Inflammatory biomarkers as predictors for unlocking antidepressant efficacy: Assessing predictive value and risk stratification in major depressive disorder in a prospective longitudinal study

<h3>Background</h3><p dir="ltr">Major depressive disorder (MDD) is characterized by significant heterogeneity in treatment response, with inflammation hypothesized to play a role in its pathophysiology. Peripheral inflammatory biomarkers, such as the neutrophil-to-lymphoc...

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التفاصيل البيبلوغرافية
المؤلف الرئيسي: Nervana Elbakary (21480140) (author)
مؤلفون آخرون: Noriya Al-Khuzaei (12506777) (author), Tarteel Hussain (21480143) (author), Ahmed Karawia (18102712) (author), Malek Smida (21480146) (author), Niveen Abu-Rahma (21480149) (author), Fairooz Akel (21480152) (author), Soad Esmail Mahmoud (21480155) (author), James Currie (16079431) (author), Mohamed Adil Shah Khoodoruth (14589828) (author), Sami Ouanes (9617363) (author)
منشور في: 2025
الموضوعات:
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author Nervana Elbakary (21480140)
author2 Noriya Al-Khuzaei (12506777)
Tarteel Hussain (21480143)
Ahmed Karawia (18102712)
Malek Smida (21480146)
Niveen Abu-Rahma (21480149)
Fairooz Akel (21480152)
Soad Esmail Mahmoud (21480155)
James Currie (16079431)
Mohamed Adil Shah Khoodoruth (14589828)
Sami Ouanes (9617363)
author2_role author
author
author
author
author
author
author
author
author
author
author_facet Nervana Elbakary (21480140)
Noriya Al-Khuzaei (12506777)
Tarteel Hussain (21480143)
Ahmed Karawia (18102712)
Malek Smida (21480146)
Niveen Abu-Rahma (21480149)
Fairooz Akel (21480152)
Soad Esmail Mahmoud (21480155)
James Currie (16079431)
Mohamed Adil Shah Khoodoruth (14589828)
Sami Ouanes (9617363)
author_role author
dc.creator.none.fl_str_mv Nervana Elbakary (21480140)
Noriya Al-Khuzaei (12506777)
Tarteel Hussain (21480143)
Ahmed Karawia (18102712)
Malek Smida (21480146)
Niveen Abu-Rahma (21480149)
Fairooz Akel (21480152)
Soad Esmail Mahmoud (21480155)
James Currie (16079431)
Mohamed Adil Shah Khoodoruth (14589828)
Sami Ouanes (9617363)
dc.date.none.fl_str_mv 2025-05-31T12:00:00Z
dc.identifier.none.fl_str_mv 10.1016/j.jad.2025.119545
dc.relation.none.fl_str_mv https://figshare.com/articles/journal_contribution/Inflammatory_biomarkers_as_predictors_for_unlocking_antidepressant_efficacy_Assessing_predictive_value_and_risk_stratification_in_major_depressive_disorder_in_a_prospective_longitudinal_study/29235080
dc.rights.none.fl_str_mv CC BY 4.0
info:eu-repo/semantics/openAccess
dc.subject.none.fl_str_mv Biomedical and clinical sciences
Cardiovascular medicine and haematology
Immunology
Neurosciences
Health sciences
Health services and systems
Neutrophiles
Lymphocytes
C-reactive protein
Cytokines
Platelets
Precision psychiatry
Machine learning
Zung rating scale
Depression
dc.title.none.fl_str_mv Inflammatory biomarkers as predictors for unlocking antidepressant efficacy: Assessing predictive value and risk stratification in major depressive disorder in a prospective longitudinal study
dc.type.none.fl_str_mv Text
Journal contribution
info:eu-repo/semantics/publishedVersion
text
contribution to journal
description <h3>Background</h3><p dir="ltr">Major depressive disorder (MDD) is characterized by significant heterogeneity in treatment response, with inflammation hypothesized to play a role in its pathophysiology. Peripheral inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP), may predict antidepressant efficacy. This study investigated the association between baseline inflammatory biomarkers, their changes, and antidepressant treatment outcomes in patients with MDD. </p><h3>Methods</h3><p dir="ltr">A prospective longitudinal cohort study in Qatar recruited 123 MDD outpatients (aged 18–64). Baseline assessments included NLR, CRP, monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR). Depression severity was measured via the Zung Self-Rating Depression Scale (ZSRS) at baseline and 12 weeks post-treatment. Statistical analyses, including multiple regression and Random Forest machine learning models, identified predictors of antidepressant response. </p><h3>Results</h3><p dir="ltr">Improvement in depressive symptoms was associated with female sex, higher mean corpuscular volume (MCV), lower absolute neutrophil count (ANC), and higher eosinophil counts. However, changes in NLR, MLR, PLR, and CRP did not predict treatment response. Folate levels and PLR were identified by the machine learning model as top predictors, suggesting potential utility as biomarkers for response classification. Our study identified predictors of improvement in suicidal ideation, including hematological markers (lower RBC, higher eosinophils, lower monocytes), younger age, female sex, medical comorbidities, and longer assessment intervals. </p><h3>Conclusion</h3><p dir="ltr">Baseline ANC and eosinophil count may help stratify MDD treatment outcomes, though post-treatment biomarker changes were not linked to symptom improvement. Our findings highlight suicidality as a distinct pathology within depression, necessitating tailored interventions. This study highlights the complexity of inflammation in depression and suicidality, emphasizing the need for advanced biomarkers utilization in precision medicine and personalized psychiatry treatment.</p><h2>Other Information</h2><p dir="ltr">Published in: Journal of Affective Disorders<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.jad.2025.119545" target="_blank">https://dx.doi.org/10.1016/j.jad.2025.119545</a></p>
eu_rights_str_mv openAccess
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oai_identifier_str oai:figshare.com:article/29235080
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spelling Inflammatory biomarkers as predictors for unlocking antidepressant efficacy: Assessing predictive value and risk stratification in major depressive disorder in a prospective longitudinal studyNervana Elbakary (21480140)Noriya Al-Khuzaei (12506777)Tarteel Hussain (21480143)Ahmed Karawia (18102712)Malek Smida (21480146)Niveen Abu-Rahma (21480149)Fairooz Akel (21480152)Soad Esmail Mahmoud (21480155)James Currie (16079431)Mohamed Adil Shah Khoodoruth (14589828)Sami Ouanes (9617363)Biomedical and clinical sciencesCardiovascular medicine and haematologyImmunologyNeurosciencesHealth sciencesHealth services and systemsNeutrophilesLymphocytesC-reactive proteinCytokinesPlateletsPrecision psychiatryMachine learningZung rating scaleDepression<h3>Background</h3><p dir="ltr">Major depressive disorder (MDD) is characterized by significant heterogeneity in treatment response, with inflammation hypothesized to play a role in its pathophysiology. Peripheral inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP), may predict antidepressant efficacy. This study investigated the association between baseline inflammatory biomarkers, their changes, and antidepressant treatment outcomes in patients with MDD. </p><h3>Methods</h3><p dir="ltr">A prospective longitudinal cohort study in Qatar recruited 123 MDD outpatients (aged 18–64). Baseline assessments included NLR, CRP, monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR). Depression severity was measured via the Zung Self-Rating Depression Scale (ZSRS) at baseline and 12 weeks post-treatment. Statistical analyses, including multiple regression and Random Forest machine learning models, identified predictors of antidepressant response. </p><h3>Results</h3><p dir="ltr">Improvement in depressive symptoms was associated with female sex, higher mean corpuscular volume (MCV), lower absolute neutrophil count (ANC), and higher eosinophil counts. However, changes in NLR, MLR, PLR, and CRP did not predict treatment response. Folate levels and PLR were identified by the machine learning model as top predictors, suggesting potential utility as biomarkers for response classification. Our study identified predictors of improvement in suicidal ideation, including hematological markers (lower RBC, higher eosinophils, lower monocytes), younger age, female sex, medical comorbidities, and longer assessment intervals. </p><h3>Conclusion</h3><p dir="ltr">Baseline ANC and eosinophil count may help stratify MDD treatment outcomes, though post-treatment biomarker changes were not linked to symptom improvement. Our findings highlight suicidality as a distinct pathology within depression, necessitating tailored interventions. This study highlights the complexity of inflammation in depression and suicidality, emphasizing the need for advanced biomarkers utilization in precision medicine and personalized psychiatry treatment.</p><h2>Other Information</h2><p dir="ltr">Published in: Journal of Affective Disorders<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.jad.2025.119545" target="_blank">https://dx.doi.org/10.1016/j.jad.2025.119545</a></p>2025-05-31T12:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.jad.2025.119545https://figshare.com/articles/journal_contribution/Inflammatory_biomarkers_as_predictors_for_unlocking_antidepressant_efficacy_Assessing_predictive_value_and_risk_stratification_in_major_depressive_disorder_in_a_prospective_longitudinal_study/29235080CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/292350802025-05-31T12:00:00Z
spellingShingle Inflammatory biomarkers as predictors for unlocking antidepressant efficacy: Assessing predictive value and risk stratification in major depressive disorder in a prospective longitudinal study
Nervana Elbakary (21480140)
Biomedical and clinical sciences
Cardiovascular medicine and haematology
Immunology
Neurosciences
Health sciences
Health services and systems
Neutrophiles
Lymphocytes
C-reactive protein
Cytokines
Platelets
Precision psychiatry
Machine learning
Zung rating scale
Depression
status_str publishedVersion
title Inflammatory biomarkers as predictors for unlocking antidepressant efficacy: Assessing predictive value and risk stratification in major depressive disorder in a prospective longitudinal study
title_full Inflammatory biomarkers as predictors for unlocking antidepressant efficacy: Assessing predictive value and risk stratification in major depressive disorder in a prospective longitudinal study
title_fullStr Inflammatory biomarkers as predictors for unlocking antidepressant efficacy: Assessing predictive value and risk stratification in major depressive disorder in a prospective longitudinal study
title_full_unstemmed Inflammatory biomarkers as predictors for unlocking antidepressant efficacy: Assessing predictive value and risk stratification in major depressive disorder in a prospective longitudinal study
title_short Inflammatory biomarkers as predictors for unlocking antidepressant efficacy: Assessing predictive value and risk stratification in major depressive disorder in a prospective longitudinal study
title_sort Inflammatory biomarkers as predictors for unlocking antidepressant efficacy: Assessing predictive value and risk stratification in major depressive disorder in a prospective longitudinal study
topic Biomedical and clinical sciences
Cardiovascular medicine and haematology
Immunology
Neurosciences
Health sciences
Health services and systems
Neutrophiles
Lymphocytes
C-reactive protein
Cytokines
Platelets
Precision psychiatry
Machine learning
Zung rating scale
Depression