Relationship Between Allergen Sensitivity, Laboratory Values, and Inflammatory Markers in Patients with Asthma and/or Allergic Rhinitis

Öz

Objective: This study aimed to examine the clinical value of inflammation-related markers in pediatric asthma and to explore how these parameters are associated with the development of allergic conditions. Methods: In this retrospective analysis, 2028 children diagnosed with asthma (0–18 years) who were evaluated at the Pediatric Allergy and Immunology Clinic, Umraniye Training and Research Hospital, University of Health Sciences, between January 1, 2023, and January 1, 2024, were included. Information regarding demographic features, clinical asthma findings, coexisting allergic rhinitis, medications, allergen sensitization profiles, and laboratory data—such as complete blood count parameters, serum total IgE levels, and skin prick test outcomes—was extracted from medical records. Inflammation-related hematologic ratios, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammation response index (SIRI), were computed. All statistical procedures were conducted using SPSS software (version 25.0). Results: Of the 2028 patients, 64.3% were diagnosed with AR, and 39.9% showed allergen sensitization, predominantly to house dust mite, cat dander, and pollen. Patients with allergen sensitization exhibited significantly higher total IgE, eosinophil counts, and inflammatory indices. Those with AR also had elevated IgE and eosinophil levels, with higher inflammatory indices (p < 0.001). Conclusion: Asthma frequently coexists with allergic rhinitis in children. Sensitization to common allergens is common, and inflammatory markers such as total IgE, eosinophil count, NLR, SIRI, and PLR may serve as useful indicators of disease severity and allergic inflammation. These parameters may contribute to more effective evaluation and management of pediatric asthma.

Anahtar Kelimeler

• Asthma; Allergic rhinitis
• Allergen sensitization; NLR; PLR; ELR
• SIRI; PIV; Inflammatory hematologic indices; Pediatrics

Astım ve Alerjik Rinitli Hastalarda Alerjen Duyarlılığı, Laboratuvar Değerleri ve İnflamatuar Belirteçler Arasındaki İlişki

Öz

Amaç: Bu çalışma, pediatrik astımda inflamasyona bağlı belirteçlerin klinik değerini incelemeyi ve bu parametrelerin alerjik durumların gelişimiyle ilişkisini değerlendirmeyi amaçlamıştır. Yöntemler: Bu retrospektif analizde, 1 Ocak 2023 – 1 Ocak 2024 tarihleri arasında Sağlık Bilimleri Üniversitesi Ümraniye Eğitim ve Araştırma Hastanesi Çocuk Alerji ve İmmünoloji Kliniği’nde değerlendirilen, astım tanılı 0–18 yaş arası 2028 çocuk çalışmaya dâhil edildi. Tıbbi kayıtlardan demografik özellikler, astımın klinik bulguları, eşlik eden alerjik rinit varlığı, kullanılan ilaçlar, alerjen duyarlılık profilleri ve hem tam kan sayımı parametreleri, serum total IgE düzeyleri ile deri prik testi sonuçlarını içeren laboratuvar verileri elde edildi. İnflamasyonla ilişkili hematolojik oranlar—nötrofil/lenfosit oranı (NLR), trombosit/lenfosit oranı (PLR) ve sistemik inflamasyon yanıt indeksi (SIRI) hesaplandı. Tüm istatistiksel analizler SPSS 25.0 yazılımı ile gerçekleştirildi. Bulgular: Çalışmaya dâhil edilen 2028 hastanın %64,3’ünde alerjik rinit (AR) saptandı; %39,9’unda ise alerjen duyarlılığı mevcuttu. En sık saptanan duyarlılıklar ev tozu akarı, kedi epiteli ve polen alerjenlerine karşıydı. Alerjen duyarlılığı olan hastalarda total IgE düzeyleri, eozinofil sayıları ve inflamatuar indeksler belirgin olarak daha yüksekti. Alerjik rinitli çocuklarda da IgE ve eozinofil düzeyleri artmış olup inflamatuar indekslerde anlamlı yükselmeler mevcuttu (p < 0.001). Sonuç: Çocuklarda astım sıklıkla alerjik rinit ile birlikte görülmektedir. Yaygın inhalan alerjenlere duyarlılık oldukça yaygındır ve total IgE, eozinofil sayısı, NLR, SIRI ve PLR gibi inflamatuar belirteçler hastalığın şiddeti ve alerjik inflamasyon hakkında değerli bilgiler sunabilir. Bu parametreler, pediatrik astımın daha etkili değerlendirilmesine ve yönetimine katkı sağlayabilir.

Anahtar Kelimeler

• Astım; Alerjik rinit; Alerjen duyarlılığı;
• NLR; PLR; ELR; SIRI; PIV
• İnflamatuvar hematolojik indeksler; Pediatri

Kaynakça

1. 1.Global Initiative for Asthma. Global strategy forasthma management and prevention: 2024 GINAmain report. Fontana (WI): Global Initiative forAsthma; 2024. Available from: https://ginasthma.org
2. 2.Akar-Ghibril N, Casale T, Custovic A, et al. Allergicendotypes and phenotypes of asthma. J Allergy ClinImmunol Pract 2020; 8: 429-40.
3. 3.Turkish Thoracic Society. Asthma diagnosis andtreatment guide. 2016.
4. 4.Bruunsgaard H, Pedersen BK. Age-relatedinflammatory cytokines and disease. ImmunolAllergy Clin North Am 2003 ;23 :15–39.
5. 5.Fu JJ, McDonald VM, Gibson PG, et al. Systemicinflammation in older adults with asthma–COPDoverlap syndrome. Allergy Asthma Immunol Res.2014; 6: 316–24.
6. 6.Pekkanen J, Lampi J, Genuneit J, Hartikainen AL,Jarvelin MR. Analyzing atopic and non-atopicasthma. Eur J Epidemiol. 2012;27:281–6.
7. 7.Jiang Y, Ma W. Assessment of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratioin atopic dermatitis patients. Med Sci Monit 2017;23: 1340–6.
8. 8.Dogru M, Citli R. The neutrophil-lymphocyte ratioin children with atopic dermatitis: a case-controlstudy. Clin Ter. 2017; 168: e262–5.

9. 9.Dogru M, Evcimik MF, Cirik AA. Is neutrophil-lymphocyte ratio associated with the severity ofallergic rhinitis in children? Eur ArchOtorhinolaryngol. 2016; 273: 3175–8.
10. 10.Selcuk A, Keren M. The evaluation of eosinophil-to-lymphocyte, eosinophil-to-neutrophil, andneutrophil-to-lymphocyte ratios in adults withallergic/non-allergic rhinitis. Gulhane Med J. 2023;65: 51–5.
11. 11. Ay S, Civelek E, Guvenir H, et al. Evaluation of skin test results for children with asthma alone or withallergic rhinitis. Turk J Pediatr Dis. 2017; 11: 153–8.
12. 12.Bicakci A, Altunoglu MK, Bilisik A, et al.Atmospheric pollens of Turkey. Asthma AllergyImmunol. 2009; 7: 11–17.
13. 13.Gutiérrez-Pérez IA, Buendía-Roldán I, Pérez-Rubio G, et al. Outcome predictors in COVID-19: ananalysis of emergent systemic inflammation indicesin Mexican population. Front Med 2022; 9: 1000147.
14. 14. Aydogan S, Dilli D, Soysal C, et al. Role of systemicimmune inflammatory index in early diagnosis ofsepsis in newborns with CHD. Cardiol Young. 2022;32: 1826–32.
15. 15.Wang P, Guo X, Zhou Y, et al. Monocyte-to-HDLratio and systemic inflammation response index areassociated with the risk of metabolic disorders andcardiovascular diseases in the rural population.Front Endocrinol (Lausanne). 2022; 13: 944991.
16. 16.Guven DC, Sahin TK, Erul E, et al. Associationbetween the pan-immune-inflammation value and cancer prognosis: a systematic review and meta-analysis. Cancers (Basel). 2022; 14: 2675.
17. 17.Atla P, Yılmaz A, Demir B, et al. Evaluation ofparents’ knowledge levels about the causes ofallergic asthma and their approaches to treatment.Zeynep Kamil Med Bull 2020; 51: 88–92.
18. 18.Bousquet J, Khaltaev N, Cruz AA, et al. AllergicRhinitis and its Impact on Asthma (ARIA) 2008update. Allergy 2008;63(Suppl 86): 8–160.
19. 19.Canitez Y, Cekic S. Investigation of sensitivity totree pollen allergens in children diagnosed withallergic asthma in the Bursa region. Curr Pediatr.2021; 19: 67–75.
20. 20.Akcal O, Atakul G. Evaluation of aeroallergensensitivity in atopic children living in the Marmararegion. Osmangazi Med J 2024; 46: 775–80.
21. 21.Sayar EH. Aeroallergen sensitivity of atopicchildren in Alanya region. Selcuk Med J 2020; 36(3)
22. 22. Sogutlu Y, Altas U. Predictive value of neutrophil-to-lymphocyte ratio and other inflammation indicesin febrile seizures in children. J Clin Med 2024; 13:5330.
23. 23.Altas U, Tunce E, Altas ZM, et al. Retrospectiveinvestigation of the relationship between clinicaland laboratory parameters and allergy tests inchildren with allergic rhinitis. Arch Curr Med Res 2023; 4(3): 146-52.
24. 24.Sharma M, Khaitan T, Raman S, et al.Determination of serum IgE and eosinophils asdiagnostic indicators in allergic rhinitis. Indian JOtolaryngol Head Neck Surg 2019; 71: 1957–61.
25. 25.Khanzadeh M, Foroughi Nematollahi S, ShavakhiM, et al. Prognostic role of neutrophil-to-lymphocyteratio in allergic rhinitis: a systematic review andmeta-analysis. Indian J Otolaryngol Head Neck Surg2024; 76: 1389–97.
26. 26.Cansever M, Sari N. Association of allergicrhinitis severity with neutrophil-lymphocyte andplatelet-lymphocyte ratio in children. North ClinIstanb. 2022; 9: 602–9.
27. 27.Pantea M, Iacob D, Dima M, et al. Predictive valueof inflammatory markers (NLR, PLR, APRI, SII, andliver function tests) in detecting systemicinflammatory response syndrome in full-termnewborns. Children (Basel). 2024; 11: 593.
28. 28.Alkaya H, Altaş U, Çevik S, et al. Evaluation ofhemogram parameters in patients with atopicdermatitis. J Controv Obstet Gynecol Pediatr 2025;3: 27-31.