Peripheral blood immune inflammatory markers in neuromyelitis optica spectrum disorders

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune neuroinflammatory disease with high relapse risk and cumulative neurological disability. Identifying, providing early warning, and reproducible monitoring of disease progression and therapeutic efficacy in peripheral blood biomarkers is crucial for clinical management and personalized treatment. Numerous studies have investigated the relationship between peripheral blood immune-inflammatory markers including cytological ratios, cytokines, complement components and NMOSD disease activity, relapse risk, and long-term outcomes, aiming to evaluate their potential application in clinical prognostic assessment and treatment monitoring. Meta-analyses have shown that the neutrophil-to-lymphocyte ratio (NLR) is significantly elevated in patients with NMOSD compared with healthy controls (mean difference (MD) approximately 1.04, 95% CI 0.76-1.32; high heterogeneity). The NLR is associated with relapse risk and disability (EDSS ≥4) (OR for relapse, approximately 1.33-2.14; OR for EDSS ≥ 4, approximately 1.23-1.43), supporting the potential clinical application of peripheral blood Immune inflammatory markers in NMOSD. This review summarizes the current evidence for peripheral blood inflammatory markers in NMOSD, focusing on their clinical application.