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      The effect of peripheral blood eosinophilia on inflammatory markers in asthmatic patients with lower respiratory tract infections

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          Abstract

          Background

          To investigate the behaviour of the inflammatory marker neutrophil-to-lymphocyte ratio (NLR) in the presence of peripheral blood eosinophilia (PBE) in paediatric asthma patients with lower respiratory tract (LRT) infections.

          Methods

          This retrospective study enrolled consecutive patients aged ≥5 years who were diagnosed with asthma and whose haemogram values were available. The patients were further subdivided based on the presence or absence of LRT infections and allergies. NLR and C-reactive protein (CRP) were evaluated in relation to the presence or absence of PBE (≥4% eosinophils).

          Results

          A total of 991 patients were enrolled in the study. Patients with LRT infections had significantly higher leucocyte and neutrophil counts, a greater NLR and a higher level of CRP compared with patients without LRT infections. Overall, patients with PBE had significantly lower NLRs and CRP regardless of the presence or absence of an LRT infection. The PBE percentage showed moderate inverse correlations with NLR ( r = −0.34) and CRP ( r = −0.20).

          Conclusion

          The presence of PBE was significantly associated with lower NLR and CRP regardless of the presence or absence of an infectious condition.

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          Neutrophil-to-lymphocyte ratio in chronic obstructive pulmonary disease: a retrospective study.

          Ersin Günay, Sevinc Sarinc Ulasli, Olcay Akar … (2014)
          Chronic obstructive pulmonary disease (COPD) is a common chronic inflammatory disease of the lung with a high mortality and morbidity rate. Some of the inflammatory markers such as C-reactive protein (CRP), leukocyte count are associated with COPD. In this study, we aimed to evaluate the role of neutrophil-to-lymphocyte ratio (NLR) in COPD patients comparing with the other well-known inflammatory markers. We retrospectively enrolled the laboratory results of 269 COPD patients of which 178 patients at stable period and 91 patients during acute exacerbation and 50 sex- and age- matched healthy controls. We found that NLR values of the stable COPD patients were significantly higher than those of the controls (P < 0.001). During acute exacerbation of the disease there was a further increase compared to stable period (P < 0.001). NLR values were also positively correlated with serum CRP levels and red cell distribution width (RDW) and negatively correlated with mean platelet volume (MPV) in both COPD groups. In conclusion, NLR could be considered as a new inflammatory marker for assessment of inflammation in COPD patients with its quick, cheap, easily measurable property with routine complete blood count analysis.
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            Full blood count parameters for the detection of asthma inflammatory phenotypes.

            X. Zhang, Philippa Simpson, Lynda H. Powell … (2014)
            In asthma, the airway inflammatory phenotype influences clinical characteristics and treatment response. Although induced sputum is the gold standard test for phenotyping asthma, a more accessible method is needed for clinical practice.
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              The utility of inflammatory markers to predict readmissions and mortality in COPD cases with or without eosinophilia

              Dildar Duman, Emine Aksoy, Meltem Agca … (2015)
              Background COPD exacerbations requiring hospitalization increase morbidity and mortality. Although most COPD exacerbations are neutrophilic, approximately 10%–25% of exacerbations are eosinophilic. Aim We aimed to evaluate mortality and outcomes of eosinophilic and non-eosinophilic COPD exacerbations and identify new biomarkers that predict survival. Methods A retrospective observational cohort study was carried out in a tertiary teaching hospital from January 1, 2014 to November 1, 2014. All COPD patients hospitalized with exacerbations were enrolled in the study at their initial hospitalization and followed-up for 6 months after discharge. Electronic data were collected from the hospital database. Subjects’ characteristics, hemogram parameters, CRP levels, neutrophil-to-lymphocyte ratio (NLR), platelet-to-mean platelet volume ratio on admission and discharge, length of hospital stay (days), readmissions, and mortality were recorded. Patients were grouped according to peripheral blood eosinophil (PBE) levels: Group 1, >2% PBE, eosinophilic; Group 2, non-eosinophilic ≤2%. Patient survival after hospital discharge was evaluated by Kaplan–Meier survival analysis. Results A total of 1,704 patients hospitalized with COPD exacerbation were included. Approximately 20% were classified as eosinophilic. Six-month mortality was similar in eosinophilic and non-eosinophilic groups (14.2% and 15.2%, respectively); however, the hospital stay length and readmission rate were longer and higher in the non-eosinophilic group (P<0.001 and P<0.01, respectively). CRP and NLR were significantly higher in the non-eosinophilic group (both P<0.01). The platelet-to-mean platelet volume ratio was not different between the two groups. Cox regression analysis showed that survival was negatively influenced by elevated CRP (P<0.035) and NLR (P<0.001) in the non-eosinophilic group. Conclusion Non-eosinophilic patients with COPD exacerbations with high CRP and NLR values had worse outcomes than eosinophilic patients. PBE and NLR can be helpful markers to guide treatment decisions.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Int Med Res
                Journal ID (iso-abbrev): J. Int. Med. Res
                Journal ID (publisher-id): IMR
                Journal ID (hwp): spimr
                Title: The Journal of International Medical Research
                Publisher: SAGE Publications (Sage UK: London, England )
                ISSN (Print): 0300-0605
                ISSN (Electronic): 1473-2300
                Publication date (Electronic): 21 April 2019
                Publication date (Print): June 2019
                Volume: 47
                Issue: 6
                Pages: 2452-2460
                Affiliations
                [1 ]Department of Paediatrics, University of Health Sciences Kartal Dr. Lutfi Kirdar Training and Research Hospital, Istanbul, Turkey
                [2 ]Department of Paediatric Pulmonology, Health Sciences Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
                [3 ]Department of Paediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
                [4 ]Department of Paediatric Pulmonology, Medical Faculty, Maltepe University, Istanbul, Turkey
                Author notes
                [*]Yakup Cag, Department of Paediatrics, University of Health Sciences Kartal Dr. Lutfi Kirdar Training and Research Hospital, Cevizli mah., Semsi Denizer cad., Kartal, Istanbul 34865, Turkey. Email: yakupcag@ 123456hotmail.com
                Author information
                https://orcid.org/0000-0002-3855-7280
                https://orcid.org/0000-0003-0697-4271
                Article
                Publisher ID: 10.1177_0300060519844859
                DOI: 10.1177/0300060519844859
                PMC ID: 6567716
                PubMed ID: 31006357
                SO-VID: ac99b65f-4bc3-4ef0-bd21-35e7e41c4ae3
                Copyright © © The Author(s) 2019
                License:

                Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Date received : 11 October 2018
                Date accepted : 28 March 2019
                Categories
                Subject: Clinical Research Reports

                Keywords: lower respiratory tract infection,peripheral blood eosinophilia,allergic asthma,neutrophil-to-lymphocyte ratio
                Data availability:
                Keywords: lower respiratory tract infection, peripheral blood eosinophilia, allergic asthma, neutrophil-to-lymphocyte ratio

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