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...
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2025-06-01
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| 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 |
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| 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 |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-06-01 |
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| 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 |
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