» Articles » PMID: 33418881

Neutrophil-to-Lymphocyte, Platelet-to-Lymphocyte and Monocyte-to-Lymphocyte Ratio in Bipolar Disorder

Overview
Journal Brain Sci
Publisher MDPI
Date 2021 Jan 9
PMID 33418881
Citations 31
Authors
Affiliations
Soon will be listed here.
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 -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.

Citing Articles

Gender Differences in Clinical and Biochemical Variables of Patients Affected by Bipolar Disorder.

Piccirilli L, Capuzzi E, Legnani F, Di Paolo M, Pan A, Ceresa A Brain Sci. 2025; 15(2).

PMID: 40002546 PMC: 11853631. DOI: 10.3390/brainsci15020214.


The flow cytometric analysis of depression focusing on modern-type depression and hikikomori: Exploring the link between subtypes of depression and immunological imbalances.

Matsuo K, Watanabe M, Inamine S, Matsushima T, Kyuragi S, Maeda Y Dialogues Clin Neurosci. 2025; 27(1):13-25.

PMID: 39831784 PMC: 11748865. DOI: 10.1080/19585969.2025.2452842.


Efficacy of probiotic adjuvant therapy in women with major depressive disorder: insights from a case series study.

Junior J, Aires R, de Sousa Cutrim T, Vasquez E, Pereira T, Campagnaro B Pharmacol Rep. 2025; .

PMID: 39808404 DOI: 10.1007/s43440-024-00690-6.


Suicide risk among adult subjects hospitalized in an acute psychiatric ward: 6-year retrospective investigation.

Di Lorenzo R, Scala C, Reami M, Rovesti S, Ferri P BMC Public Health. 2024; 24(1):3113.

PMID: 39529024 PMC: 11552328. DOI: 10.1186/s12889-024-20450-8.


Association between Sleep Quality and Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio in Patients with Bipolar Disorder.

Vaziri Harami R, Keyvanfar A, Semnani Y, Najafiarab H Med J Islam Repub Iran. 2024; 38:53.

PMID: 39416372 PMC: 11480673. DOI: 10.47176/mjiri.38.53.


References
1.
Chou Y, Hsieh W, Chen L, Lirng J, Wang S . Association between the serotonin transporter and cytokines: Implications for the pathophysiology of bipolar disorder. J Affect Disord. 2015; 191:29-35. DOI: 10.1016/j.jad.2015.10.056. View

2.
Haarman B, Riemersma-van der Lek R, de Groot J, Ruhe H, Klein H, Zandstra T . Neuroinflammation in bipolar disorder - A [(11)C]-(R)-PK11195 positron emission tomography study. Brain Behav Immun. 2014; 40:219-25. DOI: 10.1016/j.bbi.2014.03.016. View

3.
Rosenblat J . Targeting the immune system in the treatment of bipolar disorder. Psychopharmacology (Berl). 2019; 236(10):2909-2921. DOI: 10.1007/s00213-019-5175-x. View

4.
Ozdin S, Sarisoy G, Boke O . A comparison of the neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratios in schizophrenia and bipolar disorder patients - a retrospective file review. Nord J Psychiatry. 2017; 71(7):509-512. DOI: 10.1080/08039488.2017.1340517. View

5.
Mert D, Terzi H . Mean platelet volume in bipolar disorder: the search for an ideal biomarker. Neuropsychiatr Dis Treat. 2016; 12:2057-62. PMC: 4998027. DOI: 10.2147/NDT.S112374. View