Differential Analysis of Hemogram Parameters and Cellular Ratios in Severe Asthma Exacerbations: A Comparative Study of Eosinophilic and Non-Eosinophilic Phenotypes

Asthma exacerbations are acute worsening episodes in individuals with bronchial asthma, frequently necessitating emergency hospital care. Early differentiation between eosinophilic (≥150 eosinophils/mm<sup>3</sup>) and non-eosinophilic (<150 eosinophils/mm<sup>3</sup>) sub...

Full description

Saved in:
Bibliographic Details
Main Authors: Nicolae Demenciuc, Corina Eugenia Budin, Corina Ureche, Mircea Stoian, Teodora Nicola-Varo, Dragos-Florin Baba, Dariana-Elena Pătrîntașu, Diana Deleanu
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Life
Subjects:
Online Access:https://www.mdpi.com/2075-1729/15/6/970
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849432258652405760
author Nicolae Demenciuc
Corina Eugenia Budin
Corina Ureche
Mircea Stoian
Teodora Nicola-Varo
Dragos-Florin Baba
Dariana-Elena Pătrîntașu
Diana Deleanu
author_facet Nicolae Demenciuc
Corina Eugenia Budin
Corina Ureche
Mircea Stoian
Teodora Nicola-Varo
Dragos-Florin Baba
Dariana-Elena Pătrîntașu
Diana Deleanu
author_sort Nicolae Demenciuc
collection DOAJ
description Asthma exacerbations are acute worsening episodes in individuals with bronchial asthma, frequently necessitating emergency hospital care. Early differentiation between eosinophilic (≥150 eosinophils/mm<sup>3</sup>) and non-eosinophilic (<150 eosinophils/mm<sup>3</sup>) subtypes plays a crucial role in treatment decisions and identifying patients eligible for biologic therapies. The ExBA Study explored variations in complete blood count (CBC) parameters and derived cellular ratios—namely the neutrophil-to-lymphocyte (NLR), thrombocyte-to-lymphocyte (TLR), and eosinophil-to-leukocyte ratios (ELR)—in adults hospitalized with severe asthma exacerbations. Ninety patients were enrolled and categorized into eosinophilic (<i>n</i> = 38) and non-eosinophilic (<i>n</i> = 52) groups. Significant statistical differences were observed in the neutrophil and lymphocyte levels, as well as in all three ratios. ROC analysis highlighted the ELR as the most specific indicator of the eosinophilic phenotype (specificity 100%, AUC 0.938, cut-off 0.003), whereas the NLR and TLR showed stronger associations with the non-eosinophilic group (AUC 0.733 and 0.676). No meaningful differences emerged regarding arterial blood gas levels, length of hospital stay, treatment costs, or mortality. A notable association was found between a personal or family history of atopy and the eosinophilic subtype (<i>p</i> = 0.0181). This study underscores the relevance of CBC-based ratios in asthma phenotyping during exacerbation events.
format Article
id doaj-art-3b3fc2dda03c4087abc78f982d3c3d14
institution Kabale University
issn 2075-1729
language English
publishDate 2025-06-01
publisher MDPI AG
record_format Article
series Life
spelling doaj-art-3b3fc2dda03c4087abc78f982d3c3d142025-08-20T03:27:25ZengMDPI AGLife2075-17292025-06-0115697010.3390/life15060970Differential Analysis of Hemogram Parameters and Cellular Ratios in Severe Asthma Exacerbations: A Comparative Study of Eosinophilic and Non-Eosinophilic PhenotypesNicolae Demenciuc0Corina Eugenia Budin1Corina Ureche2Mircea Stoian3Teodora Nicola-Varo4Dragos-Florin Baba5Dariana-Elena Pătrîntașu6Diana Deleanu7Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, RomaniaPneumology Department, Mureș Clinical County Hospital, 540098 Târgu Mureș, RomaniaSecond Internal Medical Department, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, RomaniaDepartment of Anesthesiology and Intensive Care, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, RomaniaSecond Internal Medical Department, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, RomaniaDepartmant of Cell and Molecular Biology, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, RomaniaPneumology Department, Mureș Clinical County Hospital, 540098 Târgu Mureș, RomaniaDepartment of Internal Medicine, Regional Institute of Gastroenterology (IRGH), 400394 Cluj-Napoca, RomaniaAsthma exacerbations are acute worsening episodes in individuals with bronchial asthma, frequently necessitating emergency hospital care. Early differentiation between eosinophilic (≥150 eosinophils/mm<sup>3</sup>) and non-eosinophilic (<150 eosinophils/mm<sup>3</sup>) subtypes plays a crucial role in treatment decisions and identifying patients eligible for biologic therapies. The ExBA Study explored variations in complete blood count (CBC) parameters and derived cellular ratios—namely the neutrophil-to-lymphocyte (NLR), thrombocyte-to-lymphocyte (TLR), and eosinophil-to-leukocyte ratios (ELR)—in adults hospitalized with severe asthma exacerbations. Ninety patients were enrolled and categorized into eosinophilic (<i>n</i> = 38) and non-eosinophilic (<i>n</i> = 52) groups. Significant statistical differences were observed in the neutrophil and lymphocyte levels, as well as in all three ratios. ROC analysis highlighted the ELR as the most specific indicator of the eosinophilic phenotype (specificity 100%, AUC 0.938, cut-off 0.003), whereas the NLR and TLR showed stronger associations with the non-eosinophilic group (AUC 0.733 and 0.676). No meaningful differences emerged regarding arterial blood gas levels, length of hospital stay, treatment costs, or mortality. A notable association was found between a personal or family history of atopy and the eosinophilic subtype (<i>p</i> = 0.0181). This study underscores the relevance of CBC-based ratios in asthma phenotyping during exacerbation events.https://www.mdpi.com/2075-1729/15/6/970asthmaeosinophilexacerbationneutrophil-to-lymphocyte ratiocomplete blood count
spellingShingle Nicolae Demenciuc
Corina Eugenia Budin
Corina Ureche
Mircea Stoian
Teodora Nicola-Varo
Dragos-Florin Baba
Dariana-Elena Pătrîntașu
Diana Deleanu
Differential Analysis of Hemogram Parameters and Cellular Ratios in Severe Asthma Exacerbations: A Comparative Study of Eosinophilic and Non-Eosinophilic Phenotypes
Life
asthma
eosinophil
exacerbation
neutrophil-to-lymphocyte ratio
complete blood count
title Differential Analysis of Hemogram Parameters and Cellular Ratios in Severe Asthma Exacerbations: A Comparative Study of Eosinophilic and Non-Eosinophilic Phenotypes
title_full Differential Analysis of Hemogram Parameters and Cellular Ratios in Severe Asthma Exacerbations: A Comparative Study of Eosinophilic and Non-Eosinophilic Phenotypes
title_fullStr Differential Analysis of Hemogram Parameters and Cellular Ratios in Severe Asthma Exacerbations: A Comparative Study of Eosinophilic and Non-Eosinophilic Phenotypes
title_full_unstemmed Differential Analysis of Hemogram Parameters and Cellular Ratios in Severe Asthma Exacerbations: A Comparative Study of Eosinophilic and Non-Eosinophilic Phenotypes
title_short Differential Analysis of Hemogram Parameters and Cellular Ratios in Severe Asthma Exacerbations: A Comparative Study of Eosinophilic and Non-Eosinophilic Phenotypes
title_sort differential analysis of hemogram parameters and cellular ratios in severe asthma exacerbations a comparative study of eosinophilic and non eosinophilic phenotypes
topic asthma
eosinophil
exacerbation
neutrophil-to-lymphocyte ratio
complete blood count
url https://www.mdpi.com/2075-1729/15/6/970
work_keys_str_mv AT nicolaedemenciuc differentialanalysisofhemogramparametersandcellularratiosinsevereasthmaexacerbationsacomparativestudyofeosinophilicandnoneosinophilicphenotypes
AT corinaeugeniabudin differentialanalysisofhemogramparametersandcellularratiosinsevereasthmaexacerbationsacomparativestudyofeosinophilicandnoneosinophilicphenotypes
AT corinaureche differentialanalysisofhemogramparametersandcellularratiosinsevereasthmaexacerbationsacomparativestudyofeosinophilicandnoneosinophilicphenotypes
AT mirceastoian differentialanalysisofhemogramparametersandcellularratiosinsevereasthmaexacerbationsacomparativestudyofeosinophilicandnoneosinophilicphenotypes
AT teodoranicolavaro differentialanalysisofhemogramparametersandcellularratiosinsevereasthmaexacerbationsacomparativestudyofeosinophilicandnoneosinophilicphenotypes
AT dragosflorinbaba differentialanalysisofhemogramparametersandcellularratiosinsevereasthmaexacerbationsacomparativestudyofeosinophilicandnoneosinophilicphenotypes
AT darianaelenapatrintasu differentialanalysisofhemogramparametersandcellularratiosinsevereasthmaexacerbationsacomparativestudyofeosinophilicandnoneosinophilicphenotypes
AT dianadeleanu differentialanalysisofhemogramparametersandcellularratiosinsevereasthmaexacerbationsacomparativestudyofeosinophilicandnoneosinophilicphenotypes