The Monocyte-to-Lymphocyte Ratio Correlates with Psycho-Neuro-Inflammatory Factors in Patients with Stable Coronary Artery Disease

Abstract

Background: Psychosocial stress and depression have been recognized as major risk factors of coronary artery disease (CAD). Although monocytes are known to be key players in atherosclerosis, monocyte-based associations with psychoneuroendocrino-immuno-inflammatory (PNI) markers have not been widely investigated in stable CAD. Objective: We examined associations between the monocyte-to-lymphocyte ratio (MLR) and key PNI markers in stable CAD. Methods: We studied 23 patients with stable CAD who completed the Beck Depression Inventory (BDI) and Rahe's Brief Stress and Coping Inventory. A white blood cell differential was performed, and levels of cortisol, chromogranin A (CgA), LL-37, interleukin-6 (IL-6) and C-reactive protein (CRP) were assayed in plasma. Results: Monocyte fraction, MLR and plasma CgA levels exceeded reference values, the social support score was low, and 7 patients had elevated BDI scores. In the multivariate-adjusted analysis, a higher MLR was associated with greater depressive symptom severity (r = 0.624, p < 0.01) as well as with higher concentrations of CgA (r = 0.660, p < 0.01), LL-37 (r = 0.643, p < 0.01), IL-6 (r = 0.532, p < 0.05) and CRP (r = 0.470, p < 0.05). BDI scores associated with CgA concentration (r = 0.618, p < 0.01) and CgA level correlated negatively with the social support score (r = -0.511, p < 0.05). Conclusions: Our findings suggest that, in patients with stable CAD, elevated MLR may be associated with depressive symptoms, with increased neuroendocrine-sympathetic activity (marked by CgA) and inflammatory markers that are pertinent to atherosclerosis initiation and progression. The increased neuroendocrine-sympathetic activity correlated with low social support and depressive symptom severity. The MLR might serve as an easy-to-obtain and inexpensive proxy measure of an activated PNI network in stable CAD.

Monocyte/lymphocyte ratio as a better predictor of cardiovascular and all‐cause mortality in hemodialysis patients: A prospective cohort study

“…It was reported that a higher MLR was correlated with increased susceptibility to clinical malaria and low malaria vaccine efficacy, implying increased MLR was also related to impaired immune responses. Recently, one study indicated that elevated MLR was associated with depressive symptoms and increased psycho‐neuro‐inflammatory markers in stable coronary artery disease . Two studies compared MLR and NLR in certain clinical settings.…”

“…Recently, one study indicated that elevated MLR was associated with depressive symptoms and increased psycho-neuro-inflammatory markers in stable coronary artery disease. 35 Two studies compared MLR and NLR in certain clinical settings. One signified that MLR was better than NLR in measuring systemic inflammatory responses in clear cell renal cell carcinoma.…”

Social regulation of the lymph node transcriptome in rhesus macaques (Macaca mulatta)

“…Myeloid cells (i.e. monocytes) have been associated both with inflammation (Gordon & Taylor, 2005; Robbins & Swirski, 2010) and several forms of psychosocial stress including low social economic status (Powell et al, 2013), perceived social isolation (Cole et al, 2015), and depressive symptoms in patients with coronary artery disease (Serfozo et al, 2016). In addition, secondary lymphoid tissue is an important initiator of the immune response, contains a high density of functional B cells (von Andrian & Mempel, 2003), and is an area of rapid turnover of B cells (Thomas et al, 2016).…”

Preoperative levels of inflammatory biomarkers in patients with bilateral inferior turbinate hypertrophy

“…In a study, in patients with coronary artery disease M/L ratio was evaluated and it was concluded that increased M/L ratio was associated with increase in depressive symptoms. In the same Preoperative levels of inflammatory biomarkers in patients with bilateral inferior turbinate hypertrophy study, increase in M/L ratio was demonstrated to be directly proportional to increase in neuroendocrine-sympathetic activity, onset, and progression of atherosclerosis, and the authors concluded that M/L ratio can be used as an inflammatory marker in the follow-up of the patients [15]. In our study we couldn't find a statistically significant difference between both groups as for N/WBC ratio.…”