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Liang J, Guan X, Sun Q, Hao Y, Xiu M. Neutrophil/lymphocyte ratio and cognitive performances in first-episode patients with schizophrenia and healthy controls. Prog Neuropsychopharmacol Biol Psychiatry 2024; 135:111092. [PMID: 39029649 DOI: 10.1016/j.pnpbp.2024.111092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 06/20/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
Abnormal immune and inflammatory responses are considered to contribute to schizophrenia (SZ). The neutrophil/lymphocyte ratio (NLR) is an inexpensive and reproducible marker of systemic inflammatory responses. Accumulating studies have demonstrated that NLR values are increased in SZ compared to healthy controls and closely related to clinical symptoms in antipsychotic-naïve first-episode SZ (ANFES) patients. However, to our knowledge, only one study has examined NLR in relation to neurocognition in 27 first-episode psychosis patients and 27 controls. This study aimed to examine the relationship of NLR values with cognitive performances in ANFES patients with a larger sample size. Whole blood cell counts were measured in ninety-seven ANFES patients and fifty-six control subjects. The neurocognitive functions of all subjects were measured by the repeatable battery for the assessment of neuropsychological status (RBANS). ANFES patients performed worse on cognition and had increased NLR values relative to healthy controls. In addition, increased NLR was negatively associated with cognitive functions in ANFES patients. Lymphocyte count was positively correlated with cognitive functions in patients. These findings suggest that the abnormal immune and inflammation system indicated by NLR may be involved in the cognitive functions in ANFES patients.
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Affiliation(s)
- Jing Liang
- Qingdao Mental Health Center, Qingdao, China
| | - Xiaoni Guan
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China
| | | | - Yong Hao
- Department of Neurology, Renji Hospital, School of Medicine Shanghai Jiao Tong University, Shanghai, China.
| | - Meihong Xiu
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, China.
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Avşar PA, Kara T, Kocaman O, Akkuş M. Evaluation of primary markers of inflammation and the systemic inflammation index in specific learning disabilities. Biomark Med 2024:1-10. [PMID: 39360657 DOI: 10.1080/17520363.2024.2404387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 09/11/2024] [Indexed: 10/04/2024] Open
Abstract
Aim: Specific learning disorder (SLD) is a term that refers to reading, writing and arithmetic difficulties. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and systemic inflammation index (SII) are affordable and accessible inflammatory biomarkers. This research aims to evaluate the relationship between NLR, PLR, SII and SLD to determine whether inflammation contributes to pathogenesis.Methods: This study included 90 SLD-diagnosed patients and 90 age-, sex- and ethnicity-matched healthy controls. Blood cell counts and NLR, PLR and SII values were obtained from medical records and compared between the two groups.Results: The NLR, PLR and SII were significantly higher (p = 0.029, p = 0.033 and p = 0.018 respectively) and lymphocyte counts were significantly lower (p = 0.041) in the SLD group. WISC-R total scores decreased with age in the SLD group (-1.988 coefficient, Beta = -0.247 ß, p = 0.041). Multivariate logistic regression analysis revealed that the SII was the only parameter independently associated with the diagnosis of SLD (Beta = 0.003, p = 0.023).Conclusion: Inflammation might play a role in SLD etiopathogenesis. NLR, PLR and SII may be potential biomarkers for SLD in children. Further research may lead to early diagnosis and additional anti-inflammatory pharmacological therapies for SLDs.
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Affiliation(s)
- Pınar Aydoğan Avşar
- Department of Child & Adolescent Psychiatry, Alanya Education & Research Hospital, Antalya, 07425, Turkey
| | - Tayfun Kara
- Department of Child & Adolescent Psychiatry, Alanya Alaaddin Keykubat University Faculty of Medicine, Antalya, 07425, Turkey
| | - Orhan Kocaman
- Department of Child & Adolescent Psychiatry, Alanya Alaaddin Keykubat University Faculty of Medicine, Antalya, 07425, Turkey
| | - Merve Akkuş
- Department of Psychiatry, Faculty of Medicine, Kütahya Health Sciences University, Kütahya, 43100, Turkey
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3
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Zheng Y, Yin K, Li L, Wang X, Li H, Li W, Fang Z. Association between immune-inflammation-based prognostic index and depression: An exploratory cross-sectional analysis of NHANES data. J Affect Disord 2024; 362:75-85. [PMID: 38944294 DOI: 10.1016/j.jad.2024.06.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 06/22/2024] [Accepted: 06/25/2024] [Indexed: 07/01/2024]
Abstract
BACKGROUND Immune-inflammatory mediators influence numerous immune and inflammatory pathways, elevating the likelihood of depression. The systemic immune-inflammation index (SII) emerges as an innovative prognostic indicator, integrating various peripheral blood immune cell subpopulations, specifically neutrophils, platelets, and lymphocytes. This exploratory study aims to examine the correlation between SII and depression. METHODS Data from the 2005-2020 National Health and Nutrition Examination Survey (NHANES) were utilized. Depression was diagnosed with a Patient Health Questionnaire score of 10 or higher. The relationship between log2-SII and depression incidence was analyzed using a restricted cubic spline (RCS). Logistic regression was employed to calculate the odds ratio of depression concerning log2-SII. In cases of non-linearity, piecewise linear models with change points were applied to assess the associations in both the overall population and specific subgroups. Additionally, subgroup analyses were conducted to determine the applicability of the findings to particular populations. RESULTS A total of 42,133 participants were included in the study, comprising 49.32 % men and 50.68 % women, with an average age of 47.02 ± 17.45 years. RCS analysis demonstrated a J-shaped non-linear relationship between log2-SII and depression incidence. When log2-SII was ≥8.50, SII showed a positive association with depression incidence, even after adjusting for covariates. Additionally, each unit increase in log2-SII corresponded to an 18 % rise in depression incidence (OR = 1.18, 95 % CI: 1.10-1.27). Subgroup analysis further revealed that the association between SII and depression incidence varied across different populations. LIMITATIONS Due to the cross-sectional nature of NHANES, causality or long-term implications cannot be inferred. Further research is needed to ascertain if a longitudinal relationship exists between SII and depression. CONCLUSION Our findings suggest a significant and complex non-linear association between SII and depression. However, further basic and prospective studies are necessary to explore SII's impact on depression and clarify its underlying mechanisms. Additionally, these studies will provide a foundation for personalized interventions targeting the immune-inflammatory processes in patients with depression and elevated SII.
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Affiliation(s)
- Yawei Zheng
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China; Nanjing University of Chinese Medicine, Nanjing, China
| | - Kailin Yin
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China; Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Li Li
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China; Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Xintong Wang
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China; Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Hui Li
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China; Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Wenlei Li
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China; Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
| | - Zhuyuan Fang
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China; Jiangsu Province Hospital of Chinese Medicine, Nanjing, China; Nanjing University of Chinese Medicine, Nanjing, China.
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Zhou J, Bränn E, Hysaj E, Seitz C, Hou Y, Song H, Bergstedt J, Chang Z, Fang F, Pedersen NL, Valdimarsdóttir UA, Lu D. Association between inflammatory biomarkers before pregnancy and risk of perinatal depression: A prospective cohort study of 4483 women in Sweden. J Affect Disord 2024; 368:S0165-0327(24)01615-X. [PMID: 39303887 DOI: 10.1016/j.jad.2024.09.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 09/16/2024] [Accepted: 09/17/2024] [Indexed: 09/22/2024]
Abstract
AIM Perinatal depression (PND) is a global health concern, affecting millions of childbearing women. Emerging data suggest that inflammation may play a role in the development of PND. Peripheral blood inflammatory biomarkers before pregnancy are widely tested in clinical practice at minimum cost, yet their potential role in PND risk remains unknown. METHODS We conducted a prospective cohort study of 4483 birthing women during 2009-2021 within the LifeGene study with linkage to Swedish registers. Peripheral blood inflammatory biomarkers were profiled at baseline. Cases of PND were identified using validated tools or clinical diagnosis from subsequent pregnancies and postpartum periods. Logistic regression models were employed to assess the associations of each inflammatory biomarker (z scored) with PND. RESULTS We identified 495 (11.0 %) PND cases with an average age of 29.2 years. Pre-pregnancy platelet-to-lymphocyte ratio (PLR) was positively associated [OR, 95 % CI:1.14(1.01,1.27)], while lymphocyte count was inversely associated [OR, 95 % CI: 0.89(0.80,0.98)] with PND. A dose-response relationship was indicated for both PLR and lymphocytes when analyzed in categories based on tertile distribution. These associations appeared more pronounced for postpartum depression than antepartum depression and were independent of psychiatric comorbidities. CONCLUSION With implications for future mechanistic research, these findings suggest that blood levels of lymphocytes and PLR before pregnancy are associated with subsequent risk of PND in a dose-response manner.
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Affiliation(s)
- Jing Zhou
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Emma Bränn
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Elgeta Hysaj
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Christina Seitz
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Ying Hou
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Huan Song
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jacob Bergstedt
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Zheng Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Fang Fang
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Unnur A Valdimarsdóttir
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Donghao Lu
- Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Chen J, Hua S, Huang L, Zhang X, Yao W, Xue Z. Exploring sedentary behavior, neutrophil-to-lymphocyte ratio, and depression: Mediation analysis in NHANES. Prog Neuropsychopharmacol Biol Psychiatry 2024; 136:111140. [PMID: 39265922 DOI: 10.1016/j.pnpbp.2024.111140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 09/08/2024] [Accepted: 09/09/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND Sedentary behavior and depression have been linked to inflammation. However, the specific role of inflammation in the relationship between sedentary behavior and depression remains unclear. METHOD We examined associations among the inflammatory marker (neutrophil-to-lymphocyte ratio [NLR]), sedentary behavior, and depression in a robust, ethnically diverse sample (n = 29,769) from the National Health and Nutrition Examination Survey (NHANES). RESULT Our findings indicate that individuals experiencing depression and/or engaging in sedentary behavior show elevated levels of the NLR. Even after adjusting for confounding variables such as age, sex, and body mass index, sedentary behavior remains significantly associated with both depression and NLR levels. Additionally, our analysis reveals a non-linear relationship between NLR levels and depression, suggesting a complex interaction. Importantly, NLR partially mediates a modest yet statistically significant portion (1.920 %, p = 0.014) of the association between sedentary behavior and depression. CONCLUSION This study highlights the intricate interplay among sedentary behavior, inflammation, and depression, providing insights into potential avenues for intervention and management.
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Affiliation(s)
- Jing Chen
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, People's Republic of China; Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, People's Republic of China
| | - Shengyuan Hua
- Shanghai Children's Hospital, People's Republic of China; Shanghai Children's Hospital, School of Medicine, Shanghai Jao Tong University, People's Republic of China
| | - Lirong Huang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, People's Republic of China; Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, People's Republic of China
| | - Xinguang Zhang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, People's Republic of China; Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, People's Republic of China.
| | - Wenbo Yao
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, People's Republic of China
| | - Zheng Xue
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, People's Republic of China; Department of Pediatrics, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, 274 Zhijiang Middle Road, Shanghai, People's Republic of China.
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Liu Z, Lv D, Li J, Li F, Zhang Y, Liu Y, Gao C, Qiu Y, Ma J, Zhang R. The potential predictive value and relationship of blood-based inflammatory markers with the clinical symptoms of Han Chinese patients with first-episode adolescent-onset schizophrenia. Front Psychiatry 2024; 15:1431350. [PMID: 39290303 PMCID: PMC11405196 DOI: 10.3389/fpsyt.2024.1431350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2024] [Accepted: 08/12/2024] [Indexed: 09/19/2024] Open
Abstract
Background Inflammation is associated with the pathophysiology of schizophrenia. The blood markers for systemic inflammation include neutrophil-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), lymphocyte-monocyte ratio (LMR), system inflammation response index (SIRI), and platelet-lymphocyte ratio (PLR). However, these inflammation markers and their relationships with clinical phenotypes among Han Chinese patients with first-episode adolescent-onset schizophrenia (AOS) is unclear. This investigation aimed to elucidate the impact of inflammation on Han Chinese AOS patients as well as the association of blood-based inflammation markers with clinical symptoms. Methods Altogether, 203 Han Chinese individuals participated in this study, 102 first-episode AOS patients and 101 healthy controls. The assessment of inflammatory indices was based on complete blood cell count. Furthermore, schizophrenia-related clinical symptoms were evaluated using the five-factor model of the Positive and Negative Syndrome Scale (PANSS). Results In Han Chinese first-episode AOS patients, levels of SIRI, PLR, SII, and NLR were significantly increased (p < 0.001), while LMR decreased (p < 0.001) compared to healthy controls. Furthermore, multivariate logistic regression showed that LMR, NLR, SII, and SIRI (all p < 0.05) were independently associated with AOS. Moreover, Receiver operating characteristics assessment indicated that NLR, SIRI, LMR, and SII could effectively distinguish AOS patients from healthy controls. Their areas under the curves were 0.734, 0.701, 0.715, and 0.730 (all p < 0.001). In addition, Correlation analysis revealed that LMR was negatively correlated with the PANSS total, negative, and cognitive factor scores (all p < 0.05); NLR was positively correlated with the cognitive factor score (p < 0.01); SII was negatively correlated with the positive factor score and positively with the negative and cognitive factor scores (all p < 0.05); SIRI was positively correlated with the PANSS total and cognitive factor scores (all p < 0.01). Conclusions This research established the involvement of peripheral blood inflammatory markers (LMR, NLR, SII, and SIRI) with the clinical manifestations and pathophysiology of schizophrenia, and these can serve as screening tools or potential indices of the inflammatory state and AOS symptoms severity.
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Affiliation(s)
- Zhihua Liu
- Department of Psychiatry, The Fourth People's Hospital of Nanyang, Nanyang, Henan, China
| | - Dali Lv
- Department of Psychiatry, The Fourth People's Hospital of Nanyang, Nanyang, Henan, China
| | - Jianfeng Li
- Department of Psychiatry, The Fourth People's Hospital of Nanyang, Nanyang, Henan, China
| | - Fuwei Li
- Department of Psychiatry, The Fourth People's Hospital of Nanyang, Nanyang, Henan, China
| | - Yanhua Zhang
- Department of Psychiatry, The Fourth People's Hospital of Nanyang, Nanyang, Henan, China
| | - Yongjie Liu
- Department of Psychiatry, The Fifth People's Hospital of Luoyang, Luoyang, Henan, China
| | - Chao Gao
- Department of Psychiatry, The Fourth People's Hospital of Nanyang, Nanyang, Henan, China
| | - Yafeng Qiu
- Department of Psychiatry, The Fourth People's Hospital of Nanyang, Nanyang, Henan, China
| | - Jun Ma
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China
| | - Ruiling Zhang
- Department of Psychiatry, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, China
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Kigar SL, Lynall ME, DePuyt AE, Atkinson R, Sun VH, Samuels JD, Eassa NE, Poffenberger CN, Lehmann ML, Listwak SJ, Livak F, Elkahloun AG, Clatworthy MR, Bullmore ET, Herkenham M. Chronic social defeat stress induces meningeal neutrophilia via type I interferon signaling. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.08.30.610447. [PMID: 39257811 PMCID: PMC11383661 DOI: 10.1101/2024.08.30.610447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2024]
Abstract
Animal models of stress and stress-related disorders are also associated with blood neutrophilia. The mechanistic relevance of this to symptoms or behavior is unclear. We used cytometry, immunohistochemistry, whole tissue clearing, and single-cell sequencing to characterize the meningeal immune response to chronic social defeat (CSD) stress in mice. We find that chronic, but not acute, stress causes meningeal neutrophil accumulation, and CSD increases neutrophil trafficking in vascular channels emanating from skull bone marrow (BM). Transcriptional analysis suggested CSD increases type I interferon (IFN-I) signaling in meningeal neutrophils. Blocking this pathway via the IFN-I receptor (IFNAR) protected against the anhedonic and anxiogenic effects of CSD stress, potentially through reduced infiltration of IFNAR+ neutrophils into the meninges from skull BM. Our identification of IFN-I signaling as a putative mediator of meningeal neutrophil recruitment may facilitate development of new therapies for stress-related disorders.
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Affiliation(s)
- Stacey L Kigar
- National Institute of Mental Health, Bethesda, MD, USA
- Department of Medicine, University of Cambridge, UK
- Department of Psychiatry, University of Cambridge, UK
| | - Mary-Ellen Lynall
- Department of Psychiatry, University of Cambridge, UK
- Molecular Immunity Unit, University of Cambridge Department of Medicine, Cambridge, UK
| | | | | | | | | | | | | | | | | | - Ferenc Livak
- Laboratory of Genome Integrity, Flow Cytometry Core, National Cancer Institute, Bethesda, MD, USA
| | - Abdel G Elkahloun
- Microarrays and Single-Cell Genomics, National Human Genome Research Institute, Bethesda, MD, USA
| | - Menna R Clatworthy
- Molecular Immunity Unit, University of Cambridge Department of Medicine, Cambridge, UK
- Cellular Genetics, Wellcome Sanger Institute, UK
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Ninla-Aesong P, Kietdumrongwong P, Neupane SP, Puangsri P, Jongkrijak H, Chotipong P, Kaewpijit P. Relative value of novel systemic immune-inflammatory indices and classical hematological parameters in predicting depression, suicide attempts and treatment response. Sci Rep 2024; 14:19018. [PMID: 39152198 PMCID: PMC11329510 DOI: 10.1038/s41598-024-70097-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 08/13/2024] [Indexed: 08/19/2024] Open
Abstract
This study compared the power of the novel inflammatory markers systemic immune inflammation index (SII) and the system inflammation response index (SIRI) versus the classical hematological indices neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and platelet counts in distinguishing between major depressive disorder (MDD) with and without suicide attempts and distinguishing the non-response to selective serotonin reuptake inhibitor (SSRI) treatment. A total of 139 young adult MDD patients and 54 healthy controls (HC) were included. We found that, in comparison to HC, baseline NLR, PLR, SII, and SIRI were significantly higher in MDD patients, but only NLR and SII had area under the ROC curve (AUC) values greater than 0.7. MDD patients with suicide attempts (SA) showed significantly higher baseline MLR and SIRI, and a tendency to increase NLR compared to those without SA. In terms of AUC, sensitivity, and specificity, NLR was better than MLR, SIRI, SII, and PLR in distinguishing SA. Non-responders to SSRI treatment showed a significant increase in baseline platelet count and PLR compared to responders with an AUC greater than 0.7. These findings highlight the potential benefit of combining novel and classical hematological indices in predicting depression, suicide attempts and treatment response.
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Affiliation(s)
- Putrada Ninla-Aesong
- Department of Medical Science, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand.
- Research Center in Tropical Pathobiology, Walailak University, Nakhon Si Thammarat, Thailand.
| | | | - Sudan Prasad Neupane
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Sognsvannsveien 21, Building 12, 2nd Floor, 0372, Oslo, Norway
| | - Pavarud Puangsri
- Department of Medical Clinical Science, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand
| | - Haruthai Jongkrijak
- Walailak University Hospital, Walailak University, Nakhon Si Thammarat, Thailand
| | - Potiga Chotipong
- The Center for Scientific and Technological Equipment, Walailak University, Nakhon Si Thammarat, Thailand
| | - Pakin Kaewpijit
- Bangkok Mental Health Rehabilitation and Recovery Center (BMRC), Bangkok Hospital, Bangkok, Thailand
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9
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Chen PH, Hsiao CY, Chiang SJ, Chung KH, Tsai SY. Association of lipids and inflammatory markers with left ventricular wall thickness in patients with bipolar disorder. J Affect Disord 2024; 358:12-18. [PMID: 38705523 DOI: 10.1016/j.jad.2024.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 04/04/2024] [Accepted: 05/02/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Individuals with bipolar disorder (BD) face a high risk of heart failure and left ventricular (LV) dysfunction. Despite strong evidence that high LV relative wall thickness (RWT) is a risk marker for heart failure, few studies have evaluated LV RWT and aggravating factors in individuals with BD. METHODS We recruited 104 participants (52 patients with BD and 52 age- and sex-matched mentally healthy controls) to undergo echocardiographic imaging and biochemistry, high-sensitivity C-reactive protein (hs-CRP), and blood cell count measurements. LV RWT was estimated using the following equation: (2 × LV posterior wall end-diastolic thickness)/LV end-diastolic diameter. Clinical data were obtained through interviews and chart reviews. RESULTS The BD group exhibited a significantly greater LV RWT (Cohen's d = 0.53, p = 0.003) and a less favorable mitral valve E/A ratio (Cohen's d = 0.54, p = 0.023) and LV global longitudinal strain (Cohen's d = 0.57, p = 0.047) than did the control group. Multiple linear regression revealed that in the BD group, serum triglyceride levels (β = 0.466, p = 0.001), platelet-to-lymphocyte ratios (β = 0.324, p = 0.022), and hs-CRP levels (β = 0.289, p = 0.043) were all significantly and positively associated with LV RWT. LIMITATIONS This study applied a cross-sectional design, meaning that the direction of causation could not be inferred. CONCLUSIONS Patients with BD are at a risk of heart failure, as indicated by their relatively high LV RWT. Lipid levels and systemic inflammation may explain this unfavorable association.
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Affiliation(s)
- Pao-Huan Chen
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Yi Hsiao
- Division of Cardiology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan; Cardiovascular Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shuo-Ju Chiang
- Division of Cardiology, Department of Internal Medicine, Taipei City Hospital Yangming Branch, Taipei, Taiwan; School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei, Taiwan
| | - Kuo-Hsuan Chung
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Shang-Ying Tsai
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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Guo N, Wang X, Xu M, Bai J, Yu H, Le Zhang. PI3K/AKT signaling pathway: Molecular mechanisms and therapeutic potential in depression. Pharmacol Res 2024; 206:107300. [PMID: 38992850 DOI: 10.1016/j.phrs.2024.107300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 07/03/2024] [Accepted: 07/05/2024] [Indexed: 07/13/2024]
Abstract
Depression is a serious global mental disorder. Numerous studies have found that depression may be closely related to decreased neurogenesis, neuroinflammation, neurotransmitter imbalance, and synaptic plasticity dysfunction. The pathogenesis of depression is complex and involves multiple signal transduction pathways and molecular changes. The PI3K/AKT pathway is an essential signaling pathways in neurons, which is widely expressed in emotion-related regions of the brain. Therefore, the PI3K/AKT pathway may play a moderating role in mood disorders. However, the role and mechanism of the PI3K/AKT signaling pathway in depression have not been fully described. This review systematically summarized the role of the PI3K/AKT signaling pathway in the pathogenesis of depression and discussed its potential in the treatment of depression. This will help in the treatment of depression and the development of antidepressants.
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Affiliation(s)
- Ningning Guo
- School of Mental Health, Jining Medical University, Jining, China
| | - Xin Wang
- Department of Radiation Therapy, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Muran Xu
- Clinical College, Jining Medical University, Jining, China
| | - Jie Bai
- Medical School, Kunming University of Science and Technology, Kunming, China.
| | - Hao Yu
- School of Mental Health, Jining Medical University, Jining, China.
| | - Le Zhang
- Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, China.
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11
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Liu Y, Li C, Ren H, Han K, Wang X, Zang S, Zhao G. The relationship of peripheral blood cell inflammatory biomarkers and psychological stress in unmedicated major depressive disorder. J Psychiatr Res 2024; 176:155-162. [PMID: 38865865 DOI: 10.1016/j.jpsychires.2024.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/07/2024] [Accepted: 06/08/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Recent research has explored the linkage between major depressive disorder (MDD) and inflammation, especially via altered peripheral blood immune markers. However, the relationship between several novel leukocyte-derived ratios (LDR) and psychological stress in MDD remains uncertain. This study aimed to explore the relationship between LDR, clinical characteristics, recent life events, and childhood maltreatment in MDD patients. METHODS A cross-sectional case-control study was conducted involving 59 healthy controls (HC) and 50 unmedicated MDD patients. Subjects underwent psychological assessments and peripheral blood measurements. LDR assessed in this study included neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), white blood cell-to-mean platelet volume ratio (WMR), systemic immune inflammation index (SII), multiplication of neutrophil and monocyte counts (MNM), and systemic inflammation response index (SIRI). RESULTS MDD patients displayed significant alterations in WMR, PLR, and MNM compared to HC, as well as correlations between several LDR and various clinical features (duration of untreated psychosis and dNLR, the nine-item Patient Health Questionnaire and PLR, the 7-item Generalized Anxiety Disorder Questionnaire and SIRI (NLR and dNLR). There was a significant difference in the comparison of WMR in first-episode patients than in recurrent patients. Analyses further revealed an association between Life Event Scale total scores and NLR (dNLR). No correlation was found between Childhood Trauma Questionnaire total (or subscale) scores and LDR. Additionally, WMR and dNLR presented potential predictive value for distinguishing between MDD and HC. CONCLUSION The study concludes that MDD and some clinical features are associated with alterations in some peripheral blood LDR. These findings emphasize the potential role of peripheral blood LDR in the pathogenesis and clinical heterogeneity of MDD.
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Affiliation(s)
- Yigang Liu
- Department of Clinical Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Cuicui Li
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Honghong Ren
- Department of Psychology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Ke Han
- Department of Rehabilitation, Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan, Shandong, China
| | - Ximing Wang
- Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Shuqi Zang
- Department of Rehabilitation, Shandong Provincial Hospital Affiliated to Shandong First Medical University Jinan, Shandong, China
| | - Guoqing Zhao
- Department of Psychology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
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12
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Lyu N, Wang H, Zhao Q, Fu B, Li J, Yue Z, Huang J, Yang F, Liu H, Zhang L, Li R. Peripheral biomarkers to differentiate bipolar depression from major depressive disorder: a real-world retrospective study. BMC Psychiatry 2024; 24:543. [PMID: 39085797 PMCID: PMC11293032 DOI: 10.1186/s12888-024-05979-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 07/22/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Bipolar depression (BPD) is often misdiagnosed as a major depressive disorder (MDD) in clinical practice, which may be attributed to a lack of robust biomarkers indicative of differentiated diagnosis. This study analysed the differences in various hormones and inflammatory markers to explore peripheral biomarkers that differentiate BPD from MDD patients. METHODS A total of 2,048 BPD and MDD patients were included. A panel of blood tests was performed to determine the levels of sex hormones, stress hormones, and immune-related indicators. Propensity score matching (PSM) was used to control for the effect of potential confounders between two groups and further a receiver operating characteristic (ROC) curve was used to analyse the potential biomarkers for differentiating BPD from MDD. RESULTS Compared to patients with MDD, patients with BPD expressed a longer duration of illness, more hospitalisations within five years, and an earlier age of onset, along with fewer comorbid psychotic symptoms. In terms of biochemical parameters, MDD patients presented higher IgA and IgM levels, while BPD patients featured more elevated neutrophil and monocyte counts. ROC analysis suggested that combined biological indicators and clinical features could moderately distinguish between BPD and MDD. In addition, different biological features exist in BPD and MDD patients of different ages and sexes. CONCLUSIONS Differential peripheral biological parameters were observed between BPD and MDD, which may be age-sex specific, and a combined diagnostic model that integrates clinical characteristics and biochemical indicators has a moderate accuracy in distinguishing BPD from MDD.
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Affiliation(s)
- Nan Lyu
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Hutong Road, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
| | - Han Wang
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Hutong Road, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
| | - Qian Zhao
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Hutong Road, Xicheng District, Beijing, 100088, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
- Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
| | - Bingbing Fu
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Hutong Road, Xicheng District, Beijing, 100088, China
| | - Jinhong Li
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Hutong Road, Xicheng District, Beijing, 100088, China
| | - Ziqi Yue
- National Center for Cardiovascular Diseases and Fuwai Hospital, Beijing, China
| | - Juan Huang
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Hutong Road, Xicheng District, Beijing, 100088, China
| | - Fan Yang
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Hutong Road, Xicheng District, Beijing, 100088, China
| | - Hao Liu
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Hutong Road, Xicheng District, Beijing, 100088, China
| | - Ling Zhang
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Hutong Road, Xicheng District, Beijing, 100088, China.
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Rena Li
- Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, 5 Ankang Hutong Road, Xicheng District, Beijing, 100088, China.
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
- Center for Brain Disorders Research, Capital Medical University & Beijing Institute of Brain Disorders, Beijing, China.
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13
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He Y, Wei Y, Wang Y, Liang F, Ma T. A cross-sectional study of non-suicidal self-injury in adolescent depression: association with demographic characteristics and physiological indicators. Front Psychiatry 2024; 15:1359400. [PMID: 39119074 PMCID: PMC11306130 DOI: 10.3389/fpsyt.2024.1359400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 06/18/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Non-suicidal self-injury (NSSI) is a prevalent concern among adolescents with depression, yet its relationship with demographic characteristics and physiological indicators remains underexplored. This study aimed to investigate these relationships among inpatient adolescents aged 13 to 18 at a hospital affiliated with Guizhou Medical University. Methods A cross-sectional study was conducted involving 222 adolescent inpatients diagnosed with depression. Data on NSSI occurrence, demographic variables (gender, only-child status, age), and physiological indicators (ALT, TSH, FT4, PLR, TG, HDLC, LDLC, FT3, NLR, MLR) were collected and analyzed. Statistical analyses, including correlations and group comparisons, were performed to assess the associations between NSSI and these factors. Results The prevalence of NSSI among the participants was 40.5%. Significant correlations were found between NSSI and several demographic and physiological factors. Specifically, NSSI was significantly associated with female gender, non-only-child status, younger age, lower ALT levels, higher TSH levels, lower FT4 levels, and higher PLR values. However, no significant differences were observed in TG, HDLC, LDLC, FT3, NLR, or MLR between the NSSI and non-NSSI groups. Discussion The findings highlight distinct demographic and physiological profiles associated with NSSI among adolescents with depression. The prevalence rate of NSSI underscores its significance as a behavioral manifestation in this population. Further research should explore the underlying mechanisms linking these factors to better inform targeted interventions and treatment strategies for adolescents experiencing NSSI in the context of depression.
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Affiliation(s)
- Yangliuqing He
- Clinical Medicine College of Guizhou Medical University, Guiyang, China
| | - Yuhan Wei
- Clinical Medicine College of Guizhou Medical University, Guiyang, China
| | - Yiming Wang
- Clinical Medicine College of Guizhou Medical University, Guiyang, China
- Department of Psychiatry, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Fenrong Liang
- Clinical Medicine College of Guizhou Medical University, Guiyang, China
| | - Tianpei Ma
- Clinical Medicine College of Guizhou Medical University, Guiyang, China
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14
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Karahan A, Manzak Saka I, Sağlam Aykut D, Civil Arslan F, Selçuk Özmen E, Özkorumak Karagüzel E. The relationship between peripheral immune cell markers and cognitive functions in patients with schizophrenia. Int J Psychiatry Med 2024:912174241266059. [PMID: 39031556 DOI: 10.1177/00912174241266059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2024]
Abstract
OBJECTIVES The purpose of this study was to investigate the relationship between peripheral immune cell markers and cognitive functions in patients with schizophrenia and healthy controls. METHODS Thirty-five patients diagnosed with schizophrenia with a stable course and a control group of 35 individuals matched in terms of sex, education, and age were included in this cross-sectional study. The Wisconsin Card Sorting Test (WCST), the Rey Auditory Verbal Learning Test (RAVLT), and the Stroop Test were used for neuropsychological evaluation. Blood neutrophil and lymphocyte percentages, neutrophil-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) values were calculated. RESULTS The female patients exhibited significantly higher NLR and neutrophil percentages than the female controls and higher NLR, neutrophil percentage, and SII than the male patients. The increased neutrophil percentages and NLR and decreased lymphocyte percentages in the female patients were significantly correlated with worsening Stroop interference and RAVLT 1 scores. Additionally, a longer duration of illness was significantly correlated with elevated NLR, SII, and neutrophil percentage and a decreased lymphocyte percentage. A higher number of previous hospitalizations was correlated with elevated SII and decreased lymphocyte percentages. Regression analysis showed a significant association between neutrophil percentages and Stroop interference scores used to evaluate attentional functions in patients with schizophrenia. CONCLUSIONS These study results suggest that gender and the course of the illness may affect NLR and SII values. An elevated neutrophil percentage may be one of the factors affecting attentional dysfunction in patients with schizophrenia. Prospective studies are now needed to verify these findings.
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Affiliation(s)
- Aykut Karahan
- Department of Psychiatry, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | | | - Demet Sağlam Aykut
- Department of Psychiatry, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Filiz Civil Arslan
- Department of Psychiatry, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
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15
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Popov M, Popov Y, Kosterin D, Lepik O. Inflammatory Hematological Ratios in Adolescents with Mental Disorders: A Scoping Review. CONSORTIUM PSYCHIATRICUM 2024; 5:45-61. [PMID: 39071999 PMCID: PMC11272303 DOI: 10.17816/cp15514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 06/11/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGOUND Inflammatory hematological ratios (IHRs), such as neutrophil to lymphocyte, monocyte to lymphocyte, and platelet to lymphocyte ratios, are associated with mental disorders, symptoms severity, and the disease phase. Evidence from the studies in adult patients has been summarized in systematic reviews and meta-analyses. The results of the studies in adolescents remain poorly systematized. AIM To summarize the findings from the studies that investigated the relationship of IHRs with mental disorders in adolescent patients. METHODS This scoping review included studies of IHRs in patients aged 10-19 years with mental disorders (other than anorexia nervosa), published in English by December 31, 2023. The search for relevant papers was performed in MEDLINE. The studies were categorized into two groups: studies with external controls (healthy adolescents) and studies with internal controls (patients in different phases of mental disorder, with or without self-harm/suicidal behaviors). RESULTS A total of 11 studies were included in the review (all cross-sectional ones). The results of these studies demonstrate that 1) adolescents with mental disorders (major depressive disorder, psychotic disorders, obsessive-compulsive disorder, attention deficit hyperactivity disorder, substance use disorders) have higher IHR values than individuals of the same age without corresponding disorders (5 studies); 2) IHR values are positively correlated with the severity of psychopathological symptoms (1 study); 3) higher IHR values are associated with the phase of the mental disorder - manic episode in bipolar disorder (1 study) and exacerbation of psychosis in psychotic disorders (1 study); and 4) higher IHR values are associated with self-harm/suicidal behaviors - suicide attempts (1 study) and non-suicidal self-injury (1 study). CONCLUSION IHRs are associated with mental disorders in adolescents, and higher IHR values are associated with a more severe/acute clinical presentation (severity of symptoms, mania, acute psychosis, self-harm/suicidal behaviors). Further studies of higher methodological quality are needed to evaluate the diagnostic and prognostic value of IHRs as biomarkers of mental disorders in adolescence.
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16
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Poletti S, Mazza MG, Benedetti F. Inflammatory mediators in major depression and bipolar disorder. Transl Psychiatry 2024; 14:247. [PMID: 38851764 PMCID: PMC11162479 DOI: 10.1038/s41398-024-02921-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 06/10/2024] Open
Abstract
Major depressive disorder (MDD) and bipolar disorder (BD) are highly disabling illnesses defined by different psychopathological, neuroimaging, and cognitive profiles. In the last decades, immune dysregulation has received increasing attention as a central factor in the pathophysiology of these disorders. Several aspects of immune dysregulations have been investigated, including, low-grade inflammation cytokines, chemokines, cell populations, gene expression, and markers of both peripheral and central immune activation. Understanding the distinct immune profiles characterizing the two disorders is indeed of crucial importance for differential diagnosis and the implementation of personalized treatment strategies. In this paper, we reviewed the current literature on the dysregulation of the immune response system focusing our attention on studies using inflammatory markers to discriminate between MDD and BD. High heterogeneity characterized the available literature, reflecting the heterogeneity of the disorders. Common alterations in the immune response system include high pro-inflammatory cytokines such as IL-6 and TNF-α. On the contrary, a greater involvement of chemokines and markers associated with innate immunity has been reported in BD together with dynamic changes in T cells with differentiation defects during childhood which normalize in adulthood, whereas classic mediators of immune responses such as IL-4 and IL-10 are present in MDD together with signs of immune-senescence.
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Affiliation(s)
- Sara Poletti
- Psychiatry and Clinical Psychobiology Unit, Division of Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy.
| | - Mario Gennaro Mazza
- Psychiatry and Clinical Psychobiology Unit, Division of Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Benedetti
- Psychiatry and Clinical Psychobiology Unit, Division of Neurosciences, IRCCS San Raffaele Scientific Institute, Milan, Italy
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17
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Romeo B, Mazari A, Ali-Diabacte H, Lestra V, Martelli C, Benyamina A, Hamdani N. White blood cells and patients with psychiatric disorders needing seclusion: A retrospective non-interventional study. L'ENCEPHALE 2024; 50:241-246. [PMID: 37088578 DOI: 10.1016/j.encep.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/27/2023] [Accepted: 02/15/2023] [Indexed: 04/25/2023]
Abstract
OBJECTIVE The objective of this retrospective study was to investigate the peripheral immunological markers using leucocyte count, the neutrophil to lymphocyte ratio (NLR), the platelet to lymphocyte ratio (PLR), and the monocyte to lymphocyte ratio (MLR) in patients with aggressive behavior, during and after seclusion. METHODS Ninety-nine inpatients were included in this retrospective study. Leucocyte count was measured, and NLR, PLR and MLR were calculated and compared between a group of patients who required seclusion and a group who did not. A multivariate analysis was performed using binary logistic regression, including confounding factors such as age, gender, medication, BMI, smoking status and diagnosis. RESULTS We found the lowest levels of lymphocytes (P=0.01) and basophils (P<0.01) and the highest NLR (P=0.02) and MLR (P=0.04) in the seclusion group. We also found a restoration of these parameters after the end of the seclusion period. Furthermore, we found a positive correlation between the PANSS negative subscore, and PLR (P=0.05), or MLR (P=0.03) after seclusion, and between the MLR variation across the seclusion period and the PANSS general subscore after the end of seclusion (P=0.04). CONCLUSION This study shows that NLR and MPR are higher in patients with aggressive symptoms and/or agitation who require seclusion. These immunological markers could be considered as state markers.
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Affiliation(s)
- Bruno Romeo
- Department of Psychiatry and Addictology, AP-HP, Paul Brousse Hospital, 12, avenue Paul Vaillant Couturier, 94800 Villejuif, France; Unité de recherche UR psychiatrie-comorbidités-addictions PSYCOMADD, université Paris Saclay, Paris, France.
| | - Assia Mazari
- Department of Psychiatry and Addictology, AP-HP, Paul Brousse Hospital, 12, avenue Paul Vaillant Couturier, 94800 Villejuif, France; Unité de recherche UR psychiatrie-comorbidités-addictions PSYCOMADD, université Paris Saclay, Paris, France
| | - Husen Ali-Diabacte
- Department of Psychiatry and Addictology, AP-HP, Paul Brousse Hospital, 12, avenue Paul Vaillant Couturier, 94800 Villejuif, France
| | - Valentine Lestra
- Department of Psychiatry and Addictology, AP-HP, Paul Brousse Hospital, 12, avenue Paul Vaillant Couturier, 94800 Villejuif, France; Unité de recherche UR psychiatrie-comorbidités-addictions PSYCOMADD, université Paris Saclay, Paris, France
| | - Catherine Martelli
- Department of Psychiatry and Addictology, AP-HP, Paul Brousse Hospital, 12, avenue Paul Vaillant Couturier, 94800 Villejuif, France; Unité de recherche UR psychiatrie-comorbidités-addictions PSYCOMADD, université Paris Saclay, Paris, France; Institut national de la santé et de la recherche médicale U1299, Research unit, NeuroImaging and Psychiatry, Paris Sud University- Paris Saclay University, Paris Descartes University, Digiteo Labs, bâtiment 660, Gif-sur- Yvette, France
| | - Amine Benyamina
- Department of Psychiatry and Addictology, AP-HP, Paul Brousse Hospital, 12, avenue Paul Vaillant Couturier, 94800 Villejuif, France; Unité de recherche UR psychiatrie-comorbidités-addictions PSYCOMADD, université Paris Saclay, Paris, France
| | - Nora Hamdani
- Unité de recherche UR psychiatrie-comorbidités-addictions PSYCOMADD, université Paris Saclay, Paris, France; Cédiapsy, 87, rue d'Assas, 75006 Paris, France
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18
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Xu Y, Yan Z, Liu L. Sex differences in the combined influence of inflammation and nutrition status on depressive symptoms: insights from NHANES. Front Nutr 2024; 11:1406656. [PMID: 38868555 PMCID: PMC11168495 DOI: 10.3389/fnut.2024.1406656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 05/13/2024] [Indexed: 06/14/2024] Open
Abstract
Background Both nutrition and inflammation are associated with depression, but previous studies have focused on individual factors. Here, we assessed the association between composite indices of nutrition and inflammation and depression. Methods Adult participants selected from the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018 were chosen. The exposure variable was the Advanced Lung Cancer Inflammation Index (ALI) integrating nutrition and inflammation, categorized into low, medium, and high groups. The outcome variable was depression assessed using the Patient Health Questionnaire-9 (PHQ-9). A multivariable logistic regression model was employed to evaluate the relationship between ALI and the risk of depression. Results After extensive adjustment for covariates, in the overall population, participants with moderate and high levels of ALI had a decreased prevalence of depression compared to those with low ALI levels, with reductions of 17% (OR, 0.83; 95% CI: 0.72-0.97) and 23% (OR, 0.77; 95% CI: 0.66-0.91), respectively. Among females, participants with moderate and high ALI levels had a decreased prevalence of depression by 27% (OR, 0.73; 95% CI: 0.60-0.88) and 21% (OR, 0.79; 95% CI: 0.64-0.98), respectively, compared to those with low ALI levels, whereas no significant association was observed among males. Subgroup analyses based on females and males yielded consistent results. Conclusion In this study, we observed a negative correlation between moderate to high levels of ALI and the prevalence of depression, along with gender differences. Specifically, in females, greater attention should be given to the nutritional and inflammatory status.
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Affiliation(s)
- Yifeng Xu
- School of Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
| | - Zhaoqi Yan
- School of Clinical Medicine, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
| | - Liangji Liu
- Affiliated Hospital of Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
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Dallaspezia S, Cardaci V, Mazza MG, De Lorenzo R, Rovere Querini P, Colombo C, Benedetti F. Higher Seasonal Variation of Systemic Inflammation in Bipolar Disorder. Int J Mol Sci 2024; 25:4310. [PMID: 38673894 PMCID: PMC11049938 DOI: 10.3390/ijms25084310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Seasonal rhythms affect the immune system. Evidence supports the involvement of immuno-inflammatory mechanisms in bipolar disorder (BD), with the neutrophil to lymphocyte ratio (NLR), and the systemic immune-inflammatory index (SII; platelets × neutrophils/lymphocytes) consistently reported to be higher in patients with BD than in HC, but seasonal rhythms of innate and adaptive immunity have never been studied. We retrospectively studied NLR and SII in 824 participants divided into three groups: 321 consecutively admitted inpatients affected by a major depressive episode in course of BD, and 255 consecutively admitted inpatients affected by obsessive-compulsive disorder (OCD; positive psychiatric control), and 248 healthy controls (HC). Patients with BD showed markedly higher markers of systemic inflammation in autumn and winter, but not in spring and summer, in respect to both HC and patients with OCD, thus suggesting a specific effect of season on inflammatory markers in BD, independent of a shared hospital setting and drug treatment. Given that systemic inflammation is emerging as a new marker and as target for treatment in depressive disorders, we suggest that seasonal rhythms should be considered for tailoring antidepressant immuno-modulatory treatments in a precision medicine approach.
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Affiliation(s)
- Sara Dallaspezia
- Division of Neuroscience, IRCCS Ospedale San Raffaele, 20132 Milano, Italy; (S.D.); (M.G.M.)
| | - Vincenzo Cardaci
- Università Vita-Salute San Raffaele, 20132 Milano, Italy; (V.C.); (P.R.Q.); (C.C.)
| | - Mario Gennaro Mazza
- Division of Neuroscience, IRCCS Ospedale San Raffaele, 20132 Milano, Italy; (S.D.); (M.G.M.)
| | - Rebecca De Lorenzo
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS Ospedale San Raffaele, 20132 Milano, Italy;
| | - Patrizia Rovere Querini
- Università Vita-Salute San Raffaele, 20132 Milano, Italy; (V.C.); (P.R.Q.); (C.C.)
- Division of Immunology, Transplantation and Infectious Diseases, IRCCS Ospedale San Raffaele, 20132 Milano, Italy;
| | - Cristina Colombo
- Università Vita-Salute San Raffaele, 20132 Milano, Italy; (V.C.); (P.R.Q.); (C.C.)
- Mood Disorders Unit, IRCCS Ospedale San Raffaele, 20132 Milano, Italy
| | - Francesco Benedetti
- Division of Neuroscience, IRCCS Ospedale San Raffaele, 20132 Milano, Italy; (S.D.); (M.G.M.)
- Università Vita-Salute San Raffaele, 20132 Milano, Italy; (V.C.); (P.R.Q.); (C.C.)
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20
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Di Nicola M, Pepe M, De Mori L, Ferrara OM, Panaccione I, Sani G. Physical and cognitive correlates, inflammatory levels, and treatment response in post-COVID-19 first-onset vs. recurrent depressive episodes. Eur Arch Psychiatry Clin Neurosci 2024; 274:583-593. [PMID: 37154920 PMCID: PMC10166052 DOI: 10.1007/s00406-023-01617-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/26/2023] [Indexed: 05/10/2023]
Abstract
Psychiatric symptoms have been frequently reported in patients affected by COVID-19, both as new occurring and recurrences of pre-existing diseases. Depressive symptoms are estimated to affect at least 30% of patients following infection, with specific physical and cognitive features and relevant immune-inflammatory alterations. This study aimed to retrospectively characterize post-COVID-19 first-onset and recurrent major depressive episodes (MDE) and to evaluate the effects of antidepressants on physical and cognitive correlates of depression, in addition to mood, anxiety, and underlying inflammatory status. We evaluated 116 patients (44.8% males, 51.1 ± 17 years) with post-COVID-19 first-onset (38.8%) and recurrent (61.2%) MDE at baseline and after one- and three-month treatment with antidepressants (31% SSRIs, 25.9% SNRIs, 43.1% others). We assessed sociodemographic and clinical features and psychopathological dimensions through: Hamilton Depression and Anxiety Rating Scales; Short Form-36 Health Survey Questionnaire; Perceived Deficits Questionnaire-Depression 5-items. The systemic immune-inflammatory index was calculated to measure inflammation levels. Alongside the reduction of depression and anxiety (p < 0.001), physical and cognitive symptoms improved (p < 0.001) and inflammatory levels decreased (p < 0.001) throughout treatment in both groups. Post-COVID-19 recurrent MDE showed a significantly more severe course of physical and cognitive symptoms and persistently higher levels of inflammation than first-onset episodes. Antidepressants proved to be effective in both post-COVID-19 first-onset and recurrent MDE. However, a sustained inflammatory status might blunt treatment response in patients with recurrent depression in terms of physical correlates and cognition. Therefore, personalized approaches, possibly involving combinations with anti-inflammatory compounds, could promote better outcomes in this clinical population.
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Affiliation(s)
- Marco Di Nicola
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy.
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
| | - Maria Pepe
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lorenzo De Mori
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Ottavia Marianna Ferrara
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Gabriele Sani
- Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Psychiatry, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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21
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Ghafori SS, Yousefi Z, Bakhtiari E, mohammadi mahdiabadi hasani MH, Hassanzadeh G. Neutrophil-to-lymphocyte ratio as a predictive biomarker for early diagnosis of depression: A narrative review. Brain Behav Immun Health 2024; 36:100734. [PMID: 38362135 PMCID: PMC10867583 DOI: 10.1016/j.bbih.2024.100734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/23/2024] [Accepted: 02/04/2024] [Indexed: 02/17/2024] Open
Abstract
Depression is a mood disorder that causes persistent feelings of sadness, hopelessness, loss of interest, and decreased energy. Early diagnosis of depression can improve its negative impacts and be effective in its treatment. Previous studies have indicated that inflammation plays an important role in the initiation and development of depression, hence, various inflammatory biomarkers have been investigated for early diagnosis of depression, the most popular of which are blood biomarkers. The Neutrophil to lymphocyte ratio (NLR) may be more informative in the early diagnosis of depression than other widely used markers, such as other leukocyte characteristics or interleukins. Considering the importance of early diagnosis of depression and the role of NLR in early diagnosis of depression, our paper reviews the literature on NLR as a diagnostic biomarker of depression, which may be effective in its treatment. Various studies have shown that elevated NLR is associated with depression, suggesting that NLR may be a valuable, reproducible, easily accessible, and cost-effective method for the evaluation of depression and it may be used in outpatient clinic settings. Closer follow-up can be performed for these patients who have higher NLR levels. However, it seems that further studies on larger samples, taking into account important confounding factors, and assessing them together with other inflammatory markers are necessary to draw some conclusive statements.
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Affiliation(s)
- Sayed Soran Ghafori
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Yousefi
- School of Allied Medical Sciences, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Elham Bakhtiari
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Gholamreza Hassanzadeh
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
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22
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Yang C, Tian Y, Yang X, Liu L, Ling C, Xia L, Liu H. Hematological and inflammatory markers in Han Chinese patients with drug-free schizophrenia: relationship with symptom severity. Front Immunol 2024; 15:1337103. [PMID: 38352871 PMCID: PMC10861680 DOI: 10.3389/fimmu.2024.1337103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
Background There is a growing amount of evidence suggesting that immunity and inflammation play an important role in the pathophysiology of schizophrenia. In this study, we aimed to examine the relationship between hematological and inflammatory markers with symptom severity in Han Chinese patients with drug-free schizophrenia. Methods This retrospective study was conducted at Chaohu Hospital of Anhui Medical University and data were extracted from the electronic medical record system over a 5-year period (May 2017 to April 2022), including participants' general and clinical information as well as Brief Psychiatric Rating Scale (BPRS) scores and hematological parameters. Results A total of 2,899 patients with schizophrenia were identified through the initial search. After screening, 91 patients and 141 healthy controls (HCs) were included. The patients had a higher value of neutrophils/lymphocytes ratio (NLR), monocyte/lymphocyte ratio (MLR), and platelet/lymphocyte ratio (PLR) than HCs (all P < 0.001). MLR was positively correlated with BPRS total score (r = 0.337, P = 0.001) and resistance subscale score (r = 0.350, P = 0.001). Binary logistic regression analyses revealed that severely ill was significantly associated with being male and a higher value of MLR (Natural Logaruthm, Ln) (all P < 0.05), and the receiver operating characteristic (ROC) analysis showed good performance of a regression model with an area under the curve (AUC) value of 0.787. Conclusion Patients with drug-free schizophrenia have an unbalanced distribution of peripheral blood granulocytes, and elevated NLR, MLR and PLR. Patients with higher value of MLR tend to have more psychotic symptoms, especially those symptoms of hostility, uncooperativeness, and suspiciousness. Our study gives a preliminary indication that MLR is a potential predictor of disease severity in patients with drug-free schizophrenia.
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Affiliation(s)
- Cheng Yang
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Yinghan Tian
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Xiaoxue Yang
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Lewei Liu
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Chen Ling
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, Anhui Psychiatric Center, Anhui Medical University, Hefei, China
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23
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Fisher DW, Dunn JT, Dong H. Distinguishing features of depression in dementia from primary psychiatric disease. DISCOVER MENTAL HEALTH 2024; 4:3. [PMID: 38175420 PMCID: PMC10767128 DOI: 10.1007/s44192-023-00057-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024]
Abstract
Depression is a common and devastating neuropsychiatric symptom in the elderly and in patients with dementia. In particular, nearly 80% of patients with Alzheimer's Disease dementia experience depression during disease development and progression. However, it is unknown whether the depression in patients with dementia shares the same molecular mechanisms as depression presenting as primary psychiatric disease or occurs and persists through alternative mechanisms. In this review, we discuss how the clinical presentation and treatment differ between depression in dementia and as a primary psychiatric disease, with a focus on major depressive disorder. Then, we hypothesize several molecular mechanisms that may be unique to depression in dementia such as neuropathological changes, inflammation, and vascular events. Finally, we discuss existing issues and future directions for investigation and treatment of depression in dementia.
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Affiliation(s)
- Daniel W Fisher
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 303 E Chicago Ave, Chicago, IL, 60611, USA
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, 1959 NE Pacific Street, Box 356560, Seattle, WA, 98195, USA
| | - Jeffrey T Dunn
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 303 E Chicago Ave, Chicago, IL, 60611, USA
| | - Hongxin Dong
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 303 E Chicago Ave, Chicago, IL, 60611, USA.
- Department of Neurology, Northwestern University Feinberg School of Medicine, 303 E Chicago Ave, Chicago, IL, 60611, USA.
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24
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Chen Y, Lyu D, Wang F, Huang Q, Yang W, Zhang M, Wei Z, Shi S, Kong S, Chen S, He S, Yang V, Fang Y, Douiri A, Hong W. Adjunctive duration-doubled transcranial direct current stimulation for the treatment of depressive patients with suicidal ideation: study protocol for a double-blind, randomized, sham-controlled trial. Trials 2024; 25:15. [PMID: 38167178 PMCID: PMC10759703 DOI: 10.1186/s13063-023-07858-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 12/08/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The problem of suicide has become increasingly common in individuals with major depressive disorder (MDD). Transcranial direct current stimulation (tDCS) is an effective treatment for MDD with 2 milliamperes (mA) for at least 30 min per day for 2 weeks. This study aims to investigate the efficacy of daily duration-doubled tDCS as an adjunctive intervention for rapidly reducing suicidal ideation and improving depression in MDD patients. METHODS In this double-blind, randomized, sham-controlled study, 76 MDD patients with suicidal ideation are randomly assigned to either active (n=38) or sham (n=38) tDCS group. The anode and cathode are placed over the scalp areas corresponding to left and right dorsolateral prefrontal cortex (DLPFC), respectively, and each stimulation lasts for 60 min. The primary outcome is defined as change of Beck Scale for Suicide Ideation (BSI) after 5 and 10 sessions. The change of other clinical assessments, blood biomarkers related to suicidal ideation and depressive sumptoms are defined as secondary outcomes. Blood biomarkers related to suicidal ideation are collected at baseline and after 10 sessions. DISCUSSION This study suggests the adjunctive duration-doubled tDCS might be a novel method to rapidly reduce suicidal ideation and improve depressive symptom. The variation of biomarkers could be potential predictive models of suicide risk. TRIAL REGISTRATION The trial protocol is registered with ClinicalTrials.gov under protocol registration number NCT05555927. Registered on September 25, 2022.
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Affiliation(s)
- Yiming Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dongbin Lyu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fan Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qinte Huang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Mengke Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheyi Wei
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuxiang Shi
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuqi Kong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shentse Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuang He
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Vivien Yang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiru Fang
- Department of Psychiatry & Affective Disorders Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
- CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, China
- Hunan Second People's Hospital (Hunan Brain Hospital), Hunan, China
| | - Abdel Douiri
- King's College London, School of Life Course & Population Sciences, London, UK.
- National Institute for Health Research Biomedical Research Centre (BRC), Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.
| | - Wu Hong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China.
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25
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Hong J, Lian N, Li M. Association between the neutrophil-to-lymphocyte ratio and psoriasis: a cross-sectional study of the National Health and Nutrition Examination Survey 2011-2014. BMJ Open 2023; 13:e077596. [PMID: 38149420 PMCID: PMC10711904 DOI: 10.1136/bmjopen-2023-077596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/19/2023] [Indexed: 12/28/2023] Open
Abstract
OBJECTIVES To investigate the association between the neutrophil-to-lymphocyte ratio (NLR) and psoriasis. DESIGN Cross-sectional study. SETTING National Health and Nutrition Examination Survey 2011-2014. PARTICIPANTS A subsample of 8387 individuals aged 18 years and older were screened for inclusion, of whom 238 reported a diagnosis of psoriasis. PRIMARY AND SECONDARY OUTCOME MEASURES Psoriasis and the severity of psoriasis were defined according to participants' self-reports. Weighted logistic regression, subgroup and restricted cubic spline (RCS) analyses were conducted to estimate the potential relationship of the NLR with psoriasis. RESULTS In the fully adjusted models, the fourth quartile of the NLR was significantly and positively associated with the presence of psoriasis using the first quartile as a reference (OR: 2.22, 95% CI: 1.27 to 3.87, p=0.01). Elevated NLR was associated with an increased odds of having more severe psoriasis for the highest quartile (vs the lowest quartile), with an OR of 2.43 (95% CI: 1.10 to 5.36, p=0.003). The association between the NLR and psoriasis differed across prespecified subgroups by age, sex, race, income and education. A non-linear correlation of the NLR with psoriasis was observed using univariable and multivariable RCS (all p for non-linearity <0.05). CONCLUSIONS The NLR was non-linearly and positively correlated with the presence of psoriasis, and our findings suggest a significant association between the NLR and the severity of psoriasis. The potential role and value in the clinical diagnosis and prognostic assessment of the NLR in psoriasis calls for further longitudinal studies.
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Affiliation(s)
- Jiaxin Hong
- School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Ni Lian
- Jiangsu Key Laboratory of Molecular Biology for Skin Disease and STIs, Chinese Academy of Medical Sciences Institute of Dermatology, Nanjing, Jiangsu, China
| | - Min Li
- Jiangsu Key Laboratory of Molecular Biology for Skin Disease and STIs, Chinese Academy of Medical Sciences Institute of Dermatology, Nanjing, Jiangsu, China
- Center for Global Health, Nanjing Medical University School of Public Health, Nanjing, Jiangsu, China
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26
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Tsai SY, Sajatovic M, Chen PH, Huang YJ, Chung KH. Increased proportions of circulating pro-inflammatory monocytes and macrophages expressing toll-like receptor 4 in individuals with schizophrenia and bipolar disorder receiving medication. Psychiatry Clin Neurosci 2023; 77:672-673. [PMID: 37706614 DOI: 10.1111/pcn.13599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/10/2023] [Accepted: 09/12/2023] [Indexed: 09/15/2023]
Affiliation(s)
- Shang-Ying Tsai
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Martha Sajatovic
- Department of Psychiatry, University Hospitals of Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Pao-Huan Chen
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yu-Jui Huang
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Kuo-Hsuan Chung
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Psychiatry, Taipei Medical University Hospital, Taipei, Taiwan
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27
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Jing B, Chen D, Dai H, Liu J, Chen C, Dai M, Hu J, Lu Z, Wang J. Association between neutrophil-to-lymphocyte ratio and postoperative fatigue in elderly patients with hip fracture. Heliyon 2023; 9:e22314. [PMID: 38144319 PMCID: PMC10746395 DOI: 10.1016/j.heliyon.2023.e22314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 11/09/2023] [Accepted: 11/09/2023] [Indexed: 12/26/2023] Open
Abstract
Background and purpose: Postoperative fatigue (POF) is a common and distressing post-operative symptom. This study aimed to explore the relationship between neutrophil-to-lymphocyte ratio (NLR) and POF in elderly patients with hip fracture. Method Elderly patients (age ≥65 years) with acute hip fracture admitted to the Department of Orthopedics of Anqing Municipal Hospital from June 2018 to June 2020 were included. Fatigue was assessed using the Fatigue Severity Scale at the 3-month follow-up postoperatively. Univariate and multivariate analyses were performed to explore the associations between NLR and POF. The diagnostic performance of NLR was analysed using Receiver Operating Characteristic (ROC) curve analysis and the Delong test. Result A total of 321 elderly patients with hip fractures were included; 120 (37.4 %) of them were diagnosed with POF. Univariate analysis indicated significant differences in NLR, platelet-to-lymphocyte ratio (PLR), education, neutrophil count, lymphocyte count, Hamilton Depression Scale (HAMD) and Insomnia Severity Index (ISI) scores (P < 0.05). Multivariate analysis indicated neutrophil count (odds ratio [OR], 1.46; 95 % confidence interval [CI] 1.27-1.67), lymphocyte count (OR 0.32, 95 % CI 0.19-0.53), NLR (OR1.81, 95 % CI 1.50-2.17) and PLR (OR 1.005, 95 % CI 1.001-1.009) were significantly associated with POF. The areas under the ROC curves (AUCs) of neutrophil count, lymphocyte count, NLR and PLR were 0.712, 0.667, 0.775 and 0.605, respectively. The Delong test indicated that NLR had the best diagnostic performance (p < 0.05). Conclusion NLR independently predicts POF in elderly patients with acute hip fracture.
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Affiliation(s)
- Baosheng Jing
- Department of Orthopedics, AnQing Municipal Hospitals, Anqing, China
| | - Dangui Chen
- Department of Hematology, AnQing Municipal Hospitals, Anqing, China
| | - Huming Dai
- Department of Orthopedics, AnQing Municipal Hospitals, Anqing, China
| | - Jingrui Liu
- Department of Orthopedics, AnQing Municipal Hospitals, Anqing, China
| | - Cheng Chen
- Department of Orthopedics, AnQing Municipal Hospitals, Anqing, China
| | - Mingjun Dai
- Department of Orthopedics, AnQing Municipal Hospitals, Anqing, China
| | - Jing Hu
- Department of Orthopedics, AnQing Municipal Hospitals, Anqing, China
| | - Zhengfeng Lu
- Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Jianjun Wang
- Department of Orthopedics, AnQing Municipal Hospitals, Anqing, China
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28
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Réus GZ, Manosso LM, Quevedo J, Carvalho AF. Major depressive disorder as a neuro-immune disorder: Origin, mechanisms, and therapeutic opportunities. Neurosci Biobehav Rev 2023; 155:105425. [PMID: 37852343 DOI: 10.1016/j.neubiorev.2023.105425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/16/2023] [Accepted: 10/12/2023] [Indexed: 10/20/2023]
Abstract
Notwithstanding advances in understanding the pathophysiology of major depressive disorder (MDD), no single mechanism can explain all facets of this disorder. An expanding body of evidence indicates a putative role for the inflammatory response. Several meta-analyses showed an increase in systemic peripheral inflammatory markers in individuals with MDD. Numerous conditions and circumstances in the modern world may promote chronic systemic inflammation through mechanisms, including alterations in the gut microbiota. Peripheral cytokines may reach the brain and contribute to neuroinflammation through cellular, humoral, and neural pathways. On the other hand, antidepressant drugs may decrease peripheral levels of inflammatory markers. Anti-inflammatory drugs and nutritional strategies that reduce inflammation also could improve depressive symptoms. The present study provides a critical review of recent advances in the role of inflammation in the pathophysiology of MDD. Furthermore, this review discusses the role of glial cells and the main drivers of changes associated with neuroinflammation. Finally, we highlight possible novel neurotherapeutic targets for MDD that could exert antidepressant effects by modulating inflammation.
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Affiliation(s)
- Gislaine Z Réus
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil.
| | - Luana M Manosso
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - João Quevedo
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil; Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - André F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
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29
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Wu A, Zhang J. Neuroinflammation, memory, and depression: new approaches to hippocampal neurogenesis. J Neuroinflammation 2023; 20:283. [PMID: 38012702 PMCID: PMC10683283 DOI: 10.1186/s12974-023-02964-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/20/2023] [Indexed: 11/29/2023] Open
Abstract
As one of most common and severe mental disorders, major depressive disorder (MDD) significantly increases the risks of premature death and other medical conditions for patients. Neuroinflammation is the abnormal immune response in the brain, and its correlation with MDD is receiving increasing attention. Neuroinflammation has been reported to be involved in MDD through distinct neurobiological mechanisms, among which the dysregulation of neurogenesis in the dentate gyrus (DG) of the hippocampus (HPC) is receiving increasing attention. The DG of the hippocampus is one of two niches for neurogenesis in the adult mammalian brain, and neurotrophic factors are fundamental regulators of this neurogenesis process. The reported cell types involved in mediating neuroinflammation include microglia, astrocytes, oligodendrocytes, meningeal leukocytes, and peripheral immune cells which selectively penetrate the blood-brain barrier and infiltrate into inflammatory regions. This review summarizes the functions of the hippocampus affected by neuroinflammation during MDD progression and the corresponding influences on the memory of MDD patients and model animals.
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Affiliation(s)
- Anbiao Wu
- Beijing Institute of Basic Medical Sciences, Beijing, 100850, China
| | - Jiyan Zhang
- Beijing Institute of Basic Medical Sciences, Beijing, 100850, China.
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30
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Gędek A, Modrzejewski S, Gędek M, Antosik AZ, Mierzejewski P, Dominiak M. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and monocyte to lymphocyte ratio in ADHD: a systematic review and meta-analysis. Front Psychiatry 2023; 14:1258868. [PMID: 38034918 PMCID: PMC10682201 DOI: 10.3389/fpsyt.2023.1258868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/26/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with an unclear etiology. Systemic inflammation and immune dysregulation may play a role in the pathogenesis of ADHD. Morphology-derived parameters such as neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and monocyte to lymphocyte ratio (MLR), have been proposed as peripheral biomarkers of the immune-inflammatory process in various diseases. However, studies examining their role in ADHD remain inconclusive. Methods A systematic review and a meta-analysis were conducted to evaluate the association between NLR, MLR, PLR and ADHD. Relevant articles were identified, screened, and assessed for quality according to PRISMA guidelines. Moreover, a qualitative and quantitative analyses were performed. Results The review contained eight eligible studies, five of which were included in the meta-analysis. The meta-analysis showed that ADHD patients had higher NLR and PLR values compared to health controls. No significant difference in MLR value was observed between the two groups. Analysis in relation to ADHD subtypes showed no significant differences in inflammatory markers in any of the included studies as well. The influence of medical treatment on these ratios could not be adequately assessed due to limited data. Conclusion ADHD patients exhibit higher NLR and PLR than healthy controls, which may indicate the potential immune-inflammatory involvement in this disorder. Further studies on inflammatory markers and ADHD, especially those considering the impact of treatment and clinical symptoms, are essential to comprehensively understand this association.
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Affiliation(s)
- Adam Gędek
- Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland
- Praski Hospital, Warsaw, Poland
| | | | - Marta Gędek
- Chair and Department of Forensic Medicine, Medical University of Lublin, Lublin, Poland
- Independent Public Clinical Hospital No 1, Lublin, Poland
| | - Anna Z. Antosik
- Department of Psychiatry, Faculty of Medicine, Collegium Medicum, Cardinal Wyszynski University in Warsaw, Warsaw, Poland
| | - Paweł Mierzejewski
- Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Monika Dominiak
- Department of Pharmacology, Institute of Psychiatry and Neurology, Warsaw, Poland
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31
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Romeo B, Lestra V, Martelli C, Amirouche A, Benyamina A, Hamdani N. The Modulated Role of Toxoplasma gondii on Eosinophils in Psychiatric Disorders after Cannabis Cessation. Pathogens 2023; 12:1333. [PMID: 38003797 PMCID: PMC10675363 DOI: 10.3390/pathogens12111333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/29/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023] Open
Abstract
The aim of our study was to evaluate the impact of T. gondii status on eosinophils count (EOS), the eosinophil-to-lymphocyte ratio (ELR), and the eosinophil-to-neutrophil-to-lymphocytes ratio (ENLR) before and after cannabis cessation in patients with psychiatric disorders. One hundred and eighty-eight patients were included in the study. T. gondii, EOS, ELR, ENLR, and urinary cannabis were measured at baseline and after 4 weeks of cannabis cessation. Highest levels and increase of PNE (p = 0.02), ENLR levels (p = 0.031) and highest level of ELR (p = 0.03) were found in patients after cannabis cessation only in patients positive for T. gondii serology (Toxo+ group). At four weeks, significant interactions between cannabis and T. gondii status for EOS (p = 0.038), and for ENLR (p = 0.043) levels were found, as well as for the evolution between baseline and 4 weeks for ENLR level (p = 0.049). After cannabis cessation, we found a positive correlation between negative symptoms and EOS levels at 4 weeks in the Toxo+ group. This study shows that the increase of inflammation after cannabis cessation might be modulated by T. gondii seropositivity status in patients after cannabis cessation.
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Affiliation(s)
- Bruno Romeo
- Department of Psychiatry and Addictology, Paul Brousse Hospital, APHP, 94800 Villejuif, France; (V.L.); (C.M.); (A.A.); (A.B.)
- Unité de Recherche UR, Psychiatrie-Comorbidités-Addictions (PSYCOMadd), Paris Saclay University, 94800 Villejuif, France;
| | - Valentine Lestra
- Department of Psychiatry and Addictology, Paul Brousse Hospital, APHP, 94800 Villejuif, France; (V.L.); (C.M.); (A.A.); (A.B.)
| | - Catherine Martelli
- Department of Psychiatry and Addictology, Paul Brousse Hospital, APHP, 94800 Villejuif, France; (V.L.); (C.M.); (A.A.); (A.B.)
- Unité de Recherche UR, Psychiatrie-Comorbidités-Addictions (PSYCOMadd), Paris Saclay University, 94800 Villejuif, France;
- Institut National de la Santé et de la Recherche Médicale U1299, Research unit, NeuroImaging and Psychiatry, Paris Sud University-Paris Saclay University, Paris Descartes University, Digiteo Labs, 91190 Gif-sur-Yvette, France
| | - Ammar Amirouche
- Department of Psychiatry and Addictology, Paul Brousse Hospital, APHP, 94800 Villejuif, France; (V.L.); (C.M.); (A.A.); (A.B.)
- Unité de Recherche UR, Psychiatrie-Comorbidités-Addictions (PSYCOMadd), Paris Saclay University, 94800 Villejuif, France;
| | - Amine Benyamina
- Department of Psychiatry and Addictology, Paul Brousse Hospital, APHP, 94800 Villejuif, France; (V.L.); (C.M.); (A.A.); (A.B.)
- Unité de Recherche UR, Psychiatrie-Comorbidités-Addictions (PSYCOMadd), Paris Saclay University, 94800 Villejuif, France;
| | - Nora Hamdani
- Unité de Recherche UR, Psychiatrie-Comorbidités-Addictions (PSYCOMadd), Paris Saclay University, 94800 Villejuif, France;
- Cédiapsy, 75006 Paris, France
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Paolini M, Harrington Y, Raffaelli L, Poletti S, Zanardi R, Colombo C, Benedetti F. Neutrophil to lymphocyte ratio and antidepressant treatment response in patients with major depressive disorder: Effect of sex and hippocampal volume. Eur Neuropsychopharmacol 2023; 76:52-60. [PMID: 37544076 DOI: 10.1016/j.euroneuro.2023.07.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 07/19/2023] [Accepted: 07/24/2023] [Indexed: 08/08/2023]
Abstract
Several factors may affect response to treatment in Major Depressive Disorder (MDD) including immune/inflammatory alterations and regional brain volumes, particularly in hippocampal regions which have shown to be influenced by inflammatory status. Neutrophil-to-lymphocyte ratio (NLR) is an inflammatory marker found to be elevated in depressed women in large population studies. Here we investigate the effect of NLR on treatment response in MDD patients, and the role of sex and hippocampal volume on influencing this relationship. A sample of 124 MDD depressed inpatients (F = 80) underwent MRI acquisition, admission NLR was calculated by dividing absolute neutrophil by absolute lymphocyte counts and depression severity was assessed at admission and discharge via the Hamilton Depression Rating Scale (HDRS). As a measure of treatment response, delta HDRS was calculated. We found a significant moderation effect of sex on the relationship between NLR and Delta HDRS: a negative relation was found in females and a positive one in males. NLR was found to negatively affect hippocampal volumes in females. Both left and right hippocampal volume positively associated with Delta HDRS. Finally, left hippocampal volume mediated the effect of NLR on Delta HDRS in females. Sex moderated the relation between inflammation and treatment response in line with previous reports linking inflammation to hampered antidepressant effect in females. Further, this effect is partially mediated by hippocampal volume, suggesting that antidepressant response may be hampered by the detrimental effect of inflammation on the brain.
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Affiliation(s)
- Marco Paolini
- Vita-Salute San Raffaele University, Milano, Italy; Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy
| | - Yasmin Harrington
- Vita-Salute San Raffaele University, Milano, Italy; Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy.
| | - Laura Raffaelli
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy
| | - Sara Poletti
- Vita-Salute San Raffaele University, Milano, Italy; Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy
| | - Raffaella Zanardi
- Mood Disorders Unit, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy
| | - Cristina Colombo
- Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy; Mood Disorders Unit, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy
| | - Francesco Benedetti
- Vita-Salute San Raffaele University, Milano, Italy; Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy
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Kadier K, Dilixiati D, Ainiwaer A, Liu X, Lu J, Liu P, Ainiwan M, Yesitayi G, Ma X, Ma Y. Analysis of the relationship between sleep-related disorder and systemic immune-inflammation index in the US population. BMC Psychiatry 2023; 23:773. [PMID: 37872570 PMCID: PMC10594811 DOI: 10.1186/s12888-023-05286-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 10/16/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND The association between sleep-related disorders and inflammation has been demonstrated in previous studies. The systemic immune-inflammation index (SII) is a novel inflammatory index based on leukocytes, but its relationship with sleep-related disorder is unclear. We aimed to investigate the relationship between sleep-related disorder and SII in a nationally representative nonhospitalized sample. METHODS Data were obtained from the 2005-2008 National Health and Nutrition Examination Survey (NHANES). Exposure variables included self-reported sleep-related disorders, such as sleep duration, sleep problems, high risk of OSA, and daytime sleepiness. SII and other traditional markers of inflammation were considered as outcome variables, including platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR). Multiple linear regression models were employed to examine the correlation between sleep-related disorders and inflammatory markers. Subgroup interactions were analyzed using likelihood ratio tests, and nonlinear relationships were explored by fitting restricted cubic splines. RESULTS A total of 8,505 participants were enrolled in this study. Overall, sleep-related disorders were found to have a stronger association with SII compared to the PLR and NLR. The results of multiple linear regression analysis revealed that participants who experienced sleep problems (β: 21.421; 95% CI 1.484, 41.358), had symptoms of OSA (β: 23.088; 95% CI 0.441, 45.735), and reported daytime sleepiness (β: 30.320; 95% CI 5.851, 54.789) exhibited a positive association with higher SII. For the analysis of other inflammatory markers, we only found that daytime sleepiness was associated with increased NLR levels (β: 0.081; 95% CI 0.002, 0.159). CONCLUSION Sleep problems, symptoms of OSA, and daytime sleepiness were found to have a positive association with the SII in US adults. However, further prospective studies are necessary to establish whether there is a causal relationship between these factors.
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Affiliation(s)
- Kaisaierjiang Kadier
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi, China
| | - Diliyaer Dilixiati
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Aikeliyaer Ainiwaer
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi, China
| | - Xiaozhu Liu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiande Lu
- Department of Urology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Pengfei Liu
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi, China
| | - Mierxiati Ainiwan
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi, China
| | - Gulinazi Yesitayi
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi, China
| | - Xiang Ma
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi, China.
| | - Yitong Ma
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi, China.
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Korkmaz ŞA, Kızgın S, Oğuz EF, Neşelioğlu S, Erel Ö. Thiol-disulphide homeostasis, ischemia-modified albumin, complete blood count-derived inflammatory markers and C-reactive protein from acute mania to early remission in bipolar disorder. J Affect Disord 2023; 339:426-434. [PMID: 37459969 DOI: 10.1016/j.jad.2023.07.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/20/2023] [Accepted: 07/14/2023] [Indexed: 07/23/2023]
Abstract
OBJECTIVES There is much recent evidence that inflammation contributes to the pathophysiology of acute mania in bipolar disorder (BD). However, no study was evaluated in which the change in thiol-disulphide homeostasis, ischemia-modified albumin (IMA), complete blood count-derived inflammatory markers (CBC-IMs) and C-reactive protein (CRP) levels in bipolar patients was followed-up from acute mania to early remission. METHODS Seventy-seven bipolar patients in acute mania and ninety-one HC were enrolled. We measured levels of thiol-disulphide parameters, IMA, and CBC-IMs such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), red-cell-distribution-width (RDW)-to-platelet ratio (RPR), systemic immune-inflammatory index (SII), and systemic inflammatory response index (SIRI), CRP and platelet-to-albumin ratio (PAR), after adjusting for age, gender, body-mass index (BMI) and smoking status, during acute mania to subsequent early remission. The results were compared with HC. RESULTS The levels or ratios of all thiol-disulphide parameters except for disulphide, IMA and CRP of bipolar patients in both acute mania and early remission were significantly different from HC, after adjusting for confounders. The NLR, SII, CRP and PAR values of bipolar patients were significantly higher in only acute mania compared to HC. Significant changes in thiol-disulphide parameters and IMA levels were not found in early remission after acute mania. LIMITATIONS Short follow-up period and lack of drug-naive patients. CONCLUSIONS Our results suggest that thiol-disulphide parameters, IMA level and SIRI value might be a trait biomarkers of inflammation in BD. In addition, NLR, SII and PAR values and CRP level might be a state biomarker of inflammation in bipolar patients in a manic phase.
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Affiliation(s)
- Şükrü Alperen Korkmaz
- Çanakkale Onsekiz Mart University, Faculty of Medicine, Department of Psychiatry, Çanakkale, Turkey.
| | - Sadice Kızgın
- Ankara City Hospital, Department of Psychiatry, Ankara, Turkey
| | - Esra Fırat Oğuz
- Ankara Yıldırım Beyazıt University, Faculty of Medicine, Department of Biochemistry, Ankara/Turkey
| | - Salim Neşelioğlu
- Ankara Yıldırım Beyazıt University, Faculty of Medicine, Department of Biochemistry, Ankara/Turkey
| | - Özcan Erel
- Ankara Yıldırım Beyazıt University, Faculty of Medicine, Department of Biochemistry, Ankara/Turkey
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Qionghui H, Chaomei Z, Jie L, Jiong Q. Predictive effects of platelet-to-lymphocyte ratio on neonatal thrombocytopenia in primary immune thrombocytopenic mothers: a retrospective cohort study. BMC Pregnancy Childbirth 2023; 23:689. [PMID: 37741999 PMCID: PMC10517533 DOI: 10.1186/s12884-023-06010-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 09/19/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Primary immune thrombocytopenia (ITP) can increase the risk of neonatal thrombocytopenia (NT). This study aimed to investigate the key factors for predicting the risk of NT. METHODS Data were retrospectively collected from all pregnant women with ITP from 2015 to 2021. Newborns were divided into two groups according to the presence or absence of NT. The parameters between the two groups were then compared. Next, the correlation between maternal platelet-to-lymphocyte ratio (PLR) and neonatal platelet count was analyzed by logistic regression and generalized additive model. Additionally, the relationships among the platelet counts of siblings were also determined. RESULTS A total of 147 maternal cases were included. NT was observed in 46 (31.72%) neonates. A history of previous children with NT appeared to have predictive value for NT (OR 16.484, 95% CI 2.212-122.858, P < 0.001), as the nadir gestational platelet (OR 0.958, 95% CI 0.93-0.988, P < 0.001). Correlation analysis of platelet count on postnatal day 1 and the nadir platelet count in 36 sibling neonates showed a positive correlation (r=0.684, P<0.001; r=0.900, P<0.05). PLR was divided into 3 groups via tertiles, and the incidence of NT was dramatically higher in the group with lower PLR during the second and third trimesters than in the other two groups (48.5% vs 33.3% vs 22%, P<0.05; 50% vs 21.3% vs 26.7%, P<0.001). Moreover, the risk of NT was markedly higher in the first trimester (PLR < 78.51; OR 0.975, 95% CI 0.951-0.999, P<0.05) and the second trimester (PLR < 20.41; OR, 0.899, 95% CI 0.820-0.985, P<0.05) compared to the third trimester. CONCLUSION Our findings suggest that a history of previous children with NT is a significant factor for predicting NT in subsequent pregnancies. PLR in the first, second and third trimesters can also be used as a reference to predict NT risk.
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Affiliation(s)
- Huang Qionghui
- Department of Pediatrics, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, People's Republic of China
| | - Zeng Chaomei
- Department of Pediatrics, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, People's Republic of China
| | - Liu Jie
- Department of Pediatrics, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, People's Republic of China
| | - Qin Jiong
- Department of Pediatrics, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, People's Republic of China.
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Murata S, Baig N, Decker K, Halaris A. Systemic Inflammatory Response Index (SIRI) at Baseline Predicts Clinical Response for a Subset of Treatment-Resistant Bipolar Depressed Patients. J Pers Med 2023; 13:1408. [PMID: 37763175 PMCID: PMC10533150 DOI: 10.3390/jpm13091408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/05/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
Background: in a recent double-blind, placebo controlled RCT we demonstrated that selective inhibition of cyclo-oxygenase 2 (COX2) is an effective adjunctive strategy in treatment-resistant bipolar depression (TRBDD). To better clarify the mechanisms underlying TRBDD and treatment response, we conducted a retrospective exploratory analysis of the systemic inflammatory response index (SIRI = absolute neutrophils × absolute monocytes/absolute lymphocytes) in relation to other biomarkers and clinical outcomes after escitalopram (ESC), combined with the COX-2 inhibitor, celecoxib (CBX), versus placebo. Methods: Baseline measures of SIRI were compared between TRBDD and healthy controls (HC), and correlated with blood-based inflammatory cytokines, kynurenines, and growth factors. Post-treatment Hamilton Depression Rating Scale 17 (HAMD-17) total scores (clinical outcome) were modelled according to SIRI adjusting for demographics (including relevant interactions with SIRI), baseline depression, treatment arm, and treatment timepoint using multiple linear regression and robust linear mixed effects models. Results: Baseline SIRI did not distinguish TRBDD from HC groups. Baseline SIRI was significantly correlated with lower baseline MCP-1. The relationship between SIRI and HAMD-17 was significant at treatment week 8, in contrast to baseline. Finally, baseline SIRI predicted elevated post-treatment HAMD-17 scores, amongst patients with elevated depression scores at baseline. Significance: High pre-treatment SIRI may predict poorer depressive outcomes amongst TRBDD patients with baseline elevated depression.
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Affiliation(s)
- Stephen Murata
- Pine Rest Christian Mental Health Services, Michigan State University, 300 68th Street SE, Grand Rapids, MI 49548, USA
| | - Nausheen Baig
- Department of Psychiatry and Behavioral Neurosciences, Loyola University Chicago, Stritch School of Medicine, Loyola University Medical Center, Maywood, IL 60153, USA; (N.B.); (K.D.); (A.H.)
- Stritch School of Medicine, Loyola University, Maywood, IL 60153, USA
| | - Kyle Decker
- Department of Psychiatry and Behavioral Neurosciences, Loyola University Chicago, Stritch School of Medicine, Loyola University Medical Center, Maywood, IL 60153, USA; (N.B.); (K.D.); (A.H.)
- Stritch School of Medicine, Loyola University, Maywood, IL 60153, USA
| | - Angelos Halaris
- Department of Psychiatry and Behavioral Neurosciences, Loyola University Chicago, Stritch School of Medicine, Loyola University Medical Center, Maywood, IL 60153, USA; (N.B.); (K.D.); (A.H.)
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Paniagua G, González-Blanco L, Sáiz PA, Moya-Lacasa C, Gutiérrez L, Martínez-Botía P, Dal Santo F, Jiménez-Treviño L, García-Portilla MP, Bobes J. Platelet and white blood-cell-based ratios: Differential inflammatory markers of severe mental disorders? SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023:S2950-2853(23)00008-X. [PMID: 38591835 DOI: 10.1016/j.sjpmh.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/21/2023] [Accepted: 03/29/2023] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Neutrophil/lymphocyte (NLR), monocyte/lymphocyte (MLR), and platelet/lymphocyte (PLR) ratios, and systemic inflammatory index (SII) represent peripheral markers of inflammation associated with different severe mental disorders. MATERIAL AND METHODS In this study, these parameters were analyzed in a sample of 622 participants [197 patients with major depressive disorder (MDD), 154 with bipolar disorder (BD), 176 with schizophrenia (SCH), and 95 healthy controls (HC)]. Sociodemographic and clinical data of patients were recorded. RESULTS Differences in age and sex were detected among groups (p<0.001), with SCH patients being younger and MDD patients being older. After stratifying by sex, these ratios were compared using the nonparametric ANCOVA (Quade's test) using age as a covariate. In males, no significant statistical differences were found between groups. However, differences were observed in MLR in the subgroup of females [MDD: 0.23 (SD=0.09); BD: 0.23 (SD=0.11); SCH: 0.24 (SD=0.11); HC: 0.29 (SD=0.13); F=5.376, p=0.001]. Post hoc testing revealed that there are MLR differences between HC versus MDD and between HC versus BD, with higher values in HC versus the other two groups. On the other hand, no differences were found in either males or females for any of the studied ratios, among the three diagnostic groups. CONCLUSIONS MLR is reduced in MDD and BD patients versus HC, but exclusively in the female group. However, based on the analyzed indices, it is not possible to differentiate among the three diagnostic groups of patients. As a limitation of this study, note that the effects of psychopharmacological treatments and smoking have not been controlled for.
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Affiliation(s)
- Gonzalo Paniagua
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - Leticia González-Blanco
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Pilar A Sáiz
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
| | - Carlota Moya-Lacasa
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
| | - Laura Gutiérrez
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Department of Medicine, Universidad de Oviedo, Oviedo, Spain
| | - Patricia Martínez-Botía
- Platelet Research Lab, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Francesco Dal Santo
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Luis Jiménez-Treviño
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - María Paz García-Portilla
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Julio Bobes
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain; Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain; Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain; Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
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Gonçalves VA, Geiger MA, Sarti DA, Guillaumon AT. Association between platelet lymphocyte ratio and neutrophil lymphocyte ratio and clinical outcomes following carotid endarterectomy. J Vasc Bras 2023; 22:e20220122. [PMID: 37790888 PMCID: PMC10545233 DOI: 10.1590/1677-5449.202201222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 06/06/2023] [Indexed: 10/05/2023] Open
Abstract
Background Approximately 30% of stroke cases result from carotid disease. Although several risk factors for complications after carotid endarterectomy have been identified, the existence of a biomarker that can estimate postoperative risk in these patients has not yet been proven. Objectives This study aimed to investigate correlations between the platelet-lymphocyte ratio (PLR) and the neutrophil-lymphocyte ratio (NLR) and postoperative clinical outcomes in patients undergoing carotid endarterectomy. Methods A retrospective study was conducted, including 374 patients who underwent carotid endarterectomy between 2002 and 2019 due to moderate to high extracranial internal carotid artery stenosis. Their platelet-lymphocyte ratio and neutrophil-lymphocyte ratios were obtained from the same blood samples. Results There was a statistically significant correlation between the PLR and the occurrence of restenosis (p < 0.01) and acute myocardial infarction (AMI) after endarterectomy (p = 0.03). Additionally, there was a statistically significant correlation between the PLR and the combined outcomes stroke and/or AMI and/or death (p = 0.03) and stroke and/or AMI and/or death and/or restenosis (p < 0.01). However, there were no significant correlations between NLR and these outcomes (p = 0.05, p = 0.16). Conclusions The platelet-lymphocyte ratio proved to be a useful test for predicting occurrence of strokes, acute myocardial infarctions, and deaths during the postoperative period after carotid endarterectomy. It was also associated with the risk of postoperative restenosis.
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Affiliation(s)
- Vinicius Adorno Gonçalves
- Universidade Estadual de Campinas – UNICAMP, Faculdade de Ciências Médicas, Hospital de Clínicas, Campinas, SP, Brasil.
| | - Martin Andreas Geiger
- Universidade Estadual de Campinas – UNICAMP, Faculdade de Ciências Médicas, Hospital de Clínicas, Campinas, SP, Brasil.
| | | | - Ana Terezinha Guillaumon
- Universidade Estadual de Campinas – UNICAMP, Faculdade de Ciências Médicas, Hospital de Clínicas, Campinas, SP, Brasil.
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Szałach ŁP, Lisowska KA, Cubała WJ, Barbuti M, Perugi G. The immunomodulatory effect of lithium as a mechanism of action in bipolar disorder. Front Neurosci 2023; 17:1213766. [PMID: 37662097 PMCID: PMC10469704 DOI: 10.3389/fnins.2023.1213766] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/04/2023] [Indexed: 09/05/2023] Open
Abstract
Bipolar disorder (BD) is a chronic mental disorder characterized by recurrent episodes of mania and depression alternating with periods of euthymia. Although environmental and genetic factors have been described, their pathogenesis is not fully understood. Much evidence suggests a role for inflammatory mediators and immune dysregulation in the development of BD. The first-line treatment in BD are mood-stabilizing agents, one of which is lithium (Li) salts. The Li mechanism of action is not fully understood, but it has been proposed that its robust immunomodulatory properties might be one of the mechanisms responsible for its effectiveness. In this article, the authors present the current knowledge about immune system changes accompanying BD, as well as the immunomodulatory effect of lithium. The results of studies describing connections between immune system changes and lithium effectiveness are often incoherent. Further research is needed to understand the connection between immune system modulation and the therapeutic action of lithium in BD.
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Affiliation(s)
- Łukasz P. Szałach
- Department of Pathophysiology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
- Department of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Katarzyna A. Lisowska
- Department of Pathophysiology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Wiesław J. Cubała
- Department of Psychiatry, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Margherita Barbuti
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giulio Perugi
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Sharifan P, Darroudi S, Rafiee M, Toussi MSE, Sedgh Doust FN, Taghizadeh N, Fazl Mashhadi MR, Ghazizadeh H, Mohammadi MA, Dabagh AE, Ebrahimian AR, Yousefi M, Esmaily H, Ferns GA, Soflaei SS, Ghayour-Mobarhan M. Association of dietary and blood inflammatory indicators with depression, anxiety, and stress in adults with vitamin D deficiency. Int J Geriatr Psychiatry 2023; 38:e5972. [PMID: 37539817 DOI: 10.1002/gps.5972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 07/11/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND There is growing evidence that vitamin D may be related to mental health. The aim of the current study was to investigate the association of dietary and blood inflammatory factors with mental health disorders in subjects with vitamin D deficiency, shedding further light on the complex interplay of these conditions. METHOD In this cross-sectional study, 306 subjects completed the validated Depression, Anxiety, and Stress Scale questionnaire to evaluate their depression, anxiety, and stress scores. Dietary inflammatory index (DII) and healthy eating index (HEI) were calculated using a validated 65-item food frequency questionnaire. Blood samples were taken and vitamin D, cytokine, and hs-CRP levels were measured using enzyme-linked immunosorbent assay kits. Platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) were calculated using standard laboratory methods. RESULTS The subjects were divided into two groups based on their vitamin D levels: a vitamin D < 20 μg/dl group (N = 257) and a vitamin D ≥ 20 μg/dl group (N = 49). Between group analysis revealed that only DII (p = 0.015), platelet (p = 0.04), and hs-CRP (p = 0.015) were significantly different. In adults with vitamin D levels below 20 μg/dl, NLR and DII were significantly higher in subjects with anxiety (p < 0.05), and this relationship remained significant only for NLR after adjusting for age and sex. Additionally, PLR and HEI were significantly different in depressed compared to non-depressed subjects, and this association remained significant only for HEI after adjusting for age and sex. CONCLUSION In subjects with vitamin D deficiency, increased levels of PLR, NLR, and DII were associated with depression and anxiety, while HEI was negatively associated with depression. These associations were not found in subjects with vitamin D levels ≥20 μg/dl.
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Affiliation(s)
- Payam Sharifan
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Susan Darroudi
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Rafiee
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | | | - Niloofar Taghizadeh
- Department of Biology, Faculty of Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran
| | | | - Hamideh Ghazizadeh
- Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Ali Ebrahimi Dabagh
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Maryam Yousefi
- Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaily
- Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Division of Medical Education, Brighton and Sussex Medical School, Brighton, UK
| | - Sara Saffar Soflaei
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health-Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
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Leung KK, Wong YC, Shea KS, Chan SC, Chang WC, Mo YMF, Chan SMS. Altered neutrophil-to-lymphocyte ratio in patients with non-affective first episode psychosis and its relationship with symptom severity and cognitive impairment. Sci Rep 2023; 13:11453. [PMID: 37454218 PMCID: PMC10349799 DOI: 10.1038/s41598-023-37846-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 06/28/2023] [Indexed: 07/18/2023] Open
Abstract
Signatures of immune dysregulation as clinical biomarker for psychosis have remained unclear. We aimed to compare the Neutrophil-to-lymphocyte ratio (NLR) of patients with acute non-affective first-episode psychosis (FEP) with healthy controls after accounting for emotional states. We also explored the associations of NLR with symptom severity, onset profile and cognitive functions. The NLR was enumerated from complete blood count taken within a week of assessment. All FEP patients were rated on the Positive and Negative Syndrome Scale (PANSS) and the Clinician Global Impression-Severity (CGI-S) with verbal memory and executive functions assessed with the Cambridge Neuropsychological Test Automated Battery. Prevailing emotional state was measured with Beck Depression Inventory-II and Beck Anxiety Inventory. Out of seventy-nine consecutive FEP patients presenting to the study site, twenty-seven subjects were eligible and recruited. Twenty-seven age-/sex-matched controls were recruited. FEP patients had an NLR of 1.886 over the controls after accounting for scores on emotional states. The NLR of FEP patients was positively associated with CGI-S scores, PANSS positive symptom, disorganization and excitation scores. There was no significant correlation between NLR with the duration of untreated psychosis and cognitive performances. These findings support using NLR as a clinical biomarker in FEP, purporting further prospective study to measure NLR changes in the course of treatment.
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Affiliation(s)
- Kwan Keung Leung
- Department of Psychiatry, Tai Po Hospital, G30, Ground Floor, Multicentre, Tai Po Hospital, Tai Po, New Territories, Hong Kong, SAR, China
- Department of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China
| | - Yip Chau Wong
- Department of Psychiatry, Tai Po Hospital, G30, Ground Floor, Multicentre, Tai Po Hospital, Tai Po, New Territories, Hong Kong, SAR, China
- Department of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China
| | - Ka Sin Shea
- Department of Psychiatry, Tai Po Hospital, G30, Ground Floor, Multicentre, Tai Po Hospital, Tai Po, New Territories, Hong Kong, SAR, China
- Department of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China
| | - Sheung Chun Chan
- Department of Psychiatry, Tai Po Hospital, G30, Ground Floor, Multicentre, Tai Po Hospital, Tai Po, New Territories, Hong Kong, SAR, China
- Department of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China
| | - Wing Chung Chang
- Department of Psychiatry, Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yi Man Flora Mo
- Department of Psychiatry, Tai Po Hospital, G30, Ground Floor, Multicentre, Tai Po Hospital, Tai Po, New Territories, Hong Kong, SAR, China
- Department of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China
| | - Sau Man Sandra Chan
- Department of Psychiatry, Tai Po Hospital, G30, Ground Floor, Multicentre, Tai Po Hospital, Tai Po, New Territories, Hong Kong, SAR, China.
- Department of Psychiatry, Alice Ho Miu Ling Nethersole Hospital, Hong Kong, China.
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
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Falaschi V, Palego L, Marazziti D, Betti L, Musetti L, Maglio A, Dell'Oste V, Sagona S, Felicioli A, Carpita B, Brogi A, Mucci F, Massimetti E, Dell'Osso L, Giannaccini G. Variation of Circulating Brain-Derived Neurotrophic Factor (BDNF) in Depression: Relationships with Inflammatory Indices, Metabolic Status and Patients' Clinical Features. Life (Basel) 2023; 13:1555. [PMID: 37511930 PMCID: PMC10381762 DOI: 10.3390/life13071555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/30/2023] Open
Abstract
This study seeks to offer a contribution to the method of subtyping major depressed patients by exploring the possible relationships between circulating brain-derived neurotrophic factor (BDNF), different peripheral inflammatory/metabolic markers in the blood and clinical characteristics. Thirty-nine patients, thoroughly diagnosed according to the DSM-5 criteria, underwent a comprehensive set of evaluations encompassing structured interviews, rating scales and a panel of blood tests. Correlation and comparison analyses were carried out by means of non-parametric statistical tests. Concurrently, a principal component analysis was performed to explain biochemical variance. The findings of our research unveiled that leukocyte counts, their ratios and other inflammatory parameters are positively correlated with depression scores. Moreover, we found variations within the BDNF pools of depressed patients. Specifically, higher levels of platelet-poor plasma BDNF (PPP-BDNF) were correlated with augmented inflammatory markers in patients showing specific episode characteristics, whereas reduced platelet BDNF (PLT-BDNF) provided a better indication of the changes that were linked to a diagnosis of long-term depression. Our findings suggest that PPP-BDNF and PLT-BDNF might differentiate depression conditions. They also imply usefulness in appraising peripheral biomarker profiles in patients for a deeper characterization of major depressive episodes. At the same time, it is plausible that they might constitute novel avenues for developing more tailored therapeutic strategies for patients with MDs.
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Affiliation(s)
- Valentina Falaschi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Via Savi 10, 56126 Pisa, Italy
| | - Lionella Palego
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Via Savi 10, 56126 Pisa, Italy
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy
| | - Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Via Savi 10, 56126 Pisa, Italy
- Section of Clinical Psychology, Saint Camillus International University of Health and Medical Sciences-UniCamillus, Via sant'Alessandro 8, 00131 Rome, Italy
| | - Laura Betti
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy
| | - Laura Musetti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Via Savi 10, 56126 Pisa, Italy
| | - Alessandra Maglio
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Via Savi 10, 56126 Pisa, Italy
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Via Savi 10, 56126 Pisa, Italy
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy
| | - Simona Sagona
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy
- Department of Veterinary Science, Section of Biochemistry, Viale delle Piagge 2, 56124 Pisa, Italy
| | - Antonio Felicioli
- Department of Veterinary Science, Section of Biochemistry, Viale delle Piagge 2, 56124 Pisa, Italy
| | - Barbara Carpita
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Via Savi 10, 56126 Pisa, Italy
| | - Alberto Brogi
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy
| | - Federico Mucci
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Via Savi 10, 56126 Pisa, Italy
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Via Aldo Moro 2, 53100 Siena, Italy
- North-Western Tuscany Region NHS Local Health Unit, Department of Psychiatry, Head Office, Via Cocchi 7/9, 56121 Pisa, Italy
| | - Enrico Massimetti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Via Savi 10, 56126 Pisa, Italy
- North-Western Tuscany Region NHS Local Health Unit, Department of Psychiatry, Head Office, Via Cocchi 7/9, 56121 Pisa, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Via Savi 10, 56126 Pisa, Italy
| | - Gino Giannaccini
- Department of Pharmacy, University of Pisa, Via Bonanno 6, 56126 Pisa, Italy
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Zhu X, Li R, Zhu Y, Zhou J, Huang J, Zhou Y, Tong J, Zhang P, Luo X, Chen S, Li Y, Tian B, Tan SP, Wang Z, Han X, Tian L, Li CSR, Tan YL. Changes in Inflammatory Biomarkers in Patients with Schizophrenia: A 3-Year Retrospective Study. Neuropsychiatr Dis Treat 2023; 19:1597-1604. [PMID: 37465565 PMCID: PMC10350427 DOI: 10.2147/ndt.s411028] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/19/2023] [Indexed: 07/20/2023] Open
Abstract
Objective Accumulating evidence suggested that immune system activation might be involved in the pathophysiology of schizophrenia. The neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) can measure inflammation. This study aimed to investigate the inflammatory state in patients with schizophrenia by using these indicators. Methods In this study, the complete blood count data for 187 continuing hospitalized patients with schizophrenia and 187 age- and sex-matched healthy participants was collected annually from 2017 to 2019. Platelet (PLT), lymphocyte (LYM), monocyte (MON) and neutrophil (NEU) counts were aggregated and NLR, MLR, PLR, and SII were calculated. Using a generalized linear mixed model, we assessed the impact of age, sex, diagnosis, and sampling year on the above indicators and evaluated the interaction between the factors. Results According to the estimation results of the generalized linear mixed model, the NLR increased by 0.319 (p = 0.004), the MLR increased by 0.037 (p < 0.001), and the SII increased by 57.858 (p = 0.018) in patients with schizophrenia. Data after two years of continuous antipsychotic treatment showed that the NLR and MLR were higher in patients with schizophrenia than those in healthy controls, while the PLT and LYM counts were decreased in patients with schizophrenia. The schizophrenia diagnosis was correlated to the MON and LYM count, NLR, MLR, and SII (p < 0.05). Conclusion The differences in these markers were stable and cannot be eliminated by a full course of treatment. This study provides impetus for the inflammatory hypothesis of schizophrenia.
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Affiliation(s)
- Xiaoyu Zhu
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Ran Li
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Yu Zhu
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Jia Zhou
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Junchao Huang
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Yanfang Zhou
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Jinghui Tong
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Ping Zhang
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Xingguang Luo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Song Chen
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Yanli Li
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Baopeng Tian
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Shu-Ping Tan
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Zhiren Wang
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Xiaole Han
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
| | - Li Tian
- Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Yun-Long Tan
- Psychosomatic Department, Beijing HuiLongGuan Hospital, Beijing, People’s Republic of China
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Moreno I, Stojanovic-Pérez A, Bulduk B, Sánchez-Gistau V, Algora MJ, Ortega L, Muntané G, Vilella E, Labad J, Martorell L. High blood levels of brain-derived neurotrophic factor (BDNF) mRNA in early psychosis are associated with inflammatory markers. J Psychiatr Res 2023; 164:440-446. [PMID: 37429187 DOI: 10.1016/j.jpsychires.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/26/2023] [Accepted: 07/06/2023] [Indexed: 07/12/2023]
Abstract
The brain-derived neurotrophic factor (BDNF) single nucleotide polymorphism (SNP) rs6265C > T, Val66Met, affects BDNF secretion and has been related to inflammatory processes. Both the rs6265 and BDNF protein levels have been widely investigated in neuropsychiatric disorders with conflicting results. In the present study we examined BDNF mRNA expression in blood considering the SNP rs6265 and its relationship with inflammatory markers in the early stages of psychosis. The rs6265 genotype and blood BDNF mRNA levels were measured in 34 at-risk mental states (ARMS) individuals, 37 patients with first-episode psychosis (FEP) and 42 healthy controls (HCs) by quantitative PCR and reverse transcription (RT)-qPCR using validated TaqMan assays. We also obtained measures of interleukin-6 (IL6) mRNA levels, fibrinogen, neutrophil-to-lymphocyte ratio (NLR) and high-sensitivity C-reactive protein. We identified that BDNF mRNA levels were associated with the rs6265 genotype in an allele-dose-dependent manner, with low expression levels associated with the T allele (Met substitution). Thus, we controlled for the rs6265 genotype in all analyses. Blood BDNF mRNA levels differed between diagnostic groups: patients with FEP exhibited higher blood BDNF mRNA levels than ARMS individuals, and the lowest levels were observed in HC. In addition, we observed significant correlations between BDNF mRNA levels and inflammatory markers (IL6 mRNA levels and NLR), controlled by the rs6265 genotype, in ARMS and FEP groups. This exploratory study suggests that the rs6265 genotype is associated with differential blood mRNA expression of BDNF that increases with illness progression and correlated with inflammation in the early stages of psychosis.
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Affiliation(s)
- Irene Moreno
- Hospital Universitari Institut Pere Mata (HUIPM), Reus, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili-CERCA (IISPV-CERCA), Reus, Catalonia, Spain; Universitat Rovira i Virgili (URV), Reus, Catalonia, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Bengisu Bulduk
- Hospital Universitari Institut Pere Mata (HUIPM), Reus, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili-CERCA (IISPV-CERCA), Reus, Catalonia, Spain; Universitat Rovira i Virgili (URV), Reus, Catalonia, Spain
| | - Vanessa Sánchez-Gistau
- Hospital Universitari Institut Pere Mata (HUIPM), Reus, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili-CERCA (IISPV-CERCA), Reus, Catalonia, Spain; Universitat Rovira i Virgili (URV), Reus, Catalonia, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - María José Algora
- Hospital Universitari Institut Pere Mata (HUIPM), Reus, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili-CERCA (IISPV-CERCA), Reus, Catalonia, Spain; Universitat Rovira i Virgili (URV), Reus, Catalonia, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Ortega
- Institut d'Investigació Sanitària Pere Virgili-CERCA (IISPV-CERCA), Reus, Catalonia, Spain; Departament d'Infermeria, URV, Tarragona, Catalonia, Spain
| | - Gerard Muntané
- Hospital Universitari Institut Pere Mata (HUIPM), Reus, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili-CERCA (IISPV-CERCA), Reus, Catalonia, Spain; Universitat Rovira i Virgili (URV), Reus, Catalonia, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Institut de Biologia Evolutiva, IBE, Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata (HUIPM), Reus, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili-CERCA (IISPV-CERCA), Reus, Catalonia, Spain; Universitat Rovira i Virgili (URV), Reus, Catalonia, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Labad
- Hospital de Mataró, Consorci Sanitari del Maresme, Fundació Parc Taulí, Mataró, Catalonia, Spain; Institut d'Innovació i Investigació Parc Taulí (I3PT), Translational Neuroscience Research Unit I3PT-Inc-UAB, Institut de Neurociències, Universitat Autònoma de Barcelona (UAB), Bellaterra, Catalonia, Spain
| | - Lourdes Martorell
- Hospital Universitari Institut Pere Mata (HUIPM), Reus, Catalonia, Spain; Institut d'Investigació Sanitària Pere Virgili-CERCA (IISPV-CERCA), Reus, Catalonia, Spain; Universitat Rovira i Virgili (URV), Reus, Catalonia, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
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Sugimoto E, Matsuda H, Shibata S, Mizuno Y, Koyama A, Li L, Taira H, Ito Y, Awaji K, Yamashita T, Sato S. Impact of Pretreatment Systemic Inflammatory Markers on Treatment Persistence with Biologics and Conventional Systemic Therapy: A Retrospective Study of Patients with Psoriasis Vulgaris and Psoriatic Arthritis. J Clin Med 2023; 12:jcm12083046. [PMID: 37109382 PMCID: PMC10145777 DOI: 10.3390/jcm12083046] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/11/2023] [Accepted: 04/16/2023] [Indexed: 04/29/2023] Open
Abstract
Systemic inflammation plays a central role in the pathophysiology of psoriasis. This study examined accessible systemic inflammatory markers in patients with psoriasis vulgaris and psoriatic arthritis. We aimed to evaluate their association with psoriasis severity, the presence of arthritis, and drug continuation rates. The findings revealed that neutrophil, monocyte, and platelet count, neutrophil/lymphocyte ratio, monocyte/lymphocyte ratio, systemic inflammation response index, systemic immune/inflammation index (SII), and CRP were positively correlated with Psoriasis Area and Severity Index scores. Patients presenting with higher platelet/lymphocyte ratio (PLR) or CRP values were more likely to be diagnosed with psoriatic arthritis than with psoriasis vulgaris in the multivariate regression analysis. Importantly, patients with higher pretreatment neutrophil or platelet count, PLR, and SII were associated with lower treatment continuation rates of conventional systemic agents. Higher pretreatment scores of systemic inflammatory markers did not affect treatment retention rates of biologics. These findings suggest that several accessible systemic inflammatory markers may effectively assess underlying systemic inflammation and may provide an indication for a therapeutic approach in patients with psoriasis vulgaris and psoriatic arthritis.
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Affiliation(s)
- Eiki Sugimoto
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Hiroki Matsuda
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Sayaka Shibata
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Yuka Mizuno
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Asumi Koyama
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Lixin Li
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Haruka Taira
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Yukiko Ito
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Kentaro Awaji
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Takashi Yamashita
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
| | - Shinichi Sato
- Department of Dermatology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
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Inflammation and severity of depressive symptoms in physically active individuals after COVID-19 – An exploratory immunopsychological study investigating the effect of inflammation on depressive symptom severity. Brain Behav Immun Health 2023; 30:100614. [PMID: 37033771 PMCID: PMC10035808 DOI: 10.1016/j.bbih.2023.100614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 03/17/2023] [Accepted: 03/23/2023] [Indexed: 03/25/2023] Open
Abstract
Background SARS-CoV-2 infection is a risk factor for the development of depressive symptoms such as lack of energy, loss of interest, and depressed mood. Inflammatory processes might underline this association. The aim of this study was to investigate the association between inflammatory markers and the severity of depression after SARS-CoV-2 infection, and the predictive effect of inflammatory markers on the severity of depressive symptoms. Lifestyle factors and lifestyle-related diseases can influence inflammation and depressive symptoms. As these lifestyle factors and lifestyle-related diseases are less common in physically active individuals, they are a suitable population for investigating this research question. Methods We investigated 61 at least moderate physically active individuals on average ∼6 months (SD = 4.22, range = 0.5–19 months) after SARS-CoV-2 infection (t0) and performed a follow-up after 3 months (t1). Depressive symptoms and biomarkers of inflammation (interleukin [IL]-1β, IL-8, IL-10, Ferritin, Lipopolysaccharide-binding-protein [LBP], neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], lymphocyte-to-monocyte ratio [LMR]) and kynurenine [KYN] were measured at both time points. Concentrations of inflammatory markers at t0 were used to predict the severity of depressive symptoms at t0 and t1. Results Concentrations of KYN were negatively related to the severity of depressive symptoms at t0. Concentrations of LMR predicted higher depressive symptoms at t0 as well as at t1. Furthermore, individuals with lower concentrations of LBP at t0 showed a higher severity of depressive symptoms at t1. No correlation was found between severity of depressive symptoms and IL1β, IL-8, IL-10, ferritin, NLR, and PLR at both time points. Conclusions KYN, LBP and LMR might be useful as a predictive factor of depressive symptoms in physically active individuals after SARS-CoV-2 infection. While the results for KYN confirm the current scientific evidence, our results highlight the importance of the innovative inflammatory markers LMR and LBP. LMR and LBP might be interesting targets for predicting the development of depressive symptoms in SARS-CoV-2 infected populations and should be further investigated in future studies.
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Yang X, Wan X, Huang C, Fu J, Hu X, Le P, Ke J. Re-evaluate the Prognostic Value of Absolute Lymphocyte Count in Pediatric Immune Thrombocytopenia. J Pediatr Hematol Oncol 2023; 45:e254-e258. [PMID: 35917140 DOI: 10.1097/mph.0000000000002508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 05/23/2022] [Indexed: 10/16/2022]
Abstract
To re-evaluate the prognostic value of absolute lymphocyte count (ALC) in pediatric immune thrombocytopenia (ITP) from the perspective of age. A total of 242 ITP pediatric patients, including 141 newly diagnosed ITP (nITP), 89 chronic ITP (cITP), and 12 persistent ITP, were retrospectively reviewed for this study. These patients were divided into 3 groups according to age (group 1, ≤24 m; group 2, 24-72 m; and group 3, >72 m). The ALC detected at admission was significantly different between nITP and cITP patients without considering their age difference (5.22 vs. 3.55×10 9 /L, P <0.001). However, no significant difference was discovered after age stratification (≤24 m: 6.52 vs. 5.34×10 9 /L, P =0.161; 24-72 m: 3.78 vs. 3.63×10 9 /L, P =0.748; > 72 m: 2.53 vs. 2.40×10 9 /L, P =0.748). ROC analysis showed that the prognostic value of ALC in ITP children was limited (area under curve (AUC): ≤24 m, 24-72 m, and >72 m were 0.591, 0.570, and 0.542, respectively). Analysis of covariance showed there was no significant difference in ALC between nITP and cITP when considering age as a covariate ( P =0.131). Instead, the ROC showing that platelet to lymphocyte ratio (PLR) has prognostic value in pediatric ITP independent of age stratification (≤24 m: AUC, 0.688; 24-72 m: AUC, 0.741; >72 m: AUC, 0.680). In conclusion, there was no significant difference of ALC between nITP and cITP patients when stratified by different age groups, and PLR may be an optional prognostic indicator for ITP.
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Affiliation(s)
- Ximei Yang
- Jiangxi Provincial Children's Hospital, The Affiliated Children's Hospital of Nanchang University
| | - Xianghui Wan
- Jiangxi Provincial Cancer Hospital, Nanchang, China
| | - Chao Huang
- Jiangxi Provincial Children's Hospital, The Affiliated Children's Hospital of Nanchang University
| | - Jingjing Fu
- Jiangxi Provincial Children's Hospital, The Affiliated Children's Hospital of Nanchang University
| | - Xiaolu Hu
- Jiangxi Provincial Children's Hospital, The Affiliated Children's Hospital of Nanchang University
| | - Ping Le
- Jiangxi Provincial Children's Hospital, The Affiliated Children's Hospital of Nanchang University
| | - Jiangwei Ke
- Jiangxi Provincial Children's Hospital, The Affiliated Children's Hospital of Nanchang University
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Zhang Y, Mei H, Xiao H, Zhang Y, Gao W, Qi H, Zhang J. Association between neutrophil-lymphocyte ratio and perinatal depressive symptoms among Chinese women. J Psychosom Res 2023; 166:111101. [PMID: 36736189 DOI: 10.1016/j.jpsychores.2022.111101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/18/2022] [Accepted: 11/19/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The prevalence of depression has increased dramatically in the past few decades, and pregnant women are at high risk for depression. It is widely thought that inflammation plays a critical role in the pathogenesis of depression. Therefore, we aimed to evaluate the association between the neutrophil-lymphocyte ratio (NLR), a marker of chronic immune inflammation, and perinatal depressive symptoms. METHODS A cohort study involving 535 pregnant women was conducted based on a prospective birth cohort in Wuhan, China. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess antepartum depression (APD) and postpartum depression (PPD) during the second trimester of pregnancy and one month after delivery. The NLR during the second trimester was determined based on a routine blood test. The association between NLR and depressive symptoms was evaluated using logistic regression analysis and restricted cubic spline (RCS) regression. RESULTS We found that the prevalence of APD and PPD was 8.4% and 15.1%, respectively. NLR levels were positively associated with APD (OR = 1.52, 95% CI: 1.20--1.91). After adjusting for potential confounders, the OR (95% CI) of APD for the highest NLR quartile was 4.56 (1.58, 13.13) compared with the lowest quartile. No significant association was found between NLR and PPD. RCS regression model analysis indicated a linear correlation between NLR and APD (P for non-linearity = 0.58). CONCLUSION Overall, elevated mid-trimester NLR is independently associated with APD but not PPD.
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Affiliation(s)
- Ya Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, Hubei, China
| | - Hong Mei
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, 100 Xianggang Rd, Jiangan District, Wuhan, Hubei, China
| | - Han Xiao
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, 100 Xianggang Rd, Jiangan District, Wuhan, Hubei, China
| | - Yuanyuan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, Hubei, China
| | - Wenqi Gao
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, 100 Xianggang Rd, Jiangan District, Wuhan, Hubei, China
| | - Haiqin Qi
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, Hubei, China
| | - Jianduan Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, Hubei, China.
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49
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Foley ÉM, Parkinson JT, Mitchell RE, Turner L, Khandaker GM. Peripheral blood cellular immunophenotype in depression: a systematic review and meta-analysis. Mol Psychiatry 2023; 28:1004-1019. [PMID: 36577838 PMCID: PMC10005954 DOI: 10.1038/s41380-022-01919-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Meta-analyses implicate immune dysfunction in depression confirming increased levels of circulating immune proteins (e.g., cytokines) in depression cases compared to controls. White blood cells (WBC) both produce and are influenced by cytokines, and play key roles in orchestrating innate and adaptive immune responses, but their role in depression remains unclear. Therefore, a systematic review of studies of various WBC subsets in depression is required for a greater understanding of the nature of immune dysfunction in this illness. METHODS We searched PubMed and PsycINFO databases (inception to 5th April 2022) and conducted a systematic review and meta-analysis of identified studies comparing absolute count and/or relative percentage of flow cytometry-derived WBC subsets between depression cases and controls. Selected studies were quality assessed. Random-effect meta-analysis was performed. RESULTS Thirty-three studies were included and 27 studies (n = 2277) were meta-analysed. We report an increase in mean absolute counts of WBC (seven studies; standardised mean difference [SMD] = 1.07; 95% CI, 0.61-1.53; P < 0.01; I2 = 64%), granulocytes (two studies; SMD = 2.07; 95% CI, 1.45-2.68; P < 0.01; I2 = 0%), neutrophils (four studies; SMD = 0.91; 95% CI, 0.23-1.58; P < 0.01; I2 = 82%), monocytes (seven studies; SMD = 0.60; 95% CI, 0.19-1.01; P < 0.01; I2 = 66%), CD4+ helper T cells (11 studies; SMD = 0.30; 95% CI, 0.15-0.45; P < 0.01; I2 = 0%), natural killer cells (11 studies; SMD = 1.23; 95% CI, 0.38-2.08; P < 0.01; I2 = 95%), B cells (10 studies; SMD = 0.30; 95% CI, 0.03-0.57; P = 0.03; I2 = 56%), and activated T cells (eight studies; SMD = 0.45; 95% CI, 0.24-0.66; P < 0.01; I2 = 0%) in depression, compared to controls. Fewer studies reported relative percentage, indicating increased neutrophils and decreased total lymphocytes, Th1, and Th2 cells in depression. CONCLUSIONS Depression is characterised by widespread alterations in circulating myeloid and lymphoid cells, consistent with dysfunction in both innate and adaptive immunity. Immune cells could be useful biomarkers for illness subtyping and patient stratification in future immunotherapy trials of depression, along with cytokines, other biomarkers, and clinical measures.
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Affiliation(s)
- Éimear M Foley
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Joel T Parkinson
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - Ruth E Mitchell
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lorinda Turner
- Cambridge Institute of Therapeutic Immunology and Infectious Disease, Department of Medicine, University of Cambridge, Cambridge, UK
- bit.bio, Babraham Research Campus, Cambridge, UK
| | - Golam M Khandaker
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Bristol Biomedical Research Centre, Bristol, UK
- Avon and Wiltshire Mental Health Partnership NHS Trust, Bristol, UK
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50
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Yang X, Zhao S, Wang S, Cao X, Xu Y, Yan M, Pang M, Yi F, Wang H. Systemic inflammation indicators and risk of incident arrhythmias in 478,524 individuals: evidence from the UK Biobank cohort. BMC Med 2023; 21:76. [PMID: 36855116 PMCID: PMC9976398 DOI: 10.1186/s12916-023-02770-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 02/03/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND The role of systemic inflammation in promoting cardiovascular diseases has attracted attention, but its correlation with various arrhythmias remains to be clarified. We aimed to comprehensively assess the association between various indicators of systemic inflammation and atrial fibrillation/flutter (AF), ventricular arrhythmia (VA), and bradyarrhythmia in the UK Biobank cohort. METHODS After excluding ineligible participants, a total of 478,524 eligible individuals (46.75% male, aged 40-69 years) were enrolled in the study to assess the association between systemic inflammatory indicators and each type of arrhythmia. RESULTS After covariates were fully adjusted, CRP levels were found to have an essentially linear positive correlation with the risk of various arrhythmias; neutrophil count, monocyte count, and NLR showed a non-linear positive correlation; and lymphocyte count, SII, PLR, and LMR showed a U-shaped association. VA showed the strongest association with systemic inflammation indicators, and it was followed sequentially by AF and bradyarrhythmia. CONCLUSIONS Multiple systemic inflammatory indicators showed strong associations with the onset of AF, VA, and bradyarrhythmia, of which the latter two have been rarely studied. Active systemic inflammation management might have favorable effects in reducing the arrhythmia burden and further randomized controlled studies are needed.
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Affiliation(s)
- Xiaorong Yang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China.,Clinical Research Center of Shandong University, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Shaohua Zhao
- Department of Geriatric Medicine, Qilu Hospital of Shandong University, Jinan, China.,Key Laboratory of Cardiovascular Proteomics of Shandong Province, Qilu Hospital of Shandong University, Jinan, China
| | - Shaohua Wang
- Department of Internal Medicine, Jinan Hospital, Jinan, China
| | - Xuelei Cao
- Department of Clinical Laboratory, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Yue Xu
- Qilu Hospital of Shandong University, Jinan, China
| | - Meichen Yan
- Qilu Hospital of Shandong University, Jinan, China
| | - Mingmin Pang
- Qilu Hospital of Shandong University, Jinan, China
| | - Fan Yi
- Department of Pharmacology, School of Basic Medical Sciences, Shandong University, Jinan, Shandong, China.
| | - Hao Wang
- Department of Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China.
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