bekhterevОбозрение психиатрии и медицинской психологии имени В.М.БехтереваV.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY2313-70532713-055XV. M. BEKHTEREV NATIONAL RESEARCH MEDICAL CENTER FOR PSYCHIATRY AND NEUROLOGY OF THE RUSSIAN FEDERATION MINISTRY OF HEALTH10.31363/2313-7053-2025-3-1088bekhterev-1167Research ArticleПРОБЛЕМНЫЕ СТАТЬИPROBLEM-S0LVING ARTICLESРоль системного воспаления в патогенезе гиперкинетического расстройстваThe role of systemic inflammation in the pathogenesis of hyperkinetic disorderhttps://orcid.org/0000-0002-3045-333XГасановР. Ф.GasanovR. F.

Гасанов Рауф Фаикович — к.м.н., ведущий научный сотрудник отделения детской психиатрии НМИЦ ПН им. В.М. Бехтерева.

192019, Санкт-Петербург, ул. Бехтерева, 3

Rauf F. Gasanov.

Saint Petersburg

raufgasanov@mail.ruhttps://orcid.org/0000-0003-0176-3846МакаровИ. В.MakarovI. V.

Макаров Игорь Владимирович — д.м.н., профессор, руководитель отделения детской психиатрии НМИЦ ПН им. В.М. Бехтерева.

192019, Санкт-Петербург, ул. Бехтерева, 3

Igor V. Makarov.

Saint Petersburg

ppsy@list.ruhttps://orcid.org/0000-0002-8189-1479ЕмелинаД. А.EmelinaD. A.

Емелина Дарья Андреевна — к.м.н., старший научный сотрудник отделения детской психиатрии НМИЦ ПН им. В.М. Бехтерева.

192019, Санкт-Петербург, ул. Бехтерева, 3

Daria A. Emelina.

Saint Petersburg

dashaberkos@mail.ruhttps://orcid.org/0000-0002-0175-2453КравченкоИ. В.KravchenkoI. V.

Кравченко Илья Владимирович — к.м.н., старший научный сотрудник отделения детской психиатрии НМИЦ ПН им. В.М. Бехтерева.

192019, Санкт-Петербург, ул. Бехтерева, 3

Ilya V. Kravchenko.

Saint Petersburg

bambrs@mail.ruhttps://orcid.org/0000-0002-3867-548XПрохоренкоЕ. С.ProkhorenkoE. S.

Прохоренко Екатерина Сергеевна — младший научный сотрудник отделения детской психиатрии НМИЦ ПН им. В.М. Бехтерева.

192019, Санкт-Петербург, ул. Бехтерева, 3

Ekaterina S. Prokhorenko.

Saint Petersburg

fabulakati@gmail.comНациональный медицинский исследовательский центр психиатрии и неврологии им. В.М. БехтереваРоссияV.M. Bekhterev National Medical Research Center for Psychiatry and NeurologyRussian Federation202525092025593813Copyright © Гасанов Р.Ф., Макаров И.В., Емелина Д.А., Кравченко И.В., Прохоренко Е.С., 20252025Гасанов Р.Ф., Макаров И.В., Емелина Д.А., Кравченко И.В., Прохоренко Е.С.Gasanov R.F., Makarov I.V., Emelina D.A., Kravchenko I.V., Prokhorenko E.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bekhterevreview.com/jour/article/view/1167

Гиперкинетическое расстройство (ГР) относится к частым психическим заболеваниям детского возраста и достигает 5% популяции. В последние годы обсуждается вопрос о важной роли системного воспаления в патогенезе ГР. Считается, что уровень нейтрофилов, лимфоцитов, тромбоцитов и моноцитов, а также их отношения, могут служить маркерами системного воспаления при ГР. Однако вопрос о специфичности полученных данных остается открытым в связи с недостаточностью данных. Недостаточно исследованной остается именно специфичность маркеров нейровоспаления и системного воспаления, а также их связь с выраженностью гиперкинетического расстройства. Настоящие вопросы требуют уточнения в будущих исследованиях с исключением фоновой резидуально-органической патологии головного мозга, воспалительных и аутоиммунных заболеваний, а также при сравнении пациентов с ГР не только со здоровыми участниками исследования, но и с пациентами, страдающими другими психическими расстройствами.

Hyperkinetic disorder (HD) is a common mental disorder in children and affects 5% of the population. In recent years, the important role of systemic inflammation in the pathogenesis of HD has been discussed. It is believed that the level of neutrophils, lymphocytes, platelets and monocytes, as well as their ratios, can serve as markers of systemic inflammation in HD. However, the question of the specificity of the data obtained remains open due to insufficient data. The specificity of markers of neuroinflammation and systemic inflammation, levels of hyperkinetic disorder remains insufficiently studied, which requires clarification in future studies with the exclusion of background residual organic pathology of the brain, inflammatory and autoimmune diseases in comparison not only with a group of healthy controls, but also with a group of patients with other mental disorders.

гиперкинетическое расстройствосистемное воспалениеинтерлейкиныклеточное соотношениедепрессиявоспалениебиомаркерhyperkinetic disordersystemic inflammationinterleukinscellular ratiodepressioninflammationbiomarkerСтатья выполнена в рамках государственного задания ФГБУ «НМИЦ ПН им. В.М. Бехтерева» Минздрава России 2024-2026 гг. (XSOZ 2024 0012).The article was performed within the framework of the state assignment of the «V.M. Bekhterev National Research Medical Center for Psychiatry and Neurology of the Ministry of Health of Russia» 2024-2026 (XSOZ 2024 0012)ReferencesАндрюков Б.Г., Богданова В.Д., Ляпун И.Н. Фенотипическая гетерогенность нейтрофилов: новые антимикробные характеристики и диагностические технологии. Гематология и трансфузиология. 2019;64(2):211-221. https://doi.org/10.35754/0234-5730-2019-64-2-211-221.Andryukov BG, Bogdanova VD, Lyapun IN. Phenotypic heterogeneity of neutrophils: new antimicrobial characteristics and diagnostic technologies. Gematologiya i transfuziologiya. 2019;64(2):211-221. (In Russ.). https://doi.org/10.35754/0234-5730-2019-64-2-211-221.Гасанов Р.Ф., Макаров И.В., Емелина Д.А., Автенюк А.С. Нейровоспаление и его роль в патогенезе синдрома дефицита внимания с гиперактивностью (обзор литературы). Обозрение психиатрии и медицинской психологии им. В.М. Бехтерева. 2023;57(1):8-22. http//doi.org/10.31363/2313-7053-2023-699.Gasanov RF, Makarov IV, Emelina DA, Avtenuk AS. Neuroinflammation and its role in the pathogenesis of attention deficit hyperactivity disorder (literature review). Obozrenie psihiatrii i medicinskoj psihologii im. V.M. Bekhtereva. 2023;57(1):8-22. (In Russ.). http//doi.org/10.31363/2313-7053-2023-699.Девойно Л.В., Идова Г.В., Альперина Е.Л., Чейдо М.А., Геворгян М.М., Давыдова С.М. Системные мозговые механизмы нейроиммуномодуляции: психоэмоциональный вклад. Сибирский научный медицинский журнал. 2004;2:90–97.Devojno LV, Idova GV, Al’perina EL, Chejdo MA, Gevorgyan MM, Davydova SM. Systemic brain mechanisms of neuroimmunomodulation: psychoemotional contribution. Sibirskij nauchnyj medicinskij zhurnal. 2004;2:90–97. (In Russ.).Емелина Д.А., Кравченко И.В., Макаров И.В., Гасанов Р.Ф., Прохоренко Е.С. Роль системного воспаления в развитии психических расстройств у детей: обзор литературы. Вопросы современной педиатрии. 2024;23(4):204-212. https://doi.org/10.15690/vsp.v23i4.2780.Emelina DA, Kravchenko IV, Makarov IV., Gasanov RF., Prokhorenko E.S. The Role of Systemic Inflammation in Psychiatric Disorders Development in Children: Literature Review. Voprosy sovremennoj pediatrii. 2024;23(4):204-212. (In Russ.). https://doi.org/10.15690/vsp.v23i4.2780.Железникова Г.Ф., Скрипченко Н.В. Иммунопатогенез инфекционно-воспалительных заболеваний центральной нервной системы. Журнал инфектологии. 2011;2:28–32.Zheleznikova GF, Skripchenko NV. Immunopathogenesis of infectious and inflammatory diseases of the central nervous system. Zhurnal infektologii. 2011;2:28–32. (In Russ.).Карчевская А.Е., Паюшина О.В., Шарова Е.В., Окнина Л.Б., Титов О.Ю. Нейровоспаление как процесс вторичного повреждения при черепно-мозговой травме. Анналы клинической и экспериментальной неврологии. 2023;17(1):55–68. https://doi.org/10.54101/ACEN.2023.1.7.Karchevskaya AE, Payushina OV, Sharova EV, Oknina LB, Titov OY. Neuroinflammation as secondary damage in head injury. Annaly klinicheskoj i eksperimental’noj nevrologii. 2023;17(1):55-68. (In Russ.). https://doi.org/10.54101/ACEN.2023.1.7.Селянина Н.В., Каракулова Ю.В. Взаимодействие серотонина и цитокинов в патогенезе ушиба головного мозга. Фундаментальные исследования. 2013;7:638–641.Selyanina NV, Karakulova YUV. Interaction of serotonin and cytokines in the pathogenesis of brain contusion. Fundamental’nye issledovaniya. 2013;7:638–641. (In Russ.).Ставинская О.А. Серотониновая депривация как фактор регуляции иммунологической реактивности. Экология человека. 2008;1:22–25.Stavinskaya OA. Serotonin deprivation as a factor in the regulation of immunological reactivity. Ekologiya cheloveka. 2008;1:22–25. (In Russ.).Сумливая О.Н. Взаимосвязь изменений серотонина и цитокинов у больных клещевым энцефалитом. Пермский медицинский журнал. 2015;32(4):68-73.Sumlivaya ON. Correlation between serotonin and cytokine changes in patients with tick-borne encephalitis. Permskij medicinskij zhurnal. 2015;32(4):68-73. (In Russ.).Banks WA. Blood-brain barrier transport of cytokines: a mechanism for neuropathology. Curr. Pharm. Des. 2005;8:973–984.Banks WA. Blood-brain barrier transport of cytokines: a mechanism for neuropathology. Curr. Pharm. Des. 2005;8:973–984.Bonilla FC, Oettgen HC. Adaptive immunity. J Allergy Clin Immunol. 2010;125:33-40. https://doi.org/10.1016/j.jaci.2009.09.017.Bonilla FC, Oettgen HC. Adaptive immunity. J Allergy Clin Immunol. 2010;125:33-40. https://doi.org/10.1016/j.jaci.2009.09.017.Cheng Y, Wang Y, Wang X, Jiang Z, Zhu L, Fang S. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio in depression: an updated systematic review and meta-analysis. Front Psychiatry. 2022;13:893097. https://doi.org/10.3389/fpsyt.2022.893097.Cheng Y, Wang Y, Wang X, Jiang Z, Zhu L, Fang S. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio in depression: an updated systematic review and meta-analysis. Front Psychiatry. 2022;13:893097. https://doi.org/10.3389/fpsyt.2022.893097.Corominas-Roso M, Armario A, Palomar G, Corrales M, Carrasco J, Richarte V, et al. IL-6 and TNF-α in unmedicated adults with ADHD: relationship to cortisol awakening response. Psychoneuroendocrinology. 2017;79:67–73. https://doi.org/10.1016/j.psyneuen.2017.02.017.Corominas-Roso M, Armario A, Palomar G, Corrales M, Carrasco J, Richarte V, et al. IL-6 and TNF-α in unmedicated adults with ADHD: relationship to cortisol awakening response. Psychoneuroendocrinology. 2017;79:67–73. https://doi.org/10.1016/j.psyneuen.2017.02.017.Darwish A, Elgohary T, Nosair N. Serum Interleukin-6 level in children with Attention-Deficit Hyperactivity Disorder (ADHD). J Child Neurol. 2019;34:61–7. https://doi.org/10.1177/0883073818809831.Darwish A, Elgohary T, Nosair N. Serum Interleukin-6 level in children with Attention-Deficit Hyperactivity Disorder (ADHD). J Child Neurol. 2019;34:61–7. https://doi.org/10.1177/0883073818809831.Donfrancesco R, Nativio P, Borrelli E, Giua E, Andriola E, Villa MP, et al. Serum cytokines in pediatric neuropsychiatric syndromes: focus on Attention deficit hyperactivity disorder. Minerva Pediatr. 2021;73:398–404. https://doi.org/10.23736/S2724-5276.16.04642-9.Donfrancesco R, Nativio P, Borrelli E, Giua E, Andriola E, Villa MP, et al. Serum cytokines in pediatric neuropsychiatric syndromes: focus on Attention deficit hyperactivity disorder. Minerva Pediatr. 2021;73:398–404. https://doi.org/10.23736/S2724-5276.16.04642-9.Dunn G, Nigg J, Sullivan E. Neuroinflammation as a risk factor for attention deficit hyperactivity disorder. Pharmacol Biochem Behav. 2019;182:22–34.Dunn G, Nigg J, Sullivan E. Neuroinflammation as a risk factor for attention deficit hyperactivity disorder. Pharmacol Biochem Behav. 2019;182:22–34.Erre GL, Paliogiannis P, Castagna F, Mangoni AA, Carru C, Passiu G, et al. Meta-analysis of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio in rheumatoid arthritis. Eur J Clin Invest. 2019;49:e13037. https://doi.org/10.1111/eci.13037.Erre GL, Paliogiannis P, Castagna F, Mangoni AA, Carru C, Passiu G, et al. Meta-analysis of neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio in rheumatoid arthritis. Eur J Clin Invest. 2019;49:e13037. https://doi.org/10.1111/eci.13037.Gędek A, Modrzejewski S, Gędek M, Antosik AZ, Mierzejewski P and Dominiak M. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and monocyte to lymphocyte ratio in ADHD: a systematic review and meta-analysis. Front. Psychiatry. 2023;14:1258868. https://doi.org/10.3389/fpsyt.2023.1258868.Gędek A, Modrzejewski S, Gędek M, Antosik AZ, Mierzejewski P and Dominiak M. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and monocyte to lymphocyte ratio in ADHD: a systematic review and meta-analysis. Front. Psychiatry. 2023;14:1258868. https://doi.org/10.3389/fpsyt.2023.1258868.Germic N, Frangez Z, Yousefi S, Simon H-U. Regulation of the innate immune system by autophagy: monocytes, macrophages, dendritic cells and antigen presentation. Cell Death Differ. 2019;26:715–27. https://doi.org/10.1038/s41418-019-0297-6.Germic N, Frangez Z, Yousefi S, Simon H-U. Regulation of the innate immune system by autophagy: monocytes, macrophages, dendritic cells and antigen presentation. Cell Death Differ. 2019;26:715–27. https://doi.org/10.1038/s41418-019-0297-6.Instanes J, Halmøy A, Engeland A, Haavik J, Furu K, Klungsøyr K. Attention-deficit/hyperactivity disorder in offspring of mothers with inflammatory and immune system diseases. Biol Psychiatry. 2017;81:452–9. https://doi.org/10.1016/j.biopsych.2015.11.024.Instanes J, Halmøy A, Engeland A, Haavik J, Furu K, Klungsøyr K. Attention-deficit/hyperactivity disorder in offspring of mothers with inflammatory and immune system diseases. Biol Psychiatry. 2017;81:452–9. https://doi.org/10.1016/j.biopsych.2015.11.024.Koupenova M, Clancy L, Corkrey HA, Freedman JE. Circulating platelets as mediators of immunity, inflammation, and thrombosis. Circ Res. 2018;122:337–51. https://doi.org/10.1161/CIRCRESAHA.117.310795.Koupenova M, Clancy L, Corkrey HA, Freedman JE. Circulating platelets as mediators of immunity, inflammation, and thrombosis. Circ Res. 2018;122:337–51. https://doi.org/10.1161/CIRCRESAHA.117.310795.Li B, Concepcion K, Meng X, Zhang L. Brain-immune interactions in perinatal hypoxic-ischemic brain injury. Prog Neurobiol. 2017;159:50-68. https://doi.org/10.1016/j.pneurobio.2017.10.006.Li B, Concepcion K, Meng X, Zhang L. Brain-immune interactions in perinatal hypoxic-ischemic brain injury. Prog Neurobiol. 2017;159:50-68. https://doi.org/10.1016/j.pneurobio.2017.10.006.Liew PX, Kubes P. The neutrophil’s role during health and disease. Physiol Rev. 2019;99:1223–48. https://doi.org/10.1152/physrev.00012.2018.Liew PX, Kubes P. The neutrophil’s role during health and disease. Physiol Rev. 2019;99:1223–48. https://doi.org/10.1152/physrev.00012.2018.Lin Y, Chen Y, Gau S, Yeh T, Fan H, Hwang Y, et al. Associations between allergic diseases and attention deficit hyperactivity/oppositional defiant disorders in children. Pediatr Res. 2016;80:480–5. https://doi.org/10.1038/pr.2016.111.Lin Y, Chen Y, Gau S, Yeh T, Fan H, Hwang Y, et al. Associations between allergic diseases and attention deficit hyperactivity/oppositional defiant disorders in children. Pediatr Res. 2016;80:480–5. https://doi.org/10.1038/pr.2016.111.Mayadas TN, Cullere X, Lowell CA. The multifaceted functions of neutrophils. Annu Rev Pathol. 2014; 9:181–218. https://doi.org/10.1146/annurev-pathol-020712-164023.Mayadas TN, Cullere X, Lowell CA. The multifaceted functions of neutrophils. Annu Rev Pathol. 2014; 9:181–218. https://doi.org/10.1146/annurev-pathol-020712-164023.Mazza MG, Lucchi S, Rossetti A, Clerici M. Neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio and platelet-lymphocyte ratio in non-affective psychosis: a meta-analysis and systematic review. World J Biol Psychiatry. 2020;21:326–38. https://doi.org/10.1080/15622975.2019.1583371.Mazza MG, Lucchi S, Rossetti A, Clerici M. Neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio and platelet-lymphocyte ratio in non-affective psychosis: a meta-analysis and systematic review. World J Biol Psychiatry. 2020;21:326–38. https://doi.org/10.1080/15622975.2019.1583371.Mazza MG, Lucchi S, Tringali AGM, Rossetti A, Botti ER, Clerici M. Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in mood disorders: a meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry. 2018;84:229–36. https://doi.org/10.1016/j.pnpbp.2018.03.012.Mazza MG, Lucchi S, Tringali AGM, Rossetti A, Botti ER, Clerici M. Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in mood disorders: a meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry. 2018;84:229–36. https://doi.org/10.1016/j.pnpbp.2018.03.012.Mihai A, Caruntu A, Opris-Belinski D, Jurcut C, Dima A, Caruntu C, et al. The predictive role of Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Monocytes-to-Lymphocyte Ratio (MLR) and gammaglobulins for the development of cutaneous vasculitis lesions in Primary Sjögren’s syndrome. J Clin Med. 2022;11:5525. https://doi.org/10.3390/jcm11195525.Mihai A, Caruntu A, Opris-Belinski D, Jurcut C, Dima A, Caruntu C, et al. The predictive role of Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Monocytes-to-Lymphocyte Ratio (MLR) and gammaglobulins for the development of cutaneous vasculitis lesions in Primary Sjögren’s syndrome. J Clin Med. 2022;11:5525. https://doi.org/10.3390/jcm11195525.Molina-Carballo A, Naranjo-Gómez A, Uberos J, Justicia-Martínez F, Ruiz-Ramos MJ, Cubero-Millán I, Contreras-Chova F, Augustin-Morales MD, Khaldy-Belkadi H, Muñoz-Hoyos A. Methylphenidate effects on blood serotonin and melatonin levels may help to synchronise biological rhythms in children with ADHD. J Psychiatr Res. 2013;47(3):377-83. https://doi.org/10.1016/j.jpsychires.2012.09.020.Molina-Carballo A, Naranjo-Gómez A, Uberos J, Justicia-Martínez F, Ruiz-Ramos MJ, Cubero-Millán I, Contreras-Chova F, Augustin-Morales MD, Khaldy-Belkadi H, Muñoz-Hoyos A. Methylphenidate effects on blood serotonin and melatonin levels may help to synchronise biological rhythms in children with ADHD. J Psychiatr Res. 2013;47(3):377-83. https://doi.org/10.1016/j.jpsychires.2012.09.020.Oades RD, Dauvermann MR, Schimmelmann BG, Schwarz MJ, Myint A-M. Attention-deficit hyperactivity disorder (ADHD) and glial integrity: S100B, cytokines and kynurenine metabolism–effects of medication. Behav Brain Funct. 2010;6:29. https://doi.org/10.1186/1744-9081-6-29.Oades RD, Dauvermann MR, Schimmelmann BG, Schwarz MJ, Myint A-M. Attention-deficit hyperactivity disorder (ADHD) and glial integrity: S100B, cytokines and kynurenine metabolism–effects of medication. Behav Brain Funct. 2010;6:29. https://doi.org/10.1186/1744-9081-6-29.Qun S, Tang Y, Sun J, Liu Z, Wu J, Zhang J, et al. Neutrophil-to-lymphocyte ratio predicts 3-month outcome of acute ischemic stroke. Neurotox Res. 2017;31:444–52. https://doi.org/10.1007/s12640-017-9707-z.Qun S, Tang Y, Sun J, Liu Z, Wu J, Zhang J, et al. Neutrophil-to-lymphocyte ratio predicts 3-month outcome of acute ischemic stroke. Neurotox Res. 2017;31:444–52. https://doi.org/10.1007/s12640-017-9707-z.Ramos-Quiroga JA, Corominas-Roso M, Palomar G, Ferrer R, Valero S, Corrales M, et al. Cortisol awakening response in adults with attention deficit hyperactivity disorder: subtype differences and association with the emotional lability. Eur Neuropsychopharmacol. 2016;26:1140–9. https://doi.org/10.1016/j.euroneuro.2016.03.014.Ramos-Quiroga JA, Corominas-Roso M, Palomar G, Ferrer R, Valero S, Corrales M, et al. Cortisol awakening response in adults with attention deficit hyperactivity disorder: subtype differences and association with the emotional lability. Eur Neuropsychopharmacol. 2016;26:1140–9. https://doi.org/10.1016/j.euroneuro.2016.03.014.Saccaro L, Schilliger Z, Perroud N, Piguet C. Inflammation, anxiety, and stress in attention-deficit/ hyperactivity disorder. Biomedicines. 2021;9:1313. https://doi.org/10.3390/biomedicines9101313.Saccaro L, Schilliger Z, Perroud N, Piguet C. Inflammation, anxiety, and stress in attention-deficit/ hyperactivity disorder. Biomedicines. 2021;9:1313. https://doi.org/10.3390/biomedicines9101313.Su M, Ouyang X, Song Y. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and monocyte to lymphocyte ratio in depression: {A} meta-analysis. J Affect Disord. 2022;308:375–83. https://doi.org/10.1016/j.jad.2022.04.038.Su M, Ouyang X, Song Y. Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and monocyte to lymphocyte ratio in depression: {A} meta-analysis. J Affect Disord. 2022;308:375–83. https://doi.org/10.1016/j.jad.2022.04.038.Urbanowicz T, Olasińska-Wiśniewska A, Michalak M, Rodzki M, Witkowska A, Straburzyńska-Migaj E, et al. The prognostic significance of neutrophil to Lymphocyte Ratio (NLR), Monocyte to Lymphocyte Ratio (MLR) and Platelet to Lymphocyte Ratio (PLR) on Long-Term Survival in Off-Pump Coronary Artery Bypass Grafting (OPCAB) procedures. Biology. 2021;11:34. https://doi.org/10.3390/biology11010034.Urbanowicz T, Olasińska-Wiśniewska A, Michalak M, Rodzki M, Witkowska A, Straburzyńska-Migaj E, et al. The prognostic significance of neutrophil to Lymphocyte Ratio (NLR), Monocyte to Lymphocyte Ratio (MLR) and Platelet to Lymphocyte Ratio (PLR) on Long-Term Survival in Off-Pump Coronary Artery Bypass Grafting (OPCAB) procedures. Biology. 2021;11:34. https://doi.org/10.3390/biology11010034.Wohleb ES, Fenn AM, Pacenta AM, Powell ND, Sheridan JF, Godbout JP. Peripheral innate immune challenge exaggerated microglia activation, increased the number of inflammatory CNS macrophages, and prolonged social withdrawal in socially defeated mice. Psychoneuroendocrinology. 2012;37:1491–505. https://doi.org/10.1016/j.psyneuen.2012.02.003.Wohleb ES, Fenn AM, Pacenta AM, Powell ND, Sheridan JF, Godbout JP. Peripheral innate immune challenge exaggerated microglia activation, increased the number of inflammatory CNS macrophages, and prolonged social withdrawal in socially defeated mice. Psychoneuroendocrinology. 2012;37:1491–505. https://doi.org/10.1016/j.psyneuen.2012.02.003.

The authors declare that there are no conflicts of interest present.