Vita-Salute San Raffaele University, Milano, Italy; Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy.
Vita-Salute San Raffaele University, Milano, Italy; Psychiatry & Clinical Psychobiology, Division of Neuroscience, Scientific Institute IRCCS Ospedale San Raffaele, Milano, Italy.
Eur Neuropsychopharmacol. 2023 Nov;76:52-60. doi: 10.1016/j.euroneuro.2023.07.010. Epub 2023 Aug 4.
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.
多种因素可能会影响重度抑郁症（MDD）的治疗反应，包括免疫/炎症改变和区域脑容量，特别是在海马区，炎症状态已被证明会对其产生影响。中性粒细胞与淋巴细胞比值（NLR）是一种炎症标志物，在大型人群研究中发现，抑郁女性的 NLR 升高。在这里，我们研究了 NLR 对 MDD 患者治疗反应的影响，以及性别和海马体积对影响这种关系的作用。124 名 MDD 住院抑郁症患者（F=80）接受了 MRI 采集，通过将绝对中性粒细胞计数除以绝对淋巴细胞计数来计算 NLR，入院时和出院时通过汉密尔顿抑郁评定量表（HDRS）评估抑郁严重程度。作为治疗反应的衡量标准，计算了 HDRS 的差值。我们发现 NLR 与 Delta HDRS 之间的关系存在显著的性别调节效应：女性呈负相关，男性呈正相关。NLR 被发现会降低女性的海马体积。左、右海马体积均与 Delta HDRS 呈正相关。最后，左海马体积介导了 NLR 对女性 Delta HDRS 的影响。性别调节了炎症与治疗反应之间的关系，这与先前的报告一致，即炎症与女性抗抑郁药效果受阻有关。此外，这种效应部分是由海马体积介导的，这表明炎症对大脑的有害影响可能会阻碍抗抑郁药的反应。
