Neutrophil/Lymphocyte, Platelet/Lymphocyte, and Monocyte/Lymphocyte Ratios in Mood Disorders

Abstract

Major depressive disorder (MDD) and bipolar disorders (BDs), the most severe types of mood disorders (MDs), are considered as among the most disabling illnesses worldwide. Several studies suggested that inflammatory neuroinflammation might be involved in the pathophysiology of MDs while reporting increasing data on the relationships between these processes and classical neurotransmitters, hypothalamus-pituitaryadrenal axis (HPA), and neurotrophic factors. The assessment of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and monocyte/lymphocyte ratio (MLR) in peripheral blood represents a simple method to evaluate the inflammatory status. The aim of the present paper was to review the literature on the possible relationships between NLR, PLR, and MLR in MDs and to comment on their possible wider use in clinical research. Thirty-five studies were included in the present review. The majority of them had higher values of these parameters, particularly NLR values in patients with MDs when compared to healthy subjects. The increase would appear more robust in patients with BD during a manic episode, thus indicating that it could be considered as both state and trait markers. In addition, increased NLR and PLR levels seem to represent prognostic elements for the early discovery of post-stroke depression. The findings of the present review would indicate the need to carry out further studies in this field. In particular, NLR, PLR, and MLR seem to be promising tools to detect economically and easily the activation of the inflammatory system and to perhaps evaluate the etiology and course of MDs. Again, they could suggest some information to better understand the relationship between inflammatory and cardiovascular disease and MDs, and thus, to provide clinical implications in terms of management and treatment.

Keywords: Mood disorders; bipolar disorders; clinical biomarkers; inflammation; major depressive disorder; monocyte/lymphocyte ratio; neutrophil/lymphocyte ratio; pathophysiology; platelet/lymphocyte ratio.