Neutrophil-to-Lymphocyte, Monocyte-to-Lymphocyte, Platelet-to-Lymphocyte Ratio and Systemic Immune-Inflammatory Index in Different States of Bipolar Disorder

Dadouli, Katerina; Janho, Michel B.; Hatziefthimiou, Apostolia; Voulgaridi, Ioanna; Piaha, Konstantina; Anagnostopoulos, Lemonia; Ntellas, Panagiotis; Mouchtouri, Varvara A.; Bonotis, Konstantinos; Christodoulou, Nikos; Speletas, Matthaios; Hadjichristodoulou, Christos

doi:10.3390/brainsci12081034

Cited by 29 publications

(34 citation statements)

References 50 publications

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“…Finally, the secondary results of our study indicated decreasing PLR with age, and higher MLR in men compared to women. These sex-related results are in agreement with a study by Moosazadeh et al that showed similar sex differences in MLR [ 57 ], but were not found elsewhere [ 56 ]. On the other hand, the PLR decreased with age, which is not consistent with previously reported results [ 57 ].…”

Section: Discussionsupporting

confidence: 93%

“…On the other hand, our study was one of the few comparing both manic and depressive BD episodes to MDD, and also investigating the effects of type and duration of hospitalization, current psychotic, or suicidal features and psychiatric history on immune cell ratios. In addition, our sample size was comparable with several prior studies in the field [ 47 , 48 , 50 , 56 ].…”

Section: Discussionsupporting

confidence: 71%

“…For example, Inanli et al reported higher NLR and MLR in manic state compared to depressive state in BD patients, while depressed patients showed higher ratios compared to healthy controls [ 53 ]. Furthermore, Fusar-Poli et al found higher immune ratios in mania compared to depression in individuals with BD [ 52 ], while Dadouli et al reported higher immune ratios in patients with BD than in controls when experiencing a depressive or manic episode, while MLR was higher only in BD patients with a manic episode [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

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Immune Cell Ratios Are Higher in Bipolar Affective than Unipolar Depressive Disorder and Modulated by Mood Episode: A Retrospective, Cross-Sectional Study

et al. 2023

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Immune dysregulation is implicated in the pathophysiology of both bipolar and major depressive disorder, while immune cell ratios (IRCs) have recently been proposed as clinically applicable immune biomarkers. We investigated IRCs differences in affective disorders and their association with current mood episodes and clinical features. This retrospective cohort study analyzed neutrophil–lymphocyte (NLR), monocyte–lymphocyte (MLR), and platelet–lymphocyte (PLR) ratios upon admission in 135 affective disorder in-patients with mania (MA, n = 36), bipolar depression (BiD, n = 38), and unipolar depression (MDD, n = 61). Demographic, clinical, and immune data were extracted from medical records. Monocyte count was significantly higher in BiD compared to MDD (p < 0.001). Multivariable regression models suggested higher NLR in MA compared to MDD (p = 0.039), higher MLR in both MA and BiD compared to MDD (p < 0.001 and p = 0.004 respectively), while we found neither group differences in PLR nor an effect of type and duration of hospitalization, current psychotic, or suicidal features and psychiatric history on IRCs. Here, we show that IRCs are elevated in bipolar disorder versus MDD and affected by mood episode, while MLR could be especially valuable in the differential diagnosis between bipolar and unipolar depression. IRCs represent inexpensive, routinely accessible and clinically applicable biomarkers with diagnostic validity in affective disorders that could be easily implemented as illness activity indicators, to better follow the course of illness and eventually predict relapse or treatment response and, thus, guide therapeutic targeting.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

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Immune Cell Ratios Are Higher in Bipolar Affective than Unipolar Depressive Disorder and Modulated by Mood Episode: A Retrospective, Cross-Sectional Study

et al. 2023

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“…The severity of BD-M has been shown to be strongly correlated with abnormal MLR values. 42 Monocytes are an important component of the innate immune response and play a regulatory role in the production and release of inflammatory factors (such as interleukin 1 and TNF-α). 43 Elevated serum TNF-α levels are also closely associated with high levels of aggression in patients with mental disorders.…”

Section: Discussionmentioning

confidence: 99%

Clinical Markers of Physical Violence in Patients with Bipolar Disorder in Manic States

Li,

Gao,

Liu

et al. 2023

RMHP

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Purpose Identifying patients with bipolar disorder (BD) in manic states (BD-M) who are at a high risk of physical violence is a matter of clinical concern. This retrospective institution-based study aimed to identify simple, rapid, and inexpensive clinical markers of physical violence in patients with BD-M. Patients and Methods The anonymized sociodemographic variables (sex, age, years of education, marital status) and clinical ones (weight, height, body mass index, blood pressure, the score of BRMS, number of BD episodes, psychotic symptoms, history of violence, biochemical parameters, and blood routine parameters) of 316 BD-M participants were collected, and the risk of physical violence was identified using the Brøset Violence Checklist (BVC). Difference tests, correlation analyses, and multivariate linear regression analysis were performed to identify clinical markers for the risk of physical violence. Results The participants were categorized into groups at low (49, 15.51%), medium (129, 40.82%), and high (138, 43.67%) risk of physical violence. The number of BD episodes, serum uric acid (UA), free thyroxine (FT4) levels, history of violence, and monocyte-to-lymphocyte ratio (MLR) differed significantly between groups (all P <0.05). The number of BD episodes ( r =0.152), FT3 ( r =0.131) and FT4 ( r =0.132) levels, history of violence ( r =0.206), and MLR ( r =−0.132) were significantly correlated with the risk of physical violence (all P <0.05). The existence of history of violence, number of BD episodes, UA, FT4, and MLR were identified as clinical markers of the risk of physical violence in patients with BD-M (all P <0.05). Conclusion These identified markers are readily available at initial presentation and may help in the timely assessment and treatment of patients with BD-M.

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“…The MLR is calculated by dividing the monocyte count by the lymphocyte count. Increased MLR values can be associated with poor outcomes in various diseases, including cancer 18 . Systemic Immune-Inflammation Index (SII): Platelet Count × Neutrophil Count/Lymphocyte Count.…”

Section: Methodsmentioning

confidence: 99%

Big data insights into the diagnostic values of CBC parameters for sepsis and septic shock in burn patients: a retrospective study

Kim,

Kym,

Park

et al. 2024

Sci Rep

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Sepsis and septic shock are prevalent and life-threatening complications in burn patients. Despite their severity, existing diagnostic methods are limited. This study aims to evaluate the efficacy of Complete Blood Count (CBC) and CBC ratio markers in diagnosing sepsis and septic shock, and in predicting mortality among burn patients. A cohort of 2757 burn patients was examined to ascertain the correlation between various CBC parameters, their ratios, and the incidence of sepsis and related mortality. Key markers analyzed included Red Cell Distribution Width (RDW), Mean Platelet Volume (MPV), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Mean Platelet Volume-to-Platelet Ratio (MPVPR). Our findings indicate that 65.5% of the patients developed sepsis, and 24.3% succumbed to their conditions. The CBC parameters RDW, MPV, NLR, MPVPR, and MPV-to-Lymphocyte Ratio (MPVLR) were significantly associated with sepsis and mortality. These markers showed considerable temporal variation and yielded an Area Under the Curve (AUC) of over 0.65 in an unadjusted Generalized Estimating Equations (GEE) model. This study underscores the potential of RDW, MPV, NLR, MPVPR, and MPVLR as vital prognostic tools for diagnosing sepsis, septic shock, and predicting mortality in burn patients. Although based on a single-center dataset, our results contribute to the enhancement of sepsis management by facilitating earlier, more precise diagnosis and treatment strategies. Further multi-center research is necessary to confirm these findings and broaden their applicability, establishing a solid base for future explorations in this crucial field.

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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

Cited by 29 publications

References 50 publications

Immune Cell Ratios Are Higher in Bipolar Affective than Unipolar Depressive Disorder and Modulated by Mood Episode: A Retrospective, Cross-Sectional Study

Immune Cell Ratios Are Higher in Bipolar Affective than Unipolar Depressive Disorder and Modulated by Mood Episode: A Retrospective, Cross-Sectional Study

Clinical Markers of Physical Violence in Patients with Bipolar Disorder in Manic States

Big data insights into the diagnostic values of CBC parameters for sepsis and septic shock in burn patients: a retrospective study

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