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      Association between Neutrophil-to-Lymphocyte Ratio and Gut Microbiota in a Large Population: a Retrospective Cross-Sectional Study

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          Abstract

          Gut microbiota and blood neutrophil-to-lymphocyte ratio (NLR) are associated with systemic inflammation; however, data on the association between gut microbiota and NLR are lacking. We investigated the association between gut microbiota and NLR. A total of 1,309 subjects who had available data on NLR and 16 S rRNA sequencing of gut microbiota were included in this study. They were grouped according to NLR quartile (Q) as follows: lower Q (n = 328, <25% of NLR range), middle 2Q (n = 653, ≥25% to <75%) and upper Q (n = 328, ≥75%). The diversity and composition of the human gut microbiota in the groups were calculated. The phylogenetic diversity of gut microbiota in the lower group was significantly higher than in the middle 2Q group ( P = 0.040). The beta-diversity was significantly different among the three groups ( P = 0.043), between the lower and middle 2Q groups ( P = 0.029), and between the lower and upper groups ( P = 0.026). Bacteroides eggerthii showed a positive correlation with NLR (q = 0.015). The diversity and composition of the gut microbiome were different between the NLR groups. Particularly, patients with a lower NLR had a greater diversity of gut microbiota.

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          Most cited references30

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          Advancing our understanding of the human microbiome using QIIME.

          High-throughput DNA sequencing technologies, coupled with advanced bioinformatics tools, have enabled rapid advances in microbial ecology and our understanding of the human microbiome. QIIME (Quantitative Insights Into Microbial Ecology) is an open-source bioinformatics software package designed for microbial community analysis based on DNA sequence data, which provides a single analysis framework for analysis of raw sequence data through publication-quality statistical analyses and interactive visualizations. In this chapter, we demonstrate the use of the QIIME pipeline to analyze microbial communities obtained from several sites on the bodies of transgenic and wild-type mice, as assessed using 16S rRNA gene sequences generated on the Illumina MiSeq platform. We present our recommended pipeline for performing microbial community analysis and provide guidelines for making critical choices in the process. We present examples of some of the types of analyses that are enabled by QIIME and discuss how other tools, such as phyloseq and R, can be applied to expand upon these analyses. © 2013 Elsevier Inc. All rights reserved.
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            Neutrophil to lymphocyte ratio and cardiovascular diseases: a review.

            The role of inflammatory markers in cardiovascular diseases has been studied extensively and a consistent relationship between various inflammatory markers and cardiovascular diseases has been established in the past. Neutrophil to lymphocyte ratio (NLR) is a new addition to the long list of these inflammatory markers. NLR, which is calculated from complete blood count with differential, is an inexpensive, easy to obtain, widely available marker of inflammation, which can aid in the risk stratification of patients with various cardiovascular diseases in addition to the traditionally used markers. It has been associated with arterial stiffness and high coronary calcium score, which are themselves significant markers of cardiovascular disease. NLR is reported as an independent predictor of outcome in stable coronary artery disease, as well as a predictor of short- and long-term mortality in patients with acute coronary syndromes. It is linked with increased risk of ventricular arrhythmias during percutaneous coronary intervention (PCI) and higher long-term mortality in patients undergoing PCI irrespective of indications of PCI. In patients admitted with advanced heart failure, high NLR was reported with higher inpatient mortality. Recently, NLR has been reported as a prognostic marker for outcome from coronary artery bypass grafting and postcoronary artery bypass grafting atrial fibrillation.
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              The Gut Microbiota in Immune-Mediated Inflammatory Diseases

              The collection of microbes and their genes that exist within and on the human body, collectively known as the microbiome has emerged as a principal factor in human health and disease. Humans and microbes have established a symbiotic association over time, and perturbations in this association have been linked to several immune-mediated inflammatory diseases (IMID) including inflammatory bowel disease, rheumatoid arthritis, and multiple sclerosis. IMID is a term used to describe a group of chronic, highly disabling diseases that affect different organ systems. Though a cornerstone commonality between IMID is the idiopathic nature of disease, a considerable portion of their pathobiology overlaps including epidemiological co-occurrence, genetic susceptibility loci and environmental risk factors. At present, it is clear that persons with an IMID are at an increased risk for developing comorbidities, including additional IMID. Advancements in sequencing technologies and a parallel explosion of 16S rDNA and metagenomics community profiling studies have allowed for the characterization of microbiomes throughout the human body including the gut, in a myriad of human diseases and in health. The main challenge now is to determine if alterations of gut flora are common between IMID or, if particular changes in the gut community are in fact specific to a single disease. Herein, we review and discuss the relationships between the gut microbiota and IMID.
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                Author and article information

                Contributors
                hyung@ewha.ac.kr
                jinhwalee@ewha.ac.kr
                Journal
                Sci Rep
                Sci Rep
                Scientific Reports
                Nature Publishing Group UK (London )
                2045-2322
                30 October 2018
                30 October 2018
                2018
                : 8
                : 16031
                Affiliations
                [1 ]ISNI 0000 0001 2171 7754, GRID grid.255649.9, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, , College of Medicine, Ewha Womans University, ; Seoul, Republic of Korea
                [2 ]ISNI 0000 0001 2181 989X, GRID grid.264381.a, Medical Research Institute, Kangbuk Samsung Hospital, , Sungkyunkwan University, School of Medicine, ; Seoul, South Korea
                [3 ]ISNI 0000 0001 2181 989X, GRID grid.264381.a, Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, , Sungkyunkwan University, School of Medicine, ; Seoul, South Korea
                [4 ]ISNI 0000 0001 2181 989X, GRID grid.264381.a, Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, , Sungkyunkwan University, School of Medicine, ; Seoul, South Korea
                [5 ]ISNI 0000 0001 2181 989X, GRID grid.264381.a, Department of Family Medicine, Kangbuk Samsung Hospital, , Sungkyunkwan University School of Medicine, ; Seoul, South Korea
                [6 ]ISNI 0000 0001 2171 7754, GRID grid.255649.9, Department of Biochemistry, College of Medicine, , Ewha Womans University, ; Seoul, Republic of Korea
                Author information
                http://orcid.org/0000-0003-0843-9862
                Article
                34398
                10.1038/s41598-018-34398-4
                6207698
                30375452
                93d84dcf-4d8b-4c4a-8f4a-7b2da8d0cbdf
                © The Author(s) 2018

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 26 July 2018
                : 18 October 2018
                Funding
                Funded by: FundRef https://doi.org/10.13039/501100003710, Korea Health Industry Development Institute (KHIDI);
                Award ID: 2010-0027945
                Award ID: 2010-0027945
                Award Recipient :
                Funded by: FundRef https://doi.org/10.13039/501100003725, National Research Foundation of Korea (NRF);
                Award ID: NRF-2016R1A6A3A11932719
                Award ID: NRF-2016R1A6A3A11932719
                Award ID: NRF-2018R1D1A1B07050067
                Award Recipient :
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