Effect of Antipsychotic Treatment on Neutrophil-to-Lymphocyte Ratio during Hospitalization for Acute Psychosis in the Course of Schizophrenia—A Cross-Sectional Retrospective Study

Dawidowski, Bartosz; Grelecki, Grzegorz; Biłgorajski, Adam; Podwalski, Piotr; Misiak, Błażej; Samochowiec, Jerzy

doi:10.3390/jcm11010232

Cited by 14 publications

(11 citation statements)

References 40 publications

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“…Additionally, there was a negative correlation between chlorpromazine equivalent doses and baseline positive symptoms (r=-0.256, P = 0.033). However, chlorpromazine equivalent doses did not correlate with systemic in ammatory biomarkers in our study (all P > 0.05), which is inconsistent with previous studies showing that antipsychotics may reduce NLR results 39,40 . Although a large retrospective study revealed a negative relationship between NLR and BPRS negative symptom scores in the antipsychotic treatment group 34 , We did not nd any systemic in ammatory biomarkers associated with negative symptoms, suggesting elevated NLR may not necessarily correlated with the severity of the illness.…”

Section: Discussioncontrasting

confidence: 99%

Altered concentrations of systemic inflammatory biomarkers after electroconvulsive therapy in schizophrenia and their relationship with treatment

Wang

Gong

et al. 2023

Preprint

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Background and hypothesis: Platelet count (PLT), neutrophils, lymphocytes, monocytes and three important ratios calculated from them: NLR, PLR and MLR are inexpensive and accessible biomarkers of systemic inflammation. Electroconvulsive therapy (ECT) is a rapid and effective physical therapy for schizophrenia, but the exploration of its therapeutic mechanisms is still in the early stages. Here we hypothesized the concentrations of systemic inflammatory biomarkers are higher in schizophrenia and decreased after electroconvulsive therapy. Elevated systemic inflammatory biomarkers were associated with less improvement in psychiatric symptoms and cognitive function after ECT. Study design: This study included 70 patients with schizophrenia (all patients have been treated with antipsychotic medication for a fortnight before ECT) as well as age- and sex-matched 70 healthy controls. We compared the differences of systemic inflammatory biomarkers between schizophrenia and healthy controls, and then determined the changes of systemic inflammatory biomarkers in schizophrenia before and after 6 times of electroconvulsive therapy. Positive and negative symptom scale (PANSS) were used to measure psychiatric symptom of patients with schizophrenia, and Mini-Mental State Examination (MMSE) were used to measure the cognitive function. Spearman correlation analysis was used to assess the relationship between systemic inflammatory biomarkers and clinical symptoms. Results: At baseline, peripheral blood PLT, neutrophils, monocytes and three important ratios: NLR, PLR and MLR were significantly higher in patients with schizophrenia than in healthy controls (all P<0.05), while lymphocytes did not differ between the two groups. After 6 ECT, neutrophils and NLR significantly decreased, and there was a downward trend in monocytes and MLR. Although PLR and lymphocytes were unchanged after ECT, lymphocytes were significantly higher in remitters than in the non-remitters, and PLR was significantly lower than in the non-remitters. Moreover, the higher the baseline NLR, PLR and MLR, the less improvement in positive symptoms after ECT; and the higher the baseline monocytes, the worse the cognitive function after ECT. Lymphocytes as a protective factor, although unchanged before and after ECT, were negatively associated with total PANSS score, positive symptom score and positively associated with reduction rate of PANSS after ECT. Conclusions: Our results further emphasize the presence of systemic inflammation in schizophrenia and that electroconvulsive therapy may exert a therapeutic effect in part by attenuating systemic inflammation in schizophrenia. Thus, further studies may lead to new treatment strategies for schizophrenia targeting immune system.

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Section: Discussioncontrasting

confidence: 99%

Altered concentrations of systemic inflammatory biomarkers after electroconvulsive therapy in schizophrenia and their relationship with treatment

Wang

Gong

et al. 2023

Preprint

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“…Similarly, NLR has been proposed as a biomarker for schizophrenia and even for other neurodegenerative diseases ( 23 ). This is also ratified by this study since the age of symptom onset correlated positively and significantly with NLR, data already reported by other authors, which has been interpreted as indicative of a chronic inflammatory state both in schizophrenia and in bipolar disorder, so it could potentially be used as an indicator of the evolution of psychosis symptoms ( 24 , 25 ).…”

Section: Discussionsupporting

confidence: 90%

Mean platelet volume, platelet count, and neutrophil/lymphocyte ratio in drug-naïve patients with schizophrenia: a cross-sectional study

Cabello-Rangel,

Basurto-Morales,

Botello-Aceves

et al. 2023

Front. Psychiatry

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IntroductionMean platelet volume (MPV), platelet count, and neutrophil/lymphocyte ratio (NLR) have been proposed to be biomarkers of the chronic inflammatory process in schizophrenia and indicative of increased cardiovascular risk.ObjectiveTo describe MPV, total platelet count (PLT), and NLR between healthy controls and patients with schizophrenia to determine the correlation between these parameters and the duration of untreated psychosis (DUP).MethodsIn a retrospective cross-sectional study, we included 175 patients with schizophrenia who had never received psychiatric treatment, and who had undergone blood biometry and blood chemistry within 24 h of admission. Laboratory studies were determined by the impedance method on Coulter ac-T 5 diff hematological equipment.ResultsMean platelet volume levels in patients with schizophrenia were higher than in healthy controls but not statistically significant. The receiver operating characteristic curve for this parameter shows that the optimal cutoff point of agreement was 8.95 fL, with sensitivity and specificity for schizophrenia of 52% and 67%, respectively, and the area under the curve (AUC) was 0.580 (p = 0.079). DUP had no significant correlation with the blood parameters analyzed.ConclusionThe results partially support the hypothesis that MPV, platelet count, and NLR is related to schizophrenia, and further research is needed to establish whether there is an underlying chronic inflammatory process.

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“…Recently, a retrospective analysis revealed elevated peripheral and/or cerebrospinal fluid IL-6 levels in schizophrenic patients [ 112 ]; however, there are also reports of reduced production of this cytokine [ 8 ]. Simultaneously, other research does not find a strict positive correlation between the severity of positive symptoms, cognitive deficits and enhanced levels of proinflammatory cytokines, such as IL-6, IL-1β and TNF-α [ 113 , 114 , 115 ].…”

Section: Discussionmentioning

confidence: 99%

Quetiapine Ameliorates MIA-Induced Impairment of Sensorimotor Gating: Focus on Neuron-Microglia Communication and the Inflammatory Response in the Frontal Cortex of Adult Offspring of Wistar Rats

Chamera

Curzytek

Kamińska

et al. 2022

Cells

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The maternal immune activation produced by the systemic administration of lipopolysaccharide (LPS) in rats provides valuable insights into the basis of behavioural schizophrenia-like disturbances and biochemical changes in the brains of the offspring, such as microglial activation. Regarding therapy, antipsychotics continually constitute the cornerstone of schizophrenia treatment. To their various efficacy and side effects, as well as not fully recognised mechanisms of action, further characteristics have been suggested, including an anti-inflammatory action via the impact on neuron–microglia axes responsible for inhibition of microglial activation. Therefore, in the present study, we sought to determine whether chronic treatment with chlorpromazine, quetiapine or aripiprazole could influence schizophrenia-like behavioural disturbances at the level of sensorimotor gating in male offspring prenatally exposed to LPS. Simultaneously, we wanted to explore if the chosen antipsychotics display a positive impact on the neuroimmunological parameters in the brains of these adult animals with a special focus on the ligand-receptor axes controlling neuron–microglia communication as well as pro- and anti-inflammatory factors related to the microglial activity. The results of our research revealed the beneficial effect of quetiapine on deficits in sensorimotor gating observed in prenatally LPS-exposed offspring. In terms of axes controlling neuron–microglia communication and markers of microglial reactivity, we observed a subtle impact of quetiapine on hippocampal Cx3cl1 and Cx3cr1 levels, as well as cortical Cd68 expression. Hence, further research is required to fully define and explain the involvement of quetiapine and other antipsychotics in Cx3cl1-Cx3cr1 and/or Cd200-Cd200r axes modulation and inflammatory processes in the LPS-based model of schizophrenia-like disturbances.

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Effect of Antipsychotic Treatment on Neutrophil-to-Lymphocyte Ratio during Hospitalization for Acute Psychosis in the Course of Schizophrenia—A Cross-Sectional Retrospective Study

Cited by 14 publications

References 40 publications

Altered concentrations of systemic inflammatory biomarkers after electroconvulsive therapy in schizophrenia and their relationship with treatment

Altered concentrations of systemic inflammatory biomarkers after electroconvulsive therapy in schizophrenia and their relationship with treatment

Mean platelet volume, platelet count, and neutrophil/lymphocyte ratio in drug-naïve patients with schizophrenia: a cross-sectional study

Quetiapine Ameliorates MIA-Induced Impairment of Sensorimotor Gating: Focus on Neuron-Microglia Communication and the Inflammatory Response in the Frontal Cortex of Adult Offspring of Wistar Rats

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