Koureta Anastasia, Asimakopoulos Lampros O, Bozikas Vasilios P, Agorastos Agorastos
Department of Psychiatry, General Hospital of Katerini, GR 60100 Katerini, Greece.
Laboratory of Neurophysiology, Faculty of Medicine, School of Health Sciences, Democritus University of Thrace, GR 68100 Alexandroupolis, Greece.
Brain Sci. 2023 Mar 5;13(3):448. doi: 10.3390/brainsci13030448.
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 ( < 0.001). Multivariable regression models suggested higher NLR in MA compared to MDD ( = 0.039), higher MLR in both MA and BiD compared to MDD ( < 0.001 and = 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.
免疫失调与双相情感障碍和重度抑郁症的病理生理学有关，而免疫细胞比率（IRCs）最近被提议作为临床适用的免疫生物标志物。我们调查了情感障碍中免疫细胞比率的差异及其与当前情绪发作和临床特征的关联。这项回顾性队列研究分析了135名情感障碍住院患者入院时的中性粒细胞与淋巴细胞比率（NLR）、单核细胞与淋巴细胞比率（MLR）和血小板与淋巴细胞比率（PLR），这些患者分别患有躁狂症（MA，n = 36）、双相抑郁症（BiD，n = 38）和单相抑郁症（MDD，n = 61）。从病历中提取了人口统计学、临床和免疫数据。与单相抑郁症相比，双相抑郁症患者的单核细胞计数显著更高（<0.001）。多变量回归模型表明，与单相抑郁症相比，躁狂症患者的NLR更高（=0.039），与单相抑郁症相比，躁狂症和双相抑郁症患者的MLR均更高（分别为<0.001和=0.004），而我们发现血小板与淋巴细胞比率在两组之间没有差异，住院类型和时长、当前的精神病性症状、自杀特征以及精神病史对免疫细胞比率也没有影响。在此，我们表明双相情感障碍患者的免疫细胞比率高于单相抑郁症患者，且受情绪发作影响，而单核细胞与淋巴细胞比率在双相抑郁症和单相抑郁症的鉴别诊断中可能特别有价值。免疫细胞比率是廉价、常规可获取且临床适用的生物标志物，在情感障碍中具有诊断有效性，可轻松作为疾病活动指标来更好地跟踪疾病进程，并最终预测复发或治疗反应，从而指导治疗靶点。
