Sex-dependent grades of haematopoietic modulation in patients with major depressive episodes are associated with suicide attempts

Martínez-Botía, Patricia; Velasco, Ángela; Rollé, Valeria; Jiménez-Treviño, Luís; Fuente-Tomás, Lorena de la; Bernardo, Ángel; Arias, Tamara; Muñoz-Turrillas, María del Carmen; García-Álvarez, Leticia; González‐Blanco, Leticia; Rodríguez-Revuelta, Julia; García-Portilla, María Paz; Courtet, Philippe; Bobes, Julio; Gutiérrez, Laura; Sáiz, Pilar A.

doi:10.1016/j.euroneuro.2020.06.006

Cited by 16 publications

(16 citation statements)

References 42 publications

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“…Heterogeneity among the three studies remained high ( I 2 = 86.8%, p < 0.001) and the random-effects model was used. Sensitivity analysis eliminating one study ( 48 ) exhibited a higher and significant effect (SMD = 0.32, 95% CI: 0.20–0.44) ( Figure 4B ), which suggested that the results of the meta-analysis were unstable and that the study by Martínez-Botía et al might be a source of heterogeneity.…”

Section: Resultsmentioning

confidence: 97%

“…Ten studies ( 17 , 35 , 37 , 41 , 42 , 48 , 49 , 54 – 56 ) evaluated PLR between 1,399 patients with depression (534 males) and 1,727 controls (811 males). The PLR values were distinctly higher in depressed patients than in controls (SMD = 0.24, 95% CI: 0.02–0.46, p < 0.05), and the forest plot is shown in Figure 3A .…”

Section: Resultsmentioning

confidence: 99%

“…In our meta-analysis, patients with depression showed a trend of increased MLR than controls. Interestingly, a higher and significant effect was found when leaving out one study ( 48 ) in sensitivity analysis. Moreover, the subgroup analyses based on country and matched age and gender yielded the same results as the sensitivity analysis.…”

Section: Discussionmentioning

confidence: 97%

“…Suicide is the primary cause of non-natural death globally and the most devastating outcome for people with depression. Major depressive disorder (MDD) is the most prevalent psychological disorder among individuals with suicidal behavior, and patients with depression had a 20-fold suicide mortality compared to the general population ( 48 ). A review by Brundin et al ( 85 ) suggests that inflammation may be especially pronounced in patients with suicidal behavior.…”

Section: Discussionmentioning

confidence: 99%

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Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Monocyte-to-Lymphocyte Ratio in Depression: An Updated Systematic Review and Meta-Analysis

Cheng

Wang

et al. 2022

Front. Psychiatry

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BackgroundResearch on neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) in depression is still emerging and has increased 3-fold since the first meta-analysis. An updated meta-analysis with sufficient studies can provide more evidence for a potential relationship between NLR, PLR, MLR, and depression.MethodsWe identified 18 studies from the PubMed, EMBASE, Cochrane library, and Web of Science databases. Meta-analyses were performed to generate pooled standardized mean differences (SMDs) and 95% confidence intervals (CIs) between patients with depression and controls. Sensitivity analysis, subgroup analysis, meta-regression, and publication bias were conducted.ResultsA total of 18 studies including 2,264 depressed patients and 2,415 controls were included. Depressed patients had significantly higher NLR and PLR compared with controls (SMD = 0.33, 95% CI: 0.15–0.52, p < 0.001 and SMD = 0.24, 95% CI: 0.02–0.46, p < 0.05, respectively). MLR was slightly higher in depressed individuals compared to controls (SMD = 0.15, 95% CI: −0.26 to 0.55, p > 0.05), despite the absence of significance. Sensitivity analysis removing one study responsible for heterogeneity showed a higher and significant effect (SMD = 0.32, 95% CI: 0.20–0.44) of MLR. Three subgroup analyses of NLR, PLR, MLR, and depression revealed obvious differences in the inflammatory ratios between depressed patients and controls in China and the matched age and gender subgroup. Individuals with post-stroke depression (PSD) had higher NLR and MLR values as compared to non-PSD patients (SMD = 0.51, 95% CI: 0.36–0.67, p < 0.001 and SMD = 0.46, 95% CI: 0.12–0.79, p < 0.01, respectively). Meta-regression analyses showed that male proportion in the case group influenced the heterogeneity among studies that measured NLR values (p < 0.05).ConclusionsHigher inflammatory ratios, especially NLR, were significantly associated with an increased risk of depression. In the subgroup of China and matched age and gender, NLR, PLR, and MLR were all elevated in depressed patients vs. controls. Individuals with PSD had higher NLR and MLR values as compared to non-PSD patients. Gender differences may have an effect on NLR values in patients with depression.

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Monocyte-to-Lymphocyte Ratio in Depression: An Updated Systematic Review and Meta-Analysis

Cheng

Wang

et al. 2022

Front. Psychiatry

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“…The innate immune cells, mainly consisting of macrophages, monocytes, granulocytes, dendritic cells, and Natural Killer (NK) cells provide the first-line of defense by recognizing and responding to pathogenic and other danger signals. The pathogen-specific B cells that produce antibodies and T cells, including the helper, memory, cytotoxic and regulatory T cell subsets, mediate the acquired immune response and these cells are found altered in depression and suicidal behavior ( Ucuz and Kayhan Tetik, 2020 ; Martinez-Botia et al., 2020 ). The immune response is orchestrated in a tightly-regulated fashion by engaging innate and adaptive components and is dependent on the pro and anti-inflammatory messenger molecules, the cytokines, produced in the CNS and the periphery.…”

Section: Neuroimmune Dysregulation In Suicide Suicidal Behavior and Associated Conditionsmentioning

confidence: 99%

Psychoneuroimmunology: The new frontier in suicide research

Neupane

2021

Brain, Behavior, & Immunity - Health

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Elucidating complex, multifactorial phenomena like suicide and suicidal behaviors (SSB) require multidisciplinary fields such as Psychoneuroimmunology (PNI). Indeed, our appreciation of the bidirectional communication channels between the brain and the rest of the body with its immune arsenal as the key player has positioned PNI as a promising field of research. We now know that major psychiatric, behavioral, and somatic disorders related to SSB accompany neuroimmune dysregulation. These disorders range from depression, emotional dysregulation, atopy, and epilepsy to certain viral and parasitic infections. By utilizing epidemiological, genetic, microbial, and molecular approaches, the PNI research community has excogitated novel biomarker candidates and pathways in support of SSB risk stratification at individual level. This remarkable progress in just two previous decades shall, if successful, help implement personalized prevention and treatment strategies, using PNI-assisted tools. The aims of this narrative review and opinion piece are to summarize important discoveries concerning the role of neuroimmune activation in SSB and to highlight important future directions for the field. Major caveats of the findings concerning methodological approaches, clinical reality of frequent comorbid psychopathology, and novel molecular targets are presented. Finally, this review calls on the PNI research community for increased attention towards factors that promote resilience to suicide, while accepting “consciousness” under its wing. Thus, PNI represents the new frontier in suicide research. Future breakthroughs in this discipline shall bring us closer to understanding the biological substrates of qualia i.e., subjective, and experiential meanings of life and death.

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Relationship between complete blood count parameters and suicide: The role of neutrophil to lymphocyte ratio

Örüm

2021

The European Journal of Psychiatry

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Sex-dependent grades of haematopoietic modulation in patients with major depressive episodes are associated with suicide attempts

Cited by 16 publications

References 42 publications

Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Monocyte-to-Lymphocyte Ratio in Depression: An Updated Systematic Review and Meta-Analysis

Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Monocyte-to-Lymphocyte Ratio in Depression: An Updated Systematic Review and Meta-Analysis

Psychoneuroimmunology: The new frontier in suicide research

Relationship between complete blood count parameters and suicide: The role of neutrophil to lymphocyte ratio

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