Recurrent Wheezing in Preschoolers: Association Between Peripheral Blood Cell-Derived Inflammatory Indexes and the Asthma Predictive

Yıl 2025, Cilt: 35 Sayı: 4, 605 - 612, 29.08.2025

Yahya Gül , Ahmet Kan , Tuğba Güler

https://doi.org/10.54005/geneltip.1628227

Öz

Objective: The current study aimed to determine the role of chronic and eosinophilic inflammation in the etiopathogenesis of recurrent wheezing in preschool children and to evaluate the relationship between these inflammatory parameters and the Modified Asthma Predictive Index (mAPI) in positive and negative groups.
Materials and Methods: The study included patients under six years old who presented with recurrent wheezing complaints to pediatric immunology and allergy clinics between September 2022 and September 2023 and had not yet started asthma treatment. Demographic data such as age, gender, atopy history, and smoking exposure, along with complete blood count, total IgE levels, and aeroallergen sensitivity, were analyzed. Patients were categorized into two groups based on mAPI positivity and negativity.
Results: The mAPI-positive group had significantly higher eosinophil count (p=0.004), eosinophil percentage (p=0.034), eosinophil/lymphocyte ratio (p=0.01), eosinophil/neutrophil ratio (p=0.007), and eosinophil/monocyte ratio (p<0.001). A significant positive correlation was found between basophil and eosinophil counts (p=0.001, r=0.31). No statistical differences were observed between groups regarding hospitalization rates, oral corticosteroid use, or emergency visits.
Conclusion: Our study demonstrated that hematological parameters indicative of eosinophilic inflammation were significantly elevated in the mAPI-positive preschool children with recurrent wheezing. Additionally, basophils may play a role in chronic inflammation alongside eosinophils. Larger cohort studies are needed to further investigate the asthma risk in this patient population.

Anahtar Kelimeler

Recurrent wheezing , preschool children , asthma predictive index , inflammation

Okul Öncesi Çocuklarda Tekrarlayan Hışıltı: Periferik Kan Hücrelerinden Elde Edilen İnflamatuvar İndekslerin Astım Prediktif İndeksi ile İlişkisi

Öz

Amaç: Mevcut çalışma okul öncesi çocuklarda tekrarlayan hışıltının etiyopatogenezinde kronik ve eozinofilik inflamasyonun rolünü belirlemek ve bu inflamatuvar parametrelerin Modifiye Astım Prediktif İndeksi (mAPI) pozitif ve negatif gruplar arasındaki ilişkisini değerlendirmeyi hedefledi.
Gereç ve Yöntem: Çalışmaya, Eylül 2022 - Eylül 2023 tarihleri arasında çocuk immünoloji ve alerji polikliniklerine tekrarlayan hışıltı şikayeti ile başvuran, altı yaşından küçük, astım için herhangi bir tedaviye yeni başlayan hastalar dahil edildi. Hastaların yaş, cinsiyet, atopi öyküsü, sigara maruziyeti gibi demografik verileri ile tam kan sayımı, total IgE düzeyleri ve aeroalerjen duyarlılığı analiz edildi. Hastalar, modifiye astım prediktif indeksi pozitif ve negatif olmak üzere iki gruba ayrıldı.
Bulgular: mAPI pozitif grupta, eozinofil sayısı (p=0.004), eozinofil yüzdesi (p=0.034), eozinofil/lenfosit oranı (p=0.01), eozinofil/nötrofil oranı (p=0.007) ve eozinofil/monosit oranı (p<0.001) anlamlı derecede yüksek bulundu. Basofil sayısı ile eozinofil sayısı arasında anlamlı pozitif korelasyon saptandı (p=0.001, r=0.31). Gruplar arasında hastaneye yatış oranları, oral kortikosteroid kullanımı ve acil başvurular açısından istatistiksel fark bulunmadı.
Sonuç: Çalışmamızda, okul öncesi tekrarlayan hışıltılı çocuklarda, mAPI pozitif grupta eozinofilik inflamasyonu gösteren hematolojik parametrelerin belirgin şekilde yüksek olduğu tespit edildi. Ayrıca, bazofillerin de kronik inflamasyonda eozinofillerle birlikte rol oynayabileceği gözlemlendi. Astım riski yüksek olan bu hasta grubunda daha büyük çaplı kohort çalışmalarına ihtiyaç duyulmaktadır.

Anahtar Kelimeler

Tekrarlayan hışıltı , okul öncesi çocuklar , astım prediktif indeksi , inflamasyon

Kaynakça

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