaya,Ikumi Kanno,Kazuo Fujihara,Tomohiro Nakamura,Fumi Itabashi,Kimihiko Kaneko,Masashi Aoki,Tadashi Ishii,Hiroshi Kuroda,Rieko Hatanaka,Juichi Fujimori,Ichiro Nakashima,Yoshiki Takai,Shuhei Nishiyama,Toshiyuki Takahashi,Atsushi Hozawa,Tatsuro Misu,Mana Kogure

doi:10.1038/s41598-021-01942-8

Abstract

Multiple sclerosis (MS) is a major demyelinating disease of the central nervous system; however, its exact mechanism is unknown. This study aimed to elucidate the profile of white blood cells (WBCs) in the acute phase of an MS attack. Sixty-four patients with MS at the time of diagnosis and 2492 age- and sex-adjusted healthy controls (HCs) were enrolled. Data regarding the blood cell counts were compared between the groups. The total WBC (p < 0.0001), monocyte (p < 0.0001), basophil (p = 0.0027), and neutrophil (p < 0.0001) counts were higher in the MS group than in the HC group, whereas the lymphocyte and eosinophil counts did not differ. Adjustments for the smoking status and body mass index yielded the same results. The total and differential WBC counts of the patients with MS did not correlate with the counts of T2 hyperintense brain lesions or the levels of neurological disturbance. In summary, patients with MS showed elevated counts of total WBCs, monocytes, basophils, and neutrophils at the time of diagnosis. However, the clinical relevance of these biomarkers in the context of the development and progression of MS remains unclear.

Highlights

Multiple sclerosis (MS) is a major demyelinating disease of the central nervous system; its exact mechanism is unknown
IgM antibodies against other infections, such as measles, rubella, mumps, varicella-zoster virus (VZV), herpes simplex virus (HSV), cytomegalovirus, and human immunodeficiency virus (HIV), were absent in all of the evaluated patients with MS
The results revealed that the total white blood cells (WBCs) count and differential monocyte, basophil, and neutrophil counts, all of which are related to the innate immune system, were significantly elevated in the MS group compared to the healthy controls (HCs) group

Summary

Introduction

Multiple sclerosis (MS) is a major demyelinating disease of the central nervous system; its exact mechanism is unknown. Abbreviations HC Healthy controls MLR Monocyte-to-lymphocyte ratio MS Multiple sclerosis NLR Neutrophil-to-lymphocyte ratio PLR Platelet-to-lymphocyte ratio WBC White blood cell. Several previous studies have reported that patients with MS may show slightly elevated levels of neutrophil-to-lymphocyte ratios (NLR) in the peripheral blood compared to HCs, which may reflect the disease activity and p rognosis[4,5,6,7]. This fact suggested that the innate immune system, rather than the adaptive immune system, might be activated in patients with M S8,9. This study aimed to confirm the activation of the innate immune system in MS by enrolling a large number of HCs, and further attempted to determine the influence of differential WBC counts on the clinical manifestation of the disease

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