Low-grade systemic inflammation in patients with amyotrophic lateral sclerosis

Acta Neurol Scand. 2009 Jun;119(6):383-9. doi: 10.1111/j.1600-0404.2008.01112.x. Epub 2008 Oct 23.


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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amyotrophic Lateral Sclerosis / blood
  • Amyotrophic Lateral Sclerosis / complications
  • Amyotrophic Lateral Sclerosis / physiopathology*
  • Biomarkers / blood
  • Blood Sedimentation
  • C-Reactive Protein / analysis
  • Disease Progression
  • Female
  • Fibrinogen / analysis
  • Humans
  • Inflammation / blood
  • Inflammation / etiology
  • Inflammation / physiopathology*
  • Leukocyte Count
  • Male
  • Middle Aged
  • Prognosis


  • Biomarkers
  • Fibrinogen
  • C-Reactive Protein