Do Peripheral Blood Inflammation Indices Differ Among Schizophrenia Patients with Clozapine Treatment? A cross-secfional investigation.

Background/Aims: There remains a need to investigate alternative pathophysiological processes in schizophrenia such as neuroinflammatory processes. We aimed to compare blood count levels, with a particular focus on peripheral blood inflammatory cell levels, among three distinct groups of participants: schizophrenia patients taking clozapine, schizophrenia patients taking antipsychotics other than clozapine, and healthy controls. We also evaluated the relationship between these findings and clinical characteristics. Methods: The SC group included 47, the SA group included 61 patients and the HC group included 65 healthy controls. The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-lymphocyte ratio (MLR) were calculated by dividing the respective cell counts from white blood cell count (WBC). The relationship between these measures and clinical characteristics are done with the Positive and Negative Syndrome Scale (PANSS). Results: WBC counts were significantly higher in the SC group than in the SA and HC groups. The log transformed NLR (LnNLR) was significantly higher in the SC group than the HC group and SA group, but there were no difference between the the SA and HC groups. LnNLR was significantly correlated with PANSS positive, general and total scores, but not significantly correlated with PANNS negative score. LnNLR was significantly different between groups after adjusting for age and gender using ANCOVA. Conclusions: The current study sheds light on the potential immunological alterations associated with schizophrenia and its treatment with clozapine. The elevated NLR in individuals receiving clozapine treatment underscores the need for further research to elucidate the underlying mechanisms and clinical implications of this observation.