氯氮平
内科学
淋巴细胞
胃肠病学
医学
分裂情感障碍
中性粒细胞绝对计数
精神分裂症(面向对象编程)
非定型抗精神病薬
免疫学
抗精神病药
精神病
中性粒细胞减少症
毒性
精神科
作者
Vicent Llorca-Bofí,Miquel Bioque,Santiago Madero,Andrea Mallorquí,Cristina Oliveira,Marina Garriga,Eduard Parellada,Clemente García-Rizo
出处
期刊:Pharmacopsychiatry
[Thieme Medical Publishers (Germany)]
日期:2024-04-15
卷期号:57 (04): 173-179
被引量:2
摘要
Abstract Background Clozapine is the recommended treatment for managing treatment-resistant schizophrenia (TRS), and immunological mechanisms may be involved in its unique antipsychotic efficacy. This study investigated whether baseline immune abnormalities measured with blood cell count ratios can predict the clinical response after initiating treatment with clozapine in patients with clozapine naïve TRS. Methods A longitudinal design was developed, involving 32 patients diagnosed with treatment-resistant, clozapine-naïve schizophrenia-spectrum disorder. Patients were evaluated at baseline before clozapine starting and 8 weeks of follow-up. Psychopathological status and immune abnormalities (blood cell count ratios: neutrophil-lymphocyte ratio [NLR], monocyte-lymphocyte ratio [MLR], platelet-lymphocyte ratio [PLR] and basophil-lymphocyte ratio [BLR]) were evaluated in each visit. Results Baseline NLR (b=− 0.364; p=0.041) and MLR (b =− 0.400; p=0.023) predicted the change in positive symptoms over the 8-week period. Patients who exhibited a clinical response showed higher baseline NLR (2.38±0.96 vs. 1.75±0.83; p=0.040) and MLR (0.21±0.06 vs. 0.17±0.02; p=0.044) compared to non-responders. In the ROC analysis, the threshold points to distinguish between responders and non-responders were approximately 1.62 for NLR and 0.144 for MLR, yielding AUC values of 0.714 and 0.712, respectively. No statistically significant differences were observed in the blood cell count ratios from baseline to the 8-week follow-up. Conclusion Our study emphasizes the potential clinical significance of baseline NLR and MLR levels as predictors of initial clozapine treatment response in patients with TRS. Future studies with larger sample sizes and longer follow-up periods should replicate our findings.
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