Müberra KULU, Filiz ÖZSOY, Bahadır DEMİR

Alkol ve madde kullanım bozukluğu tanılı hastalarda inflamasyon düzeyleri

Amaç: Bu çalışmada amaç; alkol kullanım bozukluğu (AKB) ve madde kullanım bozukluğu (MKB) tanısı konulan iki ayrı hasta grubunun inflamasyon belirteçlerini sağlıklı kontroller ve birbirleri ile karşılaştırarak incelemektir. Gereç ve Yöntem: Çalışmamıza 159 kişi (100 kişi hasta grubu ve 59 kişi kontrol grubu olarak) alındı. Tüm katılımcıların demografik verileri bir form halinde yazıldı ve laboratuvar parametreleri tam kan sayımı ile değerlendirildi. Bulgular: MKB tanılı hastaların; 24’ü (%48) esrar, 26’sı (%52) sentetik kannabinoid kullanıyordu. Her iki hasta grubunda da hemoglobin, hematokrit, RDW-standart sapma olarak değeri (RDW-SD), ortalama platelet hacmi (MPV) değeri sağlıklı kontrollerden yüksek idi. Platelet değeri AKB hastalarında diğer iki gruptan düşük iken, eritrosit değeri MKB hastalarında diğer iki gruptan yüksek idi. Sonuç: Hem AMKB patofizyolojisinde bazı inflamatuvar parametrelerinin etkili olabileceği düşünülmüştür. Ayrıca bu parametrelerdeki değişikliklere bağlı olarak oluşabilecek spontan kanama, enfeksiyon hastalıklarına yatkınlık gibi komplikasyonlar da hem hastaların değerlendirilmeleri hem de tedavi planlamalarında göz önüne alınmalıdır.

Anahtar Kelimeler:

Alkol kullanım bozukluğu, esrar, sentetik kannabinoid, inflamasyon, nötrofil/lenfosit oranları, platelet/lenfosit oranları, monosit lenfosit oranı.

Inflammation levels in patients with alcohol and substance use disorders

Purpose: The aim of this study was to analyse the inflammation indicators of two patients, which were diagnosed with alcohol use disorder(AUD), and substance use disorder(SUD), with each other as well as with the healthy control group. Materials and Methods: A group of 159 people (100 patient, 59 healthy control) have been included in the study. All participants have been applied a demographical data form and laboratory parameters have been evaluated with complete blood cell count. Results: Among the patients diagnosed with SUD, 24 (%48) cannabis while 26 (%52) used synthetic cannabinoid. In both patient groups the values of haemoglobin, haematocrit, RDW-standard deviation value (RDW-SD), main platelet volume (MPV) was tested to be higher than that of the healthy control groups. While the platelet value of AUD patients was lower than the two other groups, erythrocyte value of SUD patients was higher than the two other groups. Conclusion: Some inflammatory parameters could affect ASUD pathophysiology. In addition, complications such as spontaneous bleeding and susceptibility to infectious diseases that may occur due to changes in these parameters should be kept in mind during both in treatment planning and the development of symptoms.

Keywords:

Alcohol use disorder, cannabis, synthetic cannabinoid, inflammation,

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1. Harris MG, Bharat C, Glantz MD, Sampson NA, Al Hamzawi A, Alonso J et al. World Health Organization's World Mental Health Surveys collaborators. Cross‐national patterns of substance use disorder treatment and associations with mental disorder comorbidity in the WHO World Mental Health Surveys. Addiction. 2019;114:1446-59.
2. Degenhardt L, Glantz M, Evans Lacko S, Sadikova E, Sampson N, Thornicroft G et al. Estimating treatment coverage for people with substance use disorders: an analysis of data from the World Mental Health Surveys. World Psychiatry. 2017;16:299-307.
3. World Health Organization and Research for International Tobacco Control. WHO report on the global burden of disease: 2008 update. Geneva, World Health Organization, 2008.
4. Whiteford HA, Ferrari AJ, Degenhardt L, Feigin V, Vos T. The global burden of mental, neurological and substance use disorders: an analysis from the Global Burden of Disease Study 2010. PloS One. 2015;10:e0116820.
5. Prom-Wormley EC, Ebejer J, Dick DM, Bowers MS. The genetic epidemiology of substance use disorder: a review. Drug Alcohol Depend. 2017;180:241-59.
6. Jaffe JH, Anthony JC. Substance-related disorders: introduction and overview. In Kaplan and Sadock’s Comprehensive Texbook of Psychiatry, 8th ed. (Eds HI Sadock, VA Sadock): Philadelphia, Lippincott Williams and Wilkins. 2005;1137-67.
7. Hasin DS, O’Brein CP, Auriacombe M et al. DSM-5 criteria for substance use disorders: recommendations and rationale. Am J Psychiatry. 2013;170:834-51.
8. Annette–Akgür S. Esrar ve Kannabinoidler. Bağımlılık yapan maddeler ve toksikoloji kitabı. Editör, Akgür SA, Coşkunol H. İzmir, Ege Üniversitesi. 2014;85-96.
9. Volkow ND, Fowler JS, Wang GJ, Baler R, Telang F. Imaging dopamine’s role in drug abuse and addiction. Neuropharmacology. 2009;56:3-8.
10. Müller N. Inflammation in schizophrenia: pathogenetic aspects and therapeutic considerations. Schizophr Bull. 2018;44:973-82.
11. Muneer A. Bipolar disorder: role of inflammation and the development of disease biomarkers. Psychiatry Investig. 2016;13:18-33.
12. Michopoulos V, Powers A, Gillespie CF, Ressler KJ, Jovanovic T. Inflammation in fear- and anxiety-based disorders: PTSD, GAD, and beyond. Neuropsychopharmacol. 2017;42:254-70.
13. Sunbul M, Gerin F, Durmus E, Kivrak T, Sari I, Tigen K et al. Neutrophil to lymphocyte and platelet to lymphocyte ratio in patients with dipper versus nondipper hypertension. Clin Exp Hypertens. 2014;36:217-21.
14. Orum MH, Kara MZ, Egilmez OB. Mean platelet volume and neutrophil to lymphocyte ratio as parameters to indicate the severity of suicide attempt. J Immunoassay Immunochem. 2018;39:647- 59.
15. Özdin S, Sarisoy G, Böke Ö. A comparison of the neutrophil-lymphocyte, platelet-lymphocyte and monocyte-lymphocyte ratios in schizophrenia and bipolar disorder patients–a retrospective file review. Nord J Psychiatry. 2017;71:509-12.
16. Soder HE, Berumen AM, Gomez KE, Green CE, Suchting R, Wardle MC et al. Elevated neutrophil to lymphocyte ratio in older adults with cocaine use disorder as a marker of chronic inflammation. Clin Psychopharmacol Neurosci. 2020;18:32.
17. Demir B, Kocamer Sahin S, Ozsoy F, Altindag A, Elboga G. Neutrophil-lymphocyte ratio and plateletlymphocyte ratio in methamphetamine use disorder. Psychiatr Clin Psychopharmacol. 2021;31:34-39.
18. Omar YA, Randhawa T, Attar B, Agrawal R, Wang Y, Richardo R et al. Prognostic value of neutrophillymphocyte ratio in patients with severe alcoholic hepatitis. Cureus. 2019;11:e6141.
19. Cıcek E, Demırel B, Cıcek IE, Kıraç AS, Eren I. Increased neutrophil-lymphocyte and plateletlymphocyte ratios in male heroin addicts: a prospective controlled study. Clin Psychopharmacol Neurosci. 2018;16:190.
20. Orum MH, Kara MZ. Monocyte-to-lymphocyte ratio and platelet-to-lymphocyte ratio in opioid use disorder and marijuana use disorder. Dusunen Adam. 2020;33:139-45.
21. Orum MH, Kara MZ. Platelet to lymphocyte ratio (PLR) in alcohol use disorder. J Immunoassay Immunochem. 2020;41:184-94.
22. Ballard HS. Alcohol, bone marrow, and blood. Alcohol Health Res World. 1993;17:310-15.
23. Guzel D, YaziciAB, Yazici E, Erol A. Alterations of the hematologic cells in synthetic cannabinoid users. J Clin Lab Anal. 2017;31:e22131.
24. Ozkan N, Sonmez MB, Durmus PT, Gorgulu Y, Çınar RK, Vardar ME. Elevated neutrophil lymphocyte ratio in patients with substance use disorders. Eur Psychiatry. 2017;41:872-73.
25. Nand N, Malhotra P, Dhoot DK. Clinical profile of alcoholic liver disease in a tertiary care centre and its correlation with type, amount and duration of alcohol consumption. J Assoc Physician India. 2015;63:14-20.
26. Fern Romero J, Velasco G, Tol Ramos JA, Guzm. Cannabinoid CB 2 receptor: a new target for controlling neural cell survival? Trends Pharmacol Sci. 2007;28:39-45.
27. Pertwee RG, Howlett AC, Abood ME, Alexander SPH, Di Marzo V, Elphick MR et al. International Union of Basic and Clinical Pharmacology. LXXIX. Cannabinoid receptors and their ligands: beyond CB1 and CB2. Pharmacol Rev. 2010; 62:588-31.
28. Gurdal F, Asirdizer M, Aker RG, Korkut S, Gocer Y, Kucukibrahimoglu EE et al. Review of detection frequency and type of synthetic cannabinoids in herbal compounds analyzed by Istanbul Narcotic Department of the Council of Forensic Medicine, Turkey. J Forensic Leg Med. 2013;20:667-72.
29. Nakanishi N, Yoshida H, Okamoto M, Matsuo Y, Suzuki K, Tatara K. Association of Alcohol Consumption with White Blood Cell Count: A Study of Japanese Male Office Workers. J Intern Med. 2003;253:367-74.
30. Castaneira G, Rojas K, Galili Y, Field Z, Perez-Perez A, Madruga M et al. Idiopathic thrombocytopenic purpura induced by synthetic cannabinoid. J Addict Med. 2019;13:235-36.
31. Brantl SA, Khandoga AL, Siess W. Mechanism of platelet activation induced by endocannabinoids in blood and plasma. Platelets. 2014;5:151-61.
32. De Angelis V, Koekman AC, Weeterings C, Roest M, de Groot PG, Herczenik E et al. Endocannabinoids control platelet activation and limit aggregate formation under flow. PLoS One. 2014;9:e108282.
33. Liu L, Chen M, Zhao L, Zhao Q, Hu R, Zhu J et al. Ethanol induces platelet apoptosis. Alcohol Clin Exp Res. 2017;41:291-98.
34. Grigorian A, Gambhir S, Al-Khouja L, Gabriel V, Schubl SD, Nastanski F et al. Decreased incidence of venous thromboembolism found in trauma patients with positive blood alcohol concentration on admission. Am J Drug Alcohol Abuse. 2019;45:77-83.
35. Baykara S, Kaya Ş, Berk SS. Complete blood count parameters and lymphocyte-related ratios in patients with alcohol use disorder. J Addict Depend. 2019;20:206-13.
36. Gül IG, Eryılmaz G, Özten E, Sayar GH. Decreased mean platelet volume in panic disorder. Neuropsychiatric Dis Treat. 2014;10:1665.
37. Ransing RS, Patil B, Grigo O. Mean platelet volume and platelet distribution width level in patients with panic disorder. J Neurosci Rural Pract. 2017;8:174.