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Modrzejewska M, Bosy-Gąsior W, Grzesiak W. Association of Positive Bacterial Cultures Obtained from the Throat, Anus, Ear, Bronchi and Blood in Very-Low-Birth-Weight Premature Infants with Severe Retinopathy of Prematurity-Own Observations. J Clin Med 2023; 12:6374. [PMID: 37835018 PMCID: PMC10573982 DOI: 10.3390/jcm12196374] [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: 08/02/2023] [Revised: 09/27/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The causative factors responsible for the development of Retinopathy of Prematurity (ROP) are still unexplored. Therefore, one of the most important factors can be perinatal inflammation. METHODS This retrospective study included 114 premature infants (228 eyes) meeting a birth criteria of ≤ 32 weeks gestational age (GA) and a birth weight (BW) ≤ 1710. Examined Group (EG) n = 51 of BW 852.7 ± 255.7; GA 26.3 ± 2.0 with severe ROP treated by diode laser or anti-VEGF intravitreal injection. Control Group (CG) n = 63 of BW 1313.9 ± 284.5; GA 28.8 ± 1.6 without ROP. Microbiological bacterial and fungal cultures of the ear, anus, bronchial throat and blood were taken. Medical data and laboratory tests in correlation to 3 ROP and A-ROP were analysed. RESULTS Positive bacterial tests dominated in EG, 47% vs. CG, 23%. Significant correlations between positive cultures obtained from natural cavities: anus (p < 0.001), throat (p = 0.002), as well as from blood (p = 0.001) and severe ROP which requires diode laser and anti-VEGF treatment were noted. Significant inflammation markers which correlate with the development of severe ROP are Klebsiella pneumoniae (KP) (p = 0.002) and Coagulase-negative Staphylococci (CoNS) (p < 0.001). CoNS, p < 0.001; KP, p = 0.002; the remaining Maltophilia stenotrophomonas (MS); Staphylococcus aureus (SA), p = 0.005; and Enterobacter cloacae (EC), p = 0.02 were the most frequent bacteria in severe ROP. High levels of white blood cells (WBC), C-reactive protein (CRP), lymphocytes (LYM) and low thrombocytes (PLT) correlated sequentially with (Odds Ratio, OR) CoNS (2.3); MS (5.9); KP (3.1); and all positive cultures (APC) (9.5). An important correlation between the BPD-EC (4.3); intrauterine inflammation-KP (3.4); PDA-EC (3.9); and asphyxia-CoNS (3.0) was identified. CONCLUSIONS It cannot be ruled out that positive microbiological results of blood, anal and pharyngeal cultures may become prognostic markers for the early development of ROP, which would enable early initiation of ophthalmological treatment in premature infants from the VLBW group.
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Affiliation(s)
- Monika Modrzejewska
- Scientific Association of Students, II Department of Ophthalmology, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland;
| | - Wiktoria Bosy-Gąsior
- Scientific Association of Students, II Department of Ophthalmology, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland;
| | - Wilhelm Grzesiak
- Faculty of Biotechnology and Animal Hysbandry, West-Pomeranian Technological University, Al. Piastów 48, 70-311 Szczecin, Poland;
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Inaltekin A, Yağci İ. Evaluation of Simple Markers of Inflammation and Systemic Immune Inflammation Index in Schizophrenia, Bipolar Disorder Patients and Healthy Controls. TURK PSIKIYATRI DERGISI = TURKISH JOURNAL OF PSYCHIATRY 2023; 34:11-15. [PMID: 36970957 PMCID: PMC10552167 DOI: 10.5080/u26248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), mean platelet volume (MPV), and systemic immune inflammation index (SII) are recently used as indicators of inflammation. NLR, PLR, MLR, and MPV have been evaluated in many studies in patients with schizophrenia and bipolar disorder. However, there are no studies investigating SII. This study aims to evaluate NLR, PLR, MLR, MPV and SII values and complete blood count elements in patients hospitalized with diagnoses of the schizophrenia with psychotic episode and bipolar disorder with manic episode by comparing them with the control group. METHOD A total of 149 patients who were hospitalized with the diagnoses of the schizophrenia with psychotic episode and bipolar disorder with manic episode and who met the inclusion criteria were included in our study where the control group was composed of 66 healthy individuals. White blood cell (WBC), neutrophil, lymphocyte, platelet, and monocyte counts were obtained retrospectively from complete blood counts at the time of admission, based on which NLR, PLR, MLR, and SII were calculated. RESULTS In this study, higher NLR, PLR, and SII values and lower MPV and lymphocyte counts were observed in schizophrenia patients compared to the control group. NLR, PLR, and SII values and neutrophil counts were higher in patients with bipolar disorder compared to the control group. Lower MPV values were found in patients with schizophrenia compared to patients with bipolar disorder. CONCLUSION Simple inflammatory and SII values in our study indicate the presence of low-grade systemic inflammation in schizophrenia and bipolar disorder.
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Bhikram T, Sandor P. Neutrophil-lymphocyte ratios as inflammatory biomarkers in psychiatric patients. Brain Behav Immun 2022; 105:237-246. [PMID: 35839998 DOI: 10.1016/j.bbi.2022.07.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 07/08/2022] [Accepted: 07/09/2022] [Indexed: 10/17/2022] Open
Abstract
PURPOSE There is a growing amount of evidence to suggest that inflammation may have a role in the onset and prognosis of psychiatric disorders. We reviewed the literature of studies investigating neutrophil-lymphocyte ratios (NLR), a biomarker of inflammation, in both adult and youth psychiatric populations. The limitations of NLR, in addition to the potential mechanisms underlying its relationship with psychiatric disorders, are also discussed. RECENT FINDINGS Unlike in the general population, NLR is elevated in a proportion of adult patients with schizophrenia, major depressive disorder and bipolar disorder, though associations with symptom severity and other clinical parameters are less clear. When compared to baseline, reductions in NLR are sometimes reported after treatment and remission. Results in youth populations largely resemble findings obtained from adult samples, even though youth studies are far fewer in number. SUMMARY The consistent findings of elevated NLR across the reviewed psychiatric disorders suggest that abnormal NLR is not specific to any one disorder but may reflect a pathological brain process that leads to brain dysfunction. These findings support hypotheses of neuroinflammation being important to the etiology of psychiatric disorders. More research is needed to further elucidate the relationship between specific diagnostic and behavioural constructs and NLR. Future work is also needed to determine the specific neuroinflammatory mechanisms that give rise to specific disorders.
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Affiliation(s)
- Tracy Bhikram
- Tourette Syndrome Neurodevelopmental Clinic, University Health Network, Toronto, Ontario, Canada.
| | - Paul Sandor
- Tourette Syndrome Neurodevelopmental Clinic, University Health Network, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Division of Child Psychiatry, Department of Psychiatry, Youthdale Treatment Centers, Toronto, Ontario, Canada; Youthdale Treatment Centers, Toronto, Ontario, Canada
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Neutrophil-to-Lymphocyte, Monocyte-to-Lymphocyte, Platelet-to-Lymphocyte Ratio and Systemic Immune-Inflammatory Index in Different States of Bipolar Disorder. Brain Sci 2022; 12:brainsci12081034. [PMID: 36009097 PMCID: PMC9405738 DOI: 10.3390/brainsci12081034] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 07/28/2022] [Accepted: 08/01/2022] [Indexed: 11/17/2022] Open
Abstract
The neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammatory (SII) index, which provide a simple, rapid, inexpensive method to measure the level of inflammation, have been examined as potential inflammatory biomarkers of bipolar disorder (BD) in several studies. We conducted a case-control study recruiting 180 BD patients and 407 healthy controls. BD patients who met the inclusion criteria and were hospitalized due to BD at the psychiatry clinic of the University General Hospital of Larisa, Greece, until September 2021 were included in the study. Among them, 111 patients experienced a manic episode and 69 patients experienced a depressive episode. Data including a complete blood count were retrieved from their first admission to the hospital. Bipolar patients had a higher NLR, MLR and SII index compared to healthy controls when they were experiencing a manic episode (p < 0.001) and a depressive episode (p < 0.001). MLR was increased with large effect size only in patients expressing manic episodes. Neutrophils and NLR had the highest area under the curve with a cutoff of 4.38 and 2.15 in the ROC curve, respectively. Gender-related differences were mainly observed in the SII index, with males who were expressing manic episodes and females expressing depressive episodes having an increased index compared to healthy controls. The NLR, MLR and SII index were significantly higher in patients with BD than in healthy controls, which implies a higher grade of inflammation in BD patients.
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Sanchez-Autet M, Arranz B, Sierra P, Safont G, Garcia-Blanco A, de la Fuente L, Garriga M, Marín L, García-Portilla MP. Association between neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and C-reactive protein levels and metabolic status in patients with a bipolar disorder. World J Biol Psychiatry 2022; 23:464-474. [PMID: 34856870 DOI: 10.1080/15622975.2021.2013089] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and C-Reactive Protein (CRP) are markers of inflammation that are elevated in bipolar disorder (BD) and are also related to a higher risk of metabolic syndrome (MetS). This study aimed at investigating for the first time the association between NLR, PLR, and CRP and the metabolic status in BD. METHODS We assessed the association between biomarkers and the metabolic status: number of metabolic risk factors, presence of MetS, insulin sensitivity (Quantitative Insulin Sensitivity Check Index, QUICKI) and insulin resistance (Homeostatic Model Assessment for Insulin Resistance, HOMA-IR index), in a sample of 219 outpatients with BD. RESULTS 25.9% of the sample met the criteria for MetS. High levels of CRP were found in 12% of the sample. Older age, low PLR, high NLR, and high CRP levels significantly predicted a higher number of MetS risk factors (p < 0.001). Older age and low PLR were associated with a greater likelihood of developing MetS (p = 0.007). CONCLUSIONS Although further studies are needed to replicate and validate these findings, inflammatory biomarkers as CRP, PLR and NLR could be useful tools to identify patients with a BD at risk for a metabolic adverse outcome.
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Affiliation(s)
| | - Belén Arranz
- Parc Sanitari Sant Joan de Deu, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Pilar Sierra
- Department of Psychiatry, La Fe University and Polytechnic Hospital, Valencia, Spain.,Department of Medicine, University of Valencia, Valencia, Spain
| | - Gemma Safont
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Hospital Universitari Mutua Terrassa, Barcelona, Spain
| | - Ana Garcia-Blanco
- Neonatal Research Unit, La Fe Health Research Institute, Valencia, Spain
| | - Lorena de la Fuente
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Psychiatry, University of Oviedo, Oviedo, Spain
| | - Marina Garriga
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Bipolar Disorder Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Lorena Marín
- Hospital Universitari Mutua Terrassa, Barcelona, Spain
| | - Maria Paz García-Portilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Psychiatry, University of Oviedo, Oviedo, Spain
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Karatas KS, Bahceci I, Telatar TG, Bahceci B, Hocaoglu C. Relationship between disease and disease severity and semaphorin 5A and hemogram level in obsessive-compulsive disorder. Nord J Psychiatry 2021; 75:509-515. [PMID: 33771090 DOI: 10.1080/08039488.2021.1896779] [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: 10/21/2022]
Abstract
OBJECTIVE Semaphorin 5A (SEMA 5A) is a neuroprotein that regulates the formation of excitatory synapses between neurons, important in autoimmunity, inflammatory processes and behaviors. This study aimed to investigate the SEMA 5A levels in patients with obsessive-compulsive disorder (OCD) diagnosed for the first time and evaluate the relationship of disease and disease severity with the blood SEMA 5A level and hemogram. METHODS More than 41,465 patients who applied to the psychiatry clinic from January 2018 to December 2020 were evaluated according to the DSM-5 criteria; 57 patients diagnosed with OCD for the first time, who met the inclusion criteria, were included in the study. Disease severity was investigated administering the Yale Brown Obsessive Compulsion Scale. The peripheral blood SEMA 5A level and hemogram were measured and evaluated in relation to platelet (PLT) activity, neutrophil-lymphocyte ratio (NLR), PLT-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), C-reactive protein (CRP), and compared with control group of 26 people. RESULTS The comparison of the groups revealed a significant difference in SEMA 5A and CRP level, neutrophil count and percentage, lymphocyte count, PLT activity. A significant correlation was found between disease and SEMA 5A level, NLR, PLR, and PLT parameters in diagnosis of OCD. As the severity of OCD increased, the SEMA 5A level and PLT count decreased, while the PDW and MLR values increased. CONCLUSION In patients with OCD, a relationship was found between plasma SEMA 5A, PLT activity, NLR, PLR, and MLR activity levels with disease and the disease severity.
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Affiliation(s)
- Kader Semra Karatas
- Psychiatry Department, Recep Tayyip Erdoğan University Medical School, Rize, Turkey
| | - Ilkay Bahceci
- Medical Microbiology and Clinical Microbiology Department, Recep Tayyip Erdoğan University Medical School, Rize, Turkey
| | - Tahsin Gokhan Telatar
- Public Health Department, Recep Tayyip Erdoğan University Medical School, Rize, Turkey
| | - Bulent Bahceci
- Psychiatry Department, Recep Tayyip Erdoğan University Medical School, Rize, Turkey
| | - Cicek Hocaoglu
- Psychiatry Department, Recep Tayyip Erdoğan University Medical School, Rize, Turkey
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Marazziti D, Torrigiani S, Carbone MG, Mucci F, Flamini W, Ivaldi T, Osso LD. Neutrophil/lymphocyte, platelet/lymphocyte and monocyte/lymphocyte ratios in mood disorders. Curr Med Chem 2021; 29:5758-5781. [PMID: 34551689 DOI: 10.2174/0929867328666210922160116] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/27/2021] [Accepted: 08/04/2021] [Indexed: 11/22/2022]
Abstract
Major depressive disorder (MDD) and bipolar disorders (BDs), the most severe types of mood disorders (MDs), are considered as among the most disabling illnesses worldwide. Several studies suggested that inflammatory neuroinflammation might be involved in the pathophysiology of MDs, while reporting increasing data on the relationships between these processes and classical neurotransmitters, hypothalamus-pituitary-adrenal axis (HPA), and neurotrophic factors. The assessment of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR) in peripheral blood represents a simple method to evaluate the inflammatory status. The aim of the present paper was to review the literature on the possible relationships between NLR, PLR and MLR in MDs, and to comment on their possible wider use in clinical research. Thirty-five studies were included in the present review. The majority of them higher values of these parameters, particularly NLR values, in patients with MDs, when compared to healthy subjects. The increase would appear more robust in patients with BD during a manic episode, thus indicating that it could be considered as both state and trait markers. In addition, increased NLR and PLR levels seem to represent prognostic elements for the early discovery of post-stroke depression. The findings of the present review would indicate the need to carry our further studies in this field. In particular, NLR, PLR and MLR seem to be promising tools to detect economically and easily the activation of the inflammatory system, and to perhaps evaluate the etiology and course of MDs. Again, they could suggest some information to better understand the relationship between inflammatory and cardiovascular disease and MDs, and thus, to provide clinical implications in terms of management and treatment.
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Affiliation(s)
- Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa. Italy
| | - Samuele Torrigiani
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa. Italy
| | - Manuel G Carbone
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, 21100 Varese. Italy
| | - Federico Mucci
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, 21100 Varese. Italy
| | - Walter Flamini
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa. Italy
| | - Tea Ivaldi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa. Italy
| | - Liliana Dell' Osso
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa. Italy
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Almış BH, Eğilmez OB. Platelet Parameters in First-Episode Patients with Schizophrenia and Bipolar Disorder. PSYCHIAT CLIN PSYCH 2021; 31:339-343. [PMID: 38765952 PMCID: PMC11082633 DOI: 10.5152/pcp.2021.21695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/24/2021] [Indexed: 05/22/2024] Open
Abstract
Background Measurement of platelet parameters, especially mean platelet volume (MPV), in mental disorders has been gaining importance. MPV is an indicator of platelet activity, and increased MPV is considered a risk factor for cardiovascular disease. Cardiovascular diseases and associated mortality are more common in patients with schizophrenia (SZ) and bipolar disorder (BD) than in the general population. We aimed to evaluate platelet parameters, including MPV, platelet count (PLT), platelet distribution volume (PDW), and plateletcrit (PCT) level, in first-episode patients with SZ and BD before disease progression and the effect of antipsychotic drugs caused changes in their lives. Methods In this retrospective cohort study, we compared the platelet parameters in 72 patients with SZ at the time of their first psychotic episode and 63 patients with BD at the time of their first manic episode with 64 healthy controls. Results SZ group had significantly lower MPV and PCT values than the control group (P = .003 and P = .03, respectively). BD group had significantly lower MPV and PCT values than the control group (P = .001 and P = .02, respectively). Conclusion This is the first study to compare the platelet parameters between first-episode patients with SZ and BD and healthy controls. Although a few studies have reported an increase or decrease in platelet parameters in SZ and BD, our results are valuable in terms of evaluating platelet parameters in first-episode patients who have not started drugs.
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Affiliation(s)
- Behice Han Almış
- Department of Psychiatry, Adıyaman University School of Medicine, Adıyaman, Turkey
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ÇALIŞKAN AM, ÇOKÜNLÜ Y. Evaluation of monocyte to high-density lipoprotein cholesterol ratio in the manic state of bipolar disorder. FAMILY PRACTICE AND PALLIATIVE CARE 2021. [DOI: 10.22391/fppc.875674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Dionisie V, Filip GA, Manea MC, Movileanu RC, Moisa E, Manea M, Riga S, Ciobanu AM. Neutrophil-to-Lymphocyte Ratio, a Novel Inflammatory Marker, as a Predictor of Bipolar Type in Depressed Patients: A Quest for Biological Markers. J Clin Med 2021; 10:1924. [PMID: 33946871 PMCID: PMC8125288 DOI: 10.3390/jcm10091924] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 12/27/2022] Open
Abstract
(1) Background: Recent research suggests inflammation as a factor involved in the pathophysiology of mood disorders. Neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte (PLR), and systemic immune-inflammatory (SII) index ratios have been studied as peripheral markers of inflammation in bipolar and major depressive disorders. The purpose of this study is to comparatively analyze these inflammatory ratios among manic episodes of bipolar disorder, bipolar depression and unipolar depression. (2) Methods: 182 patients were retrospectively included in the study and divided into three groups: 65 manic patients, 34 patients with bipolar depression, and 83 unipolar depressive patients. White blood cells, neutrophils, monocytes, lymphocytes, and platelets were retrieved from the patients' database. NLR, MLR, PLR, and SII index were calculated using these parameters. (3) Results: Patients with manic episodes had elevated NLR (p < 0.001), MLR (p < 0.01), PLR (p < 0.05), and SII index (p < 0.001) compared to unipolar depression and increased NLR (p < 0.05) and SII index (p < 0.05) when compared to bipolar depression. NLR (p < 0.01) and SII index (p < 0.05) were higher in the bipolar depression than unipolar depression. NLR is an independent predictor of the bipolar type of depression in depressive patients. (4) Conclusions: The results confirm the role of inflammation in the pathophysiology of mood disorders and suggest the ability of NLR as a marker for the differentiation of bipolar from unipolar depression.
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Affiliation(s)
- Vlad Dionisie
- Department of Psychiatry and Psychology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (R.C.M.); (A.M.C.)
| | - Gabriela Adriana Filip
- Department of Physiology, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania;
| | - Mihnea Costin Manea
- Department of Psychiatry and Psychology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (R.C.M.); (A.M.C.)
| | - Robert Constantin Movileanu
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (R.C.M.); (A.M.C.)
| | - Emanuel Moisa
- Department of Orthopaedics, Anaesthesia and Intensive Care Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- ‘Elias’ University Emergency Hospital, 011461 Bucharest, Romania
| | - Mirela Manea
- Department of Psychiatry and Psychology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (R.C.M.); (A.M.C.)
| | - Sorin Riga
- Department of Stress Research and Prophylaxis, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania;
- Romanian Academy of Medical Sciences, 927180 Bucharest, Romania
| | - Adela Magdalena Ciobanu
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (R.C.M.); (A.M.C.)
- Neuroscience Department, Discipline of Psychiatry, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Fusar-Poli L, Natale A, Amerio A, Cimpoesu P, Grimaldi Filioli P, Aguglia E, Amore M, Serafini G, Aguglia A. Neutrophil-to-Lymphocyte, Platelet-to-Lymphocyte and Monocyte-to-Lymphocyte Ratio in Bipolar Disorder. Brain Sci 2021; 11:brainsci11010058. [PMID: 33418881 PMCID: PMC7825034 DOI: 10.3390/brainsci11010058] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 02/07/2023] Open
Abstract
Background: Several inflammatory hypotheses have been suggested to explain the etiopathogenesis of bipolar disorder (BD) and its different phases. Neutrophil-to-lymphocyte (NLR), platelet-to-lymphocyte (PLR), and monocyte-to-lymphocyte (MLR) ratios have been proposed as potential peripheral biomarkers of mood episodes. Methods: We recruited 294 patients affected by BD, of which 143 were experiencing a (hypo)manic episode and 151 were in a depressive phase. A blood sample was drawn to perform a complete blood count. NLR, PLR, and MLR were subsequently calculated. A t-test was performed to evaluate differences in blood cell counts between depressed and (hypo)manic patients and a regression model was then computed. Results: Mean values of neutrophils, platelets, mean platelet volume, NLR, PLR, and MLR were significantly higher in (hypo)manic than depressed individuals. Logistic regression showed that PLR may represent an independent predictor of (hypo)mania. Conclusions: Altered inflammatory indexes, particularly PLR, may explain the onset and recurrence of (hypo)manic episodes in patients with BD. As inflammatory ratios represent economical and accessible markers of inflammation, further studies should be implemented to better elucidate their role as peripheral biomarkers of BD mood episodes.
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Affiliation(s)
- Laura Fusar-Poli
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (L.F.-P.); (A.N.); (E.A.)
| | - Antimo Natale
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (L.F.-P.); (A.N.); (E.A.)
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16126 Genoa, Italy; (A.A.); (P.C.); (P.G.F.); (M.A.); (G.S.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
- Department of Psychiatry, Tufts University, Boston, MA 02110, USA
| | - Patriciu Cimpoesu
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16126 Genoa, Italy; (A.A.); (P.C.); (P.G.F.); (M.A.); (G.S.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Pietro Grimaldi Filioli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16126 Genoa, Italy; (A.A.); (P.C.); (P.G.F.); (M.A.); (G.S.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Eugenio Aguglia
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (L.F.-P.); (A.N.); (E.A.)
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16126 Genoa, Italy; (A.A.); (P.C.); (P.G.F.); (M.A.); (G.S.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16126 Genoa, Italy; (A.A.); (P.C.); (P.G.F.); (M.A.); (G.S.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, Section of Psychiatry, University of Genoa, 16126 Genoa, Italy; (A.A.); (P.C.); (P.G.F.); (M.A.); (G.S.)
- IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy
- Correspondence:
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Ben Afia A, Aflouk Y, Saoud H, Zaafrane F, Gaha L, Bel Hadj Jrad B. Inteurleukin-8 gene variations and the susceptibility to schizophrenia. Psychiatry Res 2020; 293:113421. [PMID: 32920525 DOI: 10.1016/j.psychres.2020.113421] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/18/2020] [Accepted: 08/21/2020] [Indexed: 12/13/2022]
Abstract
The relevance of Interleukin-8 (IL-8) cytokine alteration in the peripheral and central system has been widely shown in psychosis while variation in the IL-8 gene remains largely unexplored and to the best of our knowledge, IL-8 polymorphisms have never been specifically targeted in Schizophrenia (Scz). Thus, we set out to search a potential correlation between rs4073, rs2227306 and rs1126647 polymorphisms in IL-8 gene and the development of Scz in a sample of the Tunisian population in a candidate gene approach. Targeted polymorphisms were analysed in 206 patients and 195 controls using PCR-RFLP method. Among all analysed polymorphisms, only rs1126647 showed a significant risk for Scz. After stratification analysis, we noted a significant association of TT genotype and T allele at rs1126647 with paranoid form, and more specifically with female sex. We find that the rare haplotypes at rs4073-rs2227306-rs1126647 of TTT, ACT and TCT, each containing the risk allele rs1126647T, were associated with increased risk for paranoid Scz while only the TCT combination constituted a risk factor for Scz more generally. Our findings support that IL-8 gene may be involved in susceptibility to Scz but this still preliminary and needs to be strengthened by further independent analyses.
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Affiliation(s)
- Amira Ben Afia
- Laboratory of Genetics, Biodiversity and Bioresource Valorization, Higher Institute of Biotechnology of Monastir, University of Monastir, Monastir 5000, street Taher Haddad, Monastir, Tunisia.
| | - Youssef Aflouk
- Laboratory of Genetics, Biodiversity and Bioresource Valorization, Higher Institute of Biotechnology of Monastir, University of Monastir, Monastir 5000, street Taher Haddad, Monastir, Tunisia
| | - Hana Saoud
- Laboratory of Genetics, Biodiversity and Bioresource Valorization, Higher Institute of Biotechnology of Monastir, University of Monastir, Monastir 5000, street Taher Haddad, Monastir, Tunisia
| | - Farid Zaafrane
- Department of Psychiatry and Vulnerability to Psychoses Laboratory-CHU Monastir, Tunisia
| | - Lotfi Gaha
- Department of Psychiatry and Vulnerability to Psychoses Laboratory-CHU Monastir, Tunisia
| | - Besma Bel Hadj Jrad
- Laboratory of Genetics, Biodiversity and Bioresource Valorization, Higher Institute of Biotechnology of Monastir, University of Monastir, Monastir 5000, street Taher Haddad, Monastir, Tunisia
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13
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Mazza MG, Lucchi S, Rossetti A, Clerici M. Neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio and platelet-lymphocyte ratio in non-affective psychosis: A meta-analysis and systematic review. World J Biol Psychiatry 2020; 21:326-338. [PMID: 30806142 DOI: 10.1080/15622975.2019.1583371] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Objectives: Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR) are inexpensive and reproducible biomarkers of inflammation. This is the first meta-analysis exploring the role of NLR, MLR and PLR in non-affective psychosis.Methods: Eight studies have been identified from the main electronic databases. Meta-analyses based on random-effects models have been carried out generating pooled standardised mean differences (SMDs) between non-affective psychotic patients and healthy controls (HCs).Results: Subjects with non-affective psychosis had a significant higher NLR and MLR as compared with HC (respectively SMD = 0.715; P < 0.001; I2=57.565% and SMD = 0.417; P = 0.001; I2=65.754%), confirmed by heterogeneity-based sensitivity analysis. Subgroup analyses showed no differences in effect size across different study characteristics, including drug treatment status, diagnosis, and setting. Meta-regression showed that age influenced the relationship between non-affective psychosis and MLR. A trend of significance, not confirmed by heterogeneity-based sensitivity analysis, was observed in PLR with patients showing higher PLR than HC.Conclusions: Our meta-analysis supports the hypothesis that an inflammatory activation occurs in non-affective psychosis and inflammatory ratios, especially NLR and MLR, may be useful to detect this activation.
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Affiliation(s)
- Mario Gennaro Mazza
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Sara Lucchi
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Aurora Rossetti
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, Italy
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Soder HE, Berumen AM, Gomez KE, Green CE, Suchting R, Wardle MC, Vincent J, Teixeira AL, Schmitz JM, Lane SD. Elevated Neutrophil to Lymphocyte Ratio in Older Adults with Cocaine Use Disorder as a Marker of Chronic Inflammation. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2020; 18:32-40. [PMID: 31958903 PMCID: PMC7006975 DOI: 10.9758/cpn.2020.18.1.32] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 01/23/2023]
Abstract
Objective The neutrophil to lymphocyte ratio (NLR) is a non-specific, easy-to-obtain marker of inflammation associated with morbidity and mortality in systemic, psychiatric, and age-related inflammatory conditions. Given the growing trend of substance use disorder (SUD) in older adults, and the relationship between inflammation and SUD elevated NLR may serve as a useful inflammatory biomarker of the combined burden of aging and SUD. The present study focused on cocaine use disorder (CUD) to examine if cocaine adds further inflammatory burden among older adults, by comparing NLR values between older adults with CUD and a non-cocaine using, aged-matched, nationally representative sample. Methods The dataset included 107 (86% male) participants (aged 50-65 years) with cocaine use disorder. NLR was derived from complete blood count tests by dividing the absolute value of peripheral neutrophil concentration by lymphocyte concentration. For comparison, we extracted data from age-matched adults without CUD using the National Health and Nutrition Examination Survey. Individuals with immunocompromising conditions were excluded (e.g., rheumatoid arthritis and sexually transmitted infections such as HIV). A doubly-robust inverse probability-weighted regression adjustment (IPWRA) propensity score method was used to estimate group differences on NLR while controlling for potential confounding variables (age, gender, race, income, nicotine, marijuana and alcohol use). Results The IPWRA model revealed that the CUD sample had significantly elevated NLR in comparison to non-cocaine users, with a moderate effect size (β weight = 0.67). Conclusion Although non-specific, NLR represents a readily obtainable inflammatory marker for SUD research. CUD may add further inflammatory burden to aging cocaine users.
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Affiliation(s)
- Heather E Soder
- Faillace Department of Psychiatry and Behavioral Sciences, TX, USA
| | - Amber M Berumen
- Faillace Department of Psychiatry and Behavioral Sciences, TX, USA
| | - Kira E Gomez
- Faillace Department of Psychiatry and Behavioral Sciences, TX, USA
| | - Charles E Green
- Faillace Department of Psychiatry and Behavioral Sciences, TX, USA.,epartment of Pediatrics, University of Texas Health Science Center at Houston, Houston,TX, USA
| | - Robert Suchting
- Faillace Department of Psychiatry and Behavioral Sciences, TX, USA
| | - Margaret C Wardle
- Faillace Department of Psychiatry and Behavioral Sciences, TX, USA.,Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Jessica Vincent
- Faillace Department of Psychiatry and Behavioral Sciences, TX, USA
| | | | - Joy M Schmitz
- Faillace Department of Psychiatry and Behavioral Sciences, TX, USA
| | - Scott D Lane
- Faillace Department of Psychiatry and Behavioral Sciences, TX, USA
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15
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Hu J, Zhou W, Zhou Z, Han J, Dong W. Elevated neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios predict post-stroke depression with acute ischemic stroke. Exp Ther Med 2020; 19:2497-2504. [PMID: 32256727 PMCID: PMC7086204 DOI: 10.3892/etm.2020.8514] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 12/19/2019] [Indexed: 02/06/2023] Open
Abstract
Post-stroke depression (PSD) is the most prevalent psychiatric complication of acute ischemic stroke. The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) are indicators of inflammation and are associated with stroke and depression. Therefore, the purpose of the present study was to examine the relationship between NLR/PLR and PSD. Retrospective analysis was carried out in 376 patients with first-ever acute ischemic stroke in the First Affiliated Yijishan Hospital of Wannan Medical College between March 2015 and September 2017. Patients were divided into PSD (n=104; 27.7%) and non-PSD (n=272; 72.3%) groups according to the Diagnostic and Statistical Manual of Mental Disorders-IV criteria at 6 months after stroke. Clinical data were collected retrospectively. NLR and PLR were acquired retrospectively from the routine blood tests performed at admission. A total of 120 healthy volunteers from the physical examination center in the First Affiliated Yijishan Hospital of Wannan Medical College were recruited as controls. Using logistic regression analysis, NLR (≥4.02) and PLR (≥203.74) were independently associated with PSD. NLR, odds ratio (OR) 3.926, 95% confidence intervals (CI, 2.365-7.947), P<0.001; PLR, OR 3.853, 95% CI (2.214-6.632), P=0.002. The ability of the combined index [area under the receiver operating characteristic curve, 0.701; 95% CI (0.622-0.780); P<0.001] to diagnose PSD was greater than that of either ratio alone. Higher NLRs and PLRs (≥4th quartile) were associated with PSD with a 5.79-fold (P<0.001) increase compared with lower levels of both. Higher NLRs and PLRs were found to be associated with depression 6 months after stroke, and the combined index was more meaningful than either alone in the early clinical detection of PSD.
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Affiliation(s)
- Jia Hu
- Department of Neurology, The First Affiliated Hospital, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, P.R. China.,Department of Neurology, The First Affiliated Hospital of Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China
| | - Wei Zhou
- Department of Cardiovascular Surgery, The First Affiliated Hospital, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, P.R. China
| | - Zhiming Zhou
- Department of Neurology, The First Affiliated Hospital, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, P.R. China
| | - Jian Han
- Department of Imaging Center, The First Affiliated Hospital, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, P.R. China
| | - Wanli Dong
- Department of Neurology, The First Affiliated Hospital of Medical College of Soochow University, Suzhou, Jiangsu 215123, P.R. China
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Inanli I, Aydin M, Çaliskan AM, Eren I. Neutrophil/lymphocyte ratio, monocyte/lymphocyte ratio, and mean platelet volume as systemic inflammatory markers in different states of bipolar disorder. Nord J Psychiatry 2019; 73:372-379. [PMID: 31304832 DOI: 10.1080/08039488.2019.1640789] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Currently, increasing evidence supports the hypothesis that alterations in the immune-inflammatory system are critical for the pathophysiology of bipolar disorder (BD). Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), and mean platelet volume (MPV) have recently been investigated as inexpensive and simple inflammatory markers. Aims: The aim of this study is to compare NLR, PLR, MLR, and MPV in depressive, manic, and euthymic patients with BD and healthy controls, and to evaluate whether values of NLR, PLR, MLR, and MPV are possible state or trait biomarkers in BD. Methods: This retrospective study was conducted with 341 patients with BD (100 patients in a depressive state, 141 patients in a manic state, and 100 patients in a euthymic state) and 114 healthy controls. Results: We found that patients with BD in manic states had higher levels of MPV, NLR, and MLR, and patients with BD in depressive states had higher levels of MPV than the controls. Moreover, MPV predicted all states of BD, while NLR and MLR predicted the manic state of BD. Conclusions: NLR, MLR, and MPV obtained from simple and inexpensive blood tests were significantly higher in patients with BD than in healthy controls, which each imply low-grade inflammation. MPV may serve as a possible trait biomarker of BD, while NLR and MLR may both serve as possible state biomarkers of the manic state.
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Affiliation(s)
- Ikbal Inanli
- a Clinic of Psychiatry, University of Health Sciences, Konya Research and Training Hospital , Konya , Turkey
| | - Memduha Aydin
- b Faculty of Medicine, Clinic of Psychiatry, Selcuk University , Konya , Turkey
| | - Ali Metehan Çaliskan
- a Clinic of Psychiatry, University of Health Sciences, Konya Research and Training Hospital , Konya , Turkey
| | - Ibrahim Eren
- a Clinic of Psychiatry, University of Health Sciences, Konya Research and Training Hospital , Konya , Turkey
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17
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Bahrami A, Khorasanchi Z, Sadeghnia HR, Tayefi M, Avan A, Ferns GA, Bahrami-Taghanaki H, Ghayour-Mobarhan M. Depression in adolescent girls: Relationship to serum vitamins a and E, immune response to heat shock protein 27 and systemic inflammation. J Affect Disord 2019; 252:68-73. [PMID: 30981058 DOI: 10.1016/j.jad.2019.04.048] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 01/09/2019] [Accepted: 04/08/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND The inflammation and oxidative stress are thought to play an important role in the etiopathogenesis of some psychological disorders. We aimed to assess the potential relationships between serum fat soluble vitamins (Vitamins A and E), antibody titers to Hsp27 (anti-Hsp27) and hematological markers of inflammation, with mood disorders in a population of adolescent girls. METHODS A total of 563 adolescent girls (Age 12-18 years) were included in the study. The presence and severity of depression, insomnia and sleepiness were assessed using validated questionnaires. Serum vitamins A and E, anti-Hsp27 antibody titers, white blood cell, lymphocyte, neutrophil, platelet counts, and red blood cell distribution width (RDW), were also measured. Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and RDW to platelet ratio (RPR) were calculated. RESULTS Serum anti-HSP27 antibody titers, PLR, and RPR values was significantly higher in subjects with a high depression score compared to normal individuals (p < 0.05). However, there was no association between serum inflammatory markers concentrations and sleep disorders; although individuals with insomnia had a lower vitamin E/HDL ratio compared to healthy adolescents. In multivariate logistic regression analyses adjusted for potential confounders, anti-HSP was an independent predictor of severe depression (OR = 5.0, 95% CI: 1.6-15.7, p < 0.05). LIMITATION The cross-sectional design of study and the inclusion of only female adolescents participants are limitations. CONCLUSION Our findings suggest that serum anti-HSP27 antibody titers may be useful biological marker in depressive patients. This finding may support a role of oxidative stress in the etiology of depression, and targeting this pathway may be of value in the treatment of depression.
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Affiliation(s)
- Afsane Bahrami
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Zahra Khorasanchi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamid Reza Sadeghnia
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Tayefi
- Clinical Research Unit, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Avan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, UK
| | - Hamidreza Bahrami-Taghanaki
- Complementary and Chinese Medicine, Persian and Complementary Medicine Faculty, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Majid Ghayour-Mobarhan
- Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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Mazza MG, Tringali AGM, Rossetti A, Botti RE, Clerici M. Cross-sectional study of neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratios in mood disorders. Gen Hosp Psychiatry 2019; 58:7-12. [PMID: 30818102 DOI: 10.1016/j.genhosppsych.2019.02.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 02/04/2019] [Accepted: 02/07/2019] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Neutrophil-lymphocyte, monocyte-lymphocyte and platelet-lymphocyte ratio are inexpensive and reproducible biomarkers of inflammation found to be elevated in mood disorders. This study aimed to compare inflammatory ratios between bipolar disorder and major depressive disorder and between bipolar disorder manic episodes and bipolar disorder depressive episodes. METHOD We included 142 Caucasian patients (major depressive disorder: n = 36; bipolar disorder manic episode: n = 66; bipolar disorder depressive episode: n = 40). We measured white blood cells, neutrophils, lymphocytes, monocytes, platelets, glucose, and total cholesterol. Neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio, and platelet-lymphocyte ratio were calculated. RESULTS Neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio were significantly higher in bipolar disorder manic episodes when compared to bipolar disorder depressive episodes and major depressive disorder episodes after adjustment for age, sex, body mass index, and smoking. CONCLUSION To our knowledge, our study is the first one to compare inflammatory ratios between different bipolar disorder phases and major depressive disorder episodes. In accord with previous studies on other inflammatory mediators, we found higher neutrophil-lymphocyte and monocyte-lymphocyte ratios in bipolar manic episodes, suggesting that inflammatory changes occur especially during acute episodes of mania.
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Affiliation(s)
- Mario Gennaro Mazza
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy.
| | | | - Aurora Rossetti
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy
| | | | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy
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ÖZTÜRK AHMET, ŞAHAN EBRU, MIRÇIK ALIBARLAS, DEVECI ERDEM, YILMAZ ONUR, KIRPINAR İSMET. Mean platelet volume and neutrophil to lymphocyte ratio decrease in patients with depression with antidepressant treatment. ARCH CLIN PSYCHIAT 2019. [DOI: 10.1590/0101-60830000000184] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Chen H, Luan X, Zhao K, Qiu H, Liu Y, Tu X, Tang W, He J. The association between neutrophil-to-lymphocyte ratio and post-stroke depression. Clin Chim Acta 2018; 486:298-302. [PMID: 30130533 DOI: 10.1016/j.cca.2018.08.026] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 07/12/2018] [Accepted: 08/14/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Post-stroke depression (PSD) is the most common complication occurring among stroke survivors. It has been shown that increased neutrophil-to-lymphocyte ratio (NLR) is associated with depression. We explored the relationship between NLR and PSD. METHODS In total, 299 ischemic stroke patients were consecutively enrolled in the study and received 1 month follow-up. The 17-Hamilton Rating Scale was used to measure depressive symptoms at 1 month after stroke. With the Hamilton Depression Scale score of >7, parents were given the DSM-IV criteria for diagnosis of PSD. NLR was computered from the admission blood work. Meanwhile, the control group consisted of 180 healthy volunteers was also recruited. RESULTS Seventy-eight patients (26.1%) were diagnosed with PSD at 1 month. PSD patients showed significantly higher levels of NLRs at admission as compared to non-PSD patients as well as normal controls (P < .001). In the logistic analysis, taking NLR values (<3.701) a reference and PSD presence as a dependent variable, NLR values (≥3.70 l) were independently associated with the development of PSD (OR 4.038, 95% CI 2.174-7.500, p < .001). CONCLUSIONS Increased NLRs at admission are found to be correlated with PSD and may add prognostic information for the early discovery of PSD.
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Affiliation(s)
- Huijun Chen
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Xiaoqian Luan
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Kai Zhao
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China; First School of Clinical Medicine, Wenzhou Medical University, Wenzhou 325000, China
| | - Huihua Qiu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Yuntao Liu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Xinjie Tu
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Wenjie Tang
- First School of Clinical Medicine, Wenzhou Medical University, Wenzhou 325000, China.
| | - Jincai He
- Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
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Yüksel RN, Ertek IE, Dikmen AU, Göka E. High neutrophil-lymphocyte ratio in schizophrenia independent of infectious and metabolic parameters. Nord J Psychiatry 2018; 72:336-340. [PMID: 29644919 DOI: 10.1080/08039488.2018.1458899] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Immunological and inflammatory mechanisms play an important role in schizophrenia. In the literature, there are studies investigating neutrophil-lymphocyte ratio (NLR) association with schizophrenia. AIMS The purpose of this study was to compare NLR values between patients with schizophrenia and healthy controls. In addition, the study aimed to investigate the relationship between NLR and disease severity and some metabolic/inflammatory parameters. METHODS Fifty-two patients diagnosed with schzophrenia and 53 healthy controls were included in the study. A socio-demographic information form was filled out by the clinician. Height, body weight, waist and hip circumference and blood pressure values of each patient were measured. Severity of disease was assessed by positive and negative syndrome scale (PANSS) and clinical global impression-severity scale (CGI-S). Complete blood count was performed to both patient and control groups. Fasting blood glucose, insulin, HbA1c, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride, total cholesterol and C-reactive protein (CRP) were measured. RESULTS The number of leukocytes, neutrophils, monocytes and NLR values in patients with schizophrenia was significantly higher than in the control group. There was no significant relationship between NLR values and the number of hospitalisation, duration of ilness or disease severity in patients. There was no correlation between other laboratory findings and NLR values. CONCLUSION NLR levels are high in schizophrenia independent of metabolic parameters according to the results. So, it can be considered that inflammatory processes may play a role in the etiology of the disease.
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Affiliation(s)
- Rabia Nazik Yüksel
- a Department of Psychiatry , Numune Education and Research Hospital , Ankara , Turkey
| | - Irem Ekmekci Ertek
- b Department of Psychiatry , Gazi University Medical Faculty , Ankara , Turkey
| | - Asiye Uğraş Dikmen
- b Department of Psychiatry , Gazi University Medical Faculty , Ankara , Turkey
| | - Erol Göka
- a Department of Psychiatry , Numune Education and Research Hospital , Ankara , Turkey
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Mazza MG, Lucchi S, Tringali AGM, Rossetti A, Botti ER, Clerici M. Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in mood disorders: A meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2018. [PMID: 29535038 DOI: 10.1016/j.pnpbp.2018.03.012] [Citation(s) in RCA: 150] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The immune and inflammatory system is involved in the etiology of mood disorders. Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) and monocyte/lymphocyte ratio (MLR) are inexpensive and reproducible biomarkers of inflammation. This is the first meta-analysis exploring the role of NLR and PLR in mood disorder. We identified 11 studies according to our inclusion criteria from the main Electronic Databases. Meta-analyses were carried out generating pooled standardized mean differences (SMDs) between index and healthy controls (HC). Heterogeneity was estimated. Relevant sensitivity and meta-regression analyses were conducted. Subjects with bipolar disorder (BD) had higher NLR and PLR as compared with HC (respectively SMD = 0.672; p < 0.001; I2 = 82.4% and SMD = 0.425; p = 0.048; I2 = 86.53%). Heterogeneity-based sensitivity analyses confirmed these findings. Subgroup analysis evidenced an influence of bipolar phase on the overall estimate whit studies including subjects in manic and any bipolar phase showing a significantly higher NLR and PLR as compared with HC whereas the effect was not significant among studies including only euthymic bipolar subjects. Meta-regression showed that age and sex influenced the relationship between BD and NLR but not the relationship between BD and PLR. Meta-analysis was not carried out for MLR because our search identified only one study when comparing BD to HC, and only one study when comparing MDD to HC. Subjects with major depressive disorder (MDD) had higher NLR as compared with HC (SMD = 0.670; p = 0.028; I2 = 89.931%). Heterogeneity-based sensitivity analyses and meta-regression confirmed these findings. Our meta-analysis supports the hypothesis that an inflammatory activation occurs in mood disorders and NLR and PLR may be useful to detect this activation. More researches including comparison of NLR, PLR and MLR between different bipolar phases and between BD and MDD are needed.
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Affiliation(s)
- Mario Gennaro Mazza
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy.
| | - Sara Lucchi
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy
| | | | - Aurora Rossetti
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy
| | - Eugenia Rossana Botti
- Servizio Psichiatrico di Diagnosi e Cura, Ospedale di Desio, Azienda Socio Sanitaria Territoriale di Monza, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano Bicocca, Monza, MB, Italy
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Munkholm K, Jacoby AS, Lenskjold T, Bruunsgaard H, Vinberg M, Kessing LV. Leukocytes in peripheral blood in patients with bipolar disorder - Trait and state alterations and association with levels of cytokines and C-reactive protein. Psychiatry Res 2018; 261:383-390. [PMID: 29353768 DOI: 10.1016/j.psychres.2018.01.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 12/20/2017] [Accepted: 01/09/2018] [Indexed: 12/13/2022]
Abstract
Low-grade inflammation has been found in patients with bipolar disorder (BD), but rarely assessed using leukocyte counts and findings are limited by lack of control for confounding factors. As a result, it is unclear whether BD per se is associated with peripheral inflammation. We pooled populations from two studies using similar longitudinal designs, including 300 blood samples from a total of 97 patients with BD and 133 blood samples from a total of 72 healthy control individuals (HC). Total leukocyte and neutrophil counts were measured together with interleukin (IL) - 6, IL-8, IL-18, tumor necrosis factor (TNF) - α and high sensitivity C-reactive protein (hsCRP). Adjusted for confounders, leukocyte counts were 23% higher and neutrophil counts were 30% higher in patients with BD compared with HC. There were no state-related differences in leukocyte or neutrophil counts. Lithium use, cigarette smoking as well as levels of IL-6, TNF-α and hsCRP were positively associated with leukocyte and neutrophil counts. Due to confounding issues it cannot be concluded that differences were related to bipolar disorder per se. Future studies are recommended to include leukocytes as markers of low-grade inflammation and to include relevant confounders in statistical analyses.
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Affiliation(s)
- Klaus Munkholm
- Psychiatric Center Copenhagen, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
| | - Anne Sophie Jacoby
- Psychiatric Center Copenhagen, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Helle Bruunsgaard
- Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Maj Vinberg
- Psychiatric Center Copenhagen, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lars Vedel Kessing
- Psychiatric Center Copenhagen, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Shi X, Li WC, Mo LJ, Li XH, Luo YZ, Qin LQ, Yang Z, Mo WN. Altered mean platelet volume in children with Henoch-Schonlein purpura and its association with disease activity. Ann Clin Biochem 2017; 55:368-372. [PMID: 28774183 DOI: 10.1177/0004563217727015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background Henoch-Schonlein purpura is a systemic small-vessel vasculitis that occurs mainly in children. A review of the literature has suggested a correlation between mean platelet volume and several inflammatory disorders. However, to the best of our knowledge, any potential correlation between mean platelet volume and Henoch-Schonlein purpura has not been reported in the literature. Therefore, our study aimed to evaluate the role of mean platelet volume concentrations in patients with Henoch-Schonlein purpura. Methods This study included 97 children with Henoch-Schonlein purpura and 120 healthy individuals as controls. Results Mean platelet volume concentrations were found to be significantly lower in Henoch-Schonlein purpura patients compared with healthy controls (8.1 ± 0.86 vs. 9.4 ± 0.81, P < 0.001). Similarly, significant negative correlations were observed between mean platelet volume and neutrophil count, platelet count and erythrocyte sedimentation rate in patients with Henoch-Schonlein purpura (r=−0.327, P = 0.001; r=−0.419, P < 0.001; r=−0.255, P = 0.012). Interestingly, mean platelet volume was significantly lower in the acute phase compared with the convalescent phase of Henoch-Schonlein purpura patients (7.8 ± 0.86 vs. 8.3 ± 0.77, P = 0.002). A cut-off value for mean platelet volume was 7.85 with area under the curve of 0.726 to identify acute phase vs. convalescent phase in patients with Henoch-Schonlein purpura. Mean platelet volume was independently associated with Henoch-Schonlein purpura in logistic regression analysis (odds ratio = 0.114, 95% confidence interval = 0.053–0.243, P < 0.001). Conclusions Our results suggest that mean platelet volume is inversely associated with disease in patients with Henoch-Schonlein purpura, and mean platelet volume may be a useful marker to identify active disease in Henoch-Schonlein purpura patients.
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Affiliation(s)
- Xiang Shi
- Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Wen-Chao Li
- Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Li-Jun Mo
- Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Xiao-Hong Li
- Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Yu-Zhen Luo
- Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Liu-Qun Qin
- Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Zheng Yang
- Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Wu-Ning Mo
- Department of Clinical Laboratory, the First Affiliated Hospital of Guangxi Medical University, Guangxi, China
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