Monocyte eosinophil ratio and red blood cell distribution width in the diagnosis of asthma

Objective: Bronchial asthma is often associated with chronic airway inflammation and airway hyperresponsiveness in which many cells and mediators are involved. Pulmonary function tests (PFTs) are used in the diagnosis of the disease. Yet PFTs are not available in every healthcare institution or some of the patients cannot cooperate with the procedure. The aim of this study was to determine whether mean platelet volume (MPV), platelet distribution width (PDW), monocyte lymphocyte ratio (MLR), monocyte eosinophil ratio (MER), and platelet lymphocyte ratio (PLR) can be used in the diagnosis of bronchial asthma. Method: Two hundred and twelve patients who were diagnosed with bronchial asthma according to the Global Initiative for Asthma (GINA) criteria and 187 patients who were deemed not to have asthma were included in the study. Two patient groups were compared by examining the hemogram parameters at the time of diagnosis or exclusion of asthma. Results: The levels of MPV, neutrophil-lymphocyte ratio (NLR), and PLR were significantly lower in the Asthma group (p <0.001, 0.005, and 0.002 respectively) while the lymphocyte, eosinophil, monocyte, basophil, PDW, MLR, and MER levels were higher in the same group. On ROC analysis areas under the curve (AUC) for RDW, MER, and PDW were found as 0.81, 0.93, and 0.76 respectively. Conclusion: In conclusion, higher lymphocyte, eosinophil, PDW, MLR, and MER whereas lower levels of MPV, NLR and PLR support the diagnosis of asthma

Keywords:

Asthma, Red Cell Distribution Width Monocyte, Eosinophil,

PDF

___

https:// GIfAGGsfamapUAf, ginasthma.org/gina-reports/. Global initiative for asthma (GINA). Global strategy for asthma management and prevention (Update 2020). Available from: https://ginasthma.org/gina-reports/. 2020.
Tarraf H, Aydin O, Mungan D, Albader M, Mahboub B, Doble A et al. Prevalence of asthma among the adult general population of five Middle Eastern countries: results of the SNAPSHOT program. BMC Pulm Med 2018;18(1):68. https://doi.org/10.1186/s12890-018-0621-9
Sekerel BE, Gemicioglu B, Soriano JB. Asthma insights and reality in Turkey (AIRET) study. Respir Med 2006;100(10):1850-1854. https://doi.org/10.1016/j.rmed.2006.01.024
Koç İ, Doğan Y, Dökme A, Kaya A, Karataş ZA, Mandollu E et al. Assessment of mean platelet volumes and platelet distribution width in patients with bronchiectasis. Ankara Med J 2015; 5(1):16-20. https://doi.org/10.17098/amj.69742
Gisondi P, Geat D, Lippi G, Montagnana M, Girolomoni G. Increased red blood cell distribution width in patients with plaque psoriasis. J Med Biochem 2021;40(2):199-201. https://doi.org/10.5937/jomb0-27237
Lorente L, Martin MM, Argueso M, Sole-Violan J, Perez A, Marcos YRJA et al. Association between red blood cell distribution width and mortality of COVID-19 patients. Anaesth Crit Care Pain Med 2021;40(1):100777. https://doi.org/10.1016/j.accpm.2020.10.013
Vega-Robledo GB, Rico-Rosillo MG. Senescence of the immune system and alterations related with asthma. Revista alergia Mexico.2017;64(2):206-219. https://doi.org/10.29262/ram.v64i2.264
Buhl R, Humbert M, Bjermer L, Chanez P, Heaney LG, Pavord I et al. Expert group of the European consensus meeting for severe eosinophilic A. Severe eosinophilic asthma: a roadmap to consensus. Eur Respir J 2017; 49(5). https://doi.org/10.1183/13993003.00634-2017
Muscari A, Puddu GM, Cenni A, Silvestri MG, Giuzio R, Rosati M et al. Mean platelet volume (MPV) increase during acute non-lacunar ischemic strokes. Thromb Res 2009; 23(4):587-591. https://doi.org/10.1016/j.thromres.2008.03.025
Gasparyan AY, Sandoo A, Stavropoulos-Kalinoglou A, Kitas GD. Mean platelet volume in patients with rheumatoid arthritis: the effect of anti-TNF-alpha therapy. Rheumatol Int 2010; 30(8):1125-1129. https://doi.org/10.1007/s00296-009-1345-1
Sun WX, Zhang JR, Cao ZG, Li Y, Wang RT. A decreased mean platelet volume is associated with stable and exacerbated asthma. Respiration 2014;88(1):31-37. https://doi.org/10.1159/000360296
Gunbatar H, Sertogullarindan B, Ekin S, Akdag S, Arisoy A, Sayhan H. The correlation between red blood cell distribution width levels with the severity of obstructive sleep apnea and carotid intima media thickness. Med Sci Monit; 20:2199-2204. https://doi.org/ 891001 [pii]10.12659/MSM.891001
Koç İ, Karataş ZA, Mandollu E, Mermer A, Kaya A, Dökme A, et al. Importance of mean platelet volume in patients with chronic obstructive pulmonary disease. Gaziantep Med J 2014;20(4):294-298. https://doi.org/10.5455/GMJ-30-154104
Ulucan S, Keser A, Kaya Z, Katlandur H, Ozdil H, Bilgi M et al. Association between PDW and long term major adverse cardiac events in patients with acute coronary syndrome. Heart Lung Circ 2016;25(1):29-34. https://doi.org/10.1016/j.hlc.2015.05.017
Barnes PJ. COPD and Asthma: Effects beyond the respiratory system. Tanaffos;11(3):9.
Gomez-Rial J, Curras-Tuala MJ, Rivero-Calle I, Gomez-Carballa A, Cebey-Lopez M, Rodriguez-Tenreiro C et al. Increased Serum Levels of sCD14 and sCD163 Indicate a preponderant role for monocytes in COVID-19 Immunopathology. Front Immunol 2020; 11:560381. https://doi.org/10.3389/fimmu.2020.560381
Zhang D, Guo R, Lei L, Liu H, Wang Y, Wang Y et al. COVID-19 infection induces readily detectable morphological and inflammation-related phenotypic changes in peripheral blood monocytes, the severity of which correlate with patient outcome. 2020:2020.2003.2024.20042655. https://doi.org/10.1101/2020.03.24.20042655
Zhi Y, Gao P, Li W, Gao F, Zhang J, Lin H et al. Soluble CD163 Levels and CD163+CD14+ monocyte/macrophage counts in patients with asthma. Iran J Immunol 2018;15(3):239-245. https://doi.org/10.22034/IJI.2018.39393
Seyit M, Avci E, Nar R, Senol H, Yilmaz A, Ozen M et al. Neutrophil to lymphocyte ratio, lymphocyte to monocyte ratio and platelet to lymphocyte ratio to predict the severity of COVID-19. Am J Emerg Med 2021; 40:110-114. https://doi.org/10.1016/j.ajem.2020.11.058
Qin B, Ma N, Tang Q, Wei T, Yang M, Fu H et al. Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were useful markers in assessment of inflammatory response and disease activity in SLE patients. Mod Rheumatol 2016; 26(3):372-376. https://doi.org/10.3109/14397595.2015.1091136
Yenigun A, Sezen S, Calim OF, Ozturan O. Evaluation of the eosinophil-to-lymphocyte ratio in pediatric patients with allergic rhinitis. Am J Rhinol Allergy 2016; 30(2):e21-25. https://doi.org/10.2500/ajra.2016.30.4296