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

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...

Full description

Bibliographic Details
Main Authors: Anastasia Koureta, Lampros O. Asimakopoulos, Vasilios P. Bozikas, Agorastos Agorastos
Format: Article
Language:English
Published: MDPI AG 2023-03-01
Series:Brain Sciences
Subjects:
Online Access:https://www.mdpi.com/2076-3425/13/3/448
_version_ 1827750908932390912
author Anastasia Koureta
Lampros O. Asimakopoulos
Vasilios P. Bozikas
Agorastos Agorastos
author_facet Anastasia Koureta
Lampros O. Asimakopoulos
Vasilios P. Bozikas
Agorastos Agorastos
author_sort Anastasia Koureta
collection DOAJ
description 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 (<i>p</i> < 0.001). Multivariable regression models suggested higher NLR in MA compared to MDD (<i>p</i> = 0.039), higher MLR in both MA and BiD compared to MDD (<i>p</i> < 0.001 and <i>p</i> = 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.
first_indexed 2024-03-11T06:51:04Z
format Article
id doaj.art-e7837132b6a94058be9b24424b3c8440
institution Directory Open Access Journal
issn 2076-3425
language English
last_indexed 2024-03-11T06:51:04Z
publishDate 2023-03-01
publisher MDPI AG
record_format Article
series Brain Sciences
spelling doaj.art-e7837132b6a94058be9b24424b3c84402023-11-17T09:59:57ZengMDPI AGBrain Sciences2076-34252023-03-0113344810.3390/brainsci13030448Immune Cell Ratios Are Higher in Bipolar Affective than Unipolar Depressive Disorder and Modulated by Mood Episode: A Retrospective, Cross-Sectional StudyAnastasia Koureta0Lampros O. Asimakopoulos1Vasilios P. Bozikas2Agorastos Agorastos3Department of Psychiatry, General Hospital of Katerini, GR 60100 Katerini, GreeceLaboratory of Neurophysiology, Faculty of Medicine, School of Health Sciences, Democritus University of Thrace, GR 68100 Alexandroupolis, GreeceII. Department of Psychiatry, School of Medicine, Faculty of Medical Sciences, Aristotle University of Thessaloniki, GR 56430 Thessaloniki, GreeceII. Department of Psychiatry, School of Medicine, Faculty of Medical Sciences, Aristotle University of Thessaloniki, GR 56430 Thessaloniki, GreeceImmune 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 (<i>p</i> < 0.001). Multivariable regression models suggested higher NLR in MA compared to MDD (<i>p</i> = 0.039), higher MLR in both MA and BiD compared to MDD (<i>p</i> < 0.001 and <i>p</i> = 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.https://www.mdpi.com/2076-3425/13/3/448affective disordersbipolar disordermaniamajor depressive disorderneutrophilsplatelets
spellingShingle Anastasia Koureta
Lampros O. Asimakopoulos
Vasilios P. Bozikas
Agorastos Agorastos
Immune Cell Ratios Are Higher in Bipolar Affective than Unipolar Depressive Disorder and Modulated by Mood Episode: A Retrospective, Cross-Sectional Study
Brain Sciences
affective disorders
bipolar disorder
mania
major depressive disorder
neutrophils
platelets
title Immune Cell Ratios Are Higher in Bipolar Affective than Unipolar Depressive Disorder and Modulated by Mood Episode: A Retrospective, Cross-Sectional Study
title_full Immune Cell Ratios Are Higher in Bipolar Affective than Unipolar Depressive Disorder and Modulated by Mood Episode: A Retrospective, Cross-Sectional Study
title_fullStr Immune Cell Ratios Are Higher in Bipolar Affective than Unipolar Depressive Disorder and Modulated by Mood Episode: A Retrospective, Cross-Sectional Study
title_full_unstemmed Immune Cell Ratios Are Higher in Bipolar Affective than Unipolar Depressive Disorder and Modulated by Mood Episode: A Retrospective, Cross-Sectional Study
title_short Immune Cell Ratios Are Higher in Bipolar Affective than Unipolar Depressive Disorder and Modulated by Mood Episode: A Retrospective, Cross-Sectional Study
title_sort immune cell ratios are higher in bipolar affective than unipolar depressive disorder and modulated by mood episode a retrospective cross sectional study
topic affective disorders
bipolar disorder
mania
major depressive disorder
neutrophils
platelets
url https://www.mdpi.com/2076-3425/13/3/448
work_keys_str_mv AT anastasiakoureta immunecellratiosarehigherinbipolaraffectivethanunipolardepressivedisorderandmodulatedbymoodepisodearetrospectivecrosssectionalstudy
AT lamprosoasimakopoulos immunecellratiosarehigherinbipolaraffectivethanunipolardepressivedisorderandmodulatedbymoodepisodearetrospectivecrosssectionalstudy
AT vasiliospbozikas immunecellratiosarehigherinbipolaraffectivethanunipolardepressivedisorderandmodulatedbymoodepisodearetrospectivecrosssectionalstudy
AT agorastosagorastos immunecellratiosarehigherinbipolaraffectivethanunipolardepressivedisorderandmodulatedbymoodepisodearetrospectivecrosssectionalstudy