Neutrophil/Lymphocyte Ratio as a Biomarker of Response to H1-Antihistamine Therapy in Patients with Chronic Spontaneous Urticaria

Backgrounds A large proportion of patients with chronic spontaneous urticaria (CSU) are resistant to a standard dose of antihistamine. Acknowledged biomarkers for identifying these patients have not been determined. The neutrophil/lymphocyte ratio (NLR) has been considered as an important indicator...

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Main Authors: Xiaonan Qiu, Qiao Ran, Juanjuan Pan, Guozhen Tan
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-11-01
Series:Indian Journal of Dermatology
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Online Access:https://journals.lww.com/10.4103/ijd.ijd_558_22
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author Xiaonan Qiu
Qiao Ran
Juanjuan Pan
Guozhen Tan
author_facet Xiaonan Qiu
Qiao Ran
Juanjuan Pan
Guozhen Tan
author_sort Xiaonan Qiu
collection DOAJ
description Backgrounds A large proportion of patients with chronic spontaneous urticaria (CSU) are resistant to a standard dose of antihistamine. Acknowledged biomarkers for identifying these patients have not been determined. The neutrophil/lymphocyte ratio (NLR) has been considered as an important indicator of inflammation in chronic diseases. Aims To explore whether NLR could serve as a biomarker for predicting the response to H1-antihistamine in patients with CSU. Methods This hospital-based, retrospective study included 109 patients with CSU diagnosed from 2017 to 2020 in our clinic and divided them into two groups by their responses to the 2-week antihistamine therapy of standard-dose: 69 with H1-antihistamine-refractory and 40 with non-H1-antihistamine-refractory CSU. The laboratory test results were collected from the hospital information system and integrated with SPSS software. Results Patients refractory to H1-antihistamine had significantly higher median NLR (P = 0.039), age (3 P = 0.021), complement C3 (P = 0.026), presence of elevated WBC (P = 0.026) and elevated monocytes (MONO) (P = 0.045) and significantly lower IgM (P = 0.022). The binary logistic regression model revealed that NLR was significantly associated with H1-antihistamine-refractory of CSU (odds ratio (OR) 1.717, 95% confidence interval (CI) 1.065–2.766, P = 0.026), which was consistent with that after adjusted for potential confounding factors including age, complement C3, presence of elevated WBC and MONO, and IgM (OR 1.681, 95% CI 1.019–2.773, P = 0.042). Conclusion Our results showed a strong and significant association between higher NLR and H1-antihistamine resistance in CSU, suggesting that NLR may be a potential biomarker for predicting the response to H1-antihistamine therapy in patients with CSU.
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spelling doaj-art-a0c59cd468b94302ade2a6eadedb004e2025-08-20T02:18:57ZengWolters Kluwer Medknow PublicationsIndian Journal of Dermatology0019-51541998-36112024-11-0169536737010.4103/ijd.ijd_558_22Neutrophil/Lymphocyte Ratio as a Biomarker of Response to H1-Antihistamine Therapy in Patients with Chronic Spontaneous UrticariaXiaonan QiuQiao RanJuanjuan PanGuozhen TanBackgrounds A large proportion of patients with chronic spontaneous urticaria (CSU) are resistant to a standard dose of antihistamine. Acknowledged biomarkers for identifying these patients have not been determined. The neutrophil/lymphocyte ratio (NLR) has been considered as an important indicator of inflammation in chronic diseases. Aims To explore whether NLR could serve as a biomarker for predicting the response to H1-antihistamine in patients with CSU. Methods This hospital-based, retrospective study included 109 patients with CSU diagnosed from 2017 to 2020 in our clinic and divided them into two groups by their responses to the 2-week antihistamine therapy of standard-dose: 69 with H1-antihistamine-refractory and 40 with non-H1-antihistamine-refractory CSU. The laboratory test results were collected from the hospital information system and integrated with SPSS software. Results Patients refractory to H1-antihistamine had significantly higher median NLR (P = 0.039), age (3 P = 0.021), complement C3 (P = 0.026), presence of elevated WBC (P = 0.026) and elevated monocytes (MONO) (P = 0.045) and significantly lower IgM (P = 0.022). The binary logistic regression model revealed that NLR was significantly associated with H1-antihistamine-refractory of CSU (odds ratio (OR) 1.717, 95% confidence interval (CI) 1.065–2.766, P = 0.026), which was consistent with that after adjusted for potential confounding factors including age, complement C3, presence of elevated WBC and MONO, and IgM (OR 1.681, 95% CI 1.019–2.773, P = 0.042). Conclusion Our results showed a strong and significant association between higher NLR and H1-antihistamine resistance in CSU, suggesting that NLR may be a potential biomarker for predicting the response to H1-antihistamine therapy in patients with CSU.https://journals.lww.com/10.4103/ijd.ijd_558_22biomarkercsuh1-antihistaminerefractoryneutrophil/lymphocyte ratio
spellingShingle Xiaonan Qiu
Qiao Ran
Juanjuan Pan
Guozhen Tan
Neutrophil/Lymphocyte Ratio as a Biomarker of Response to H1-Antihistamine Therapy in Patients with Chronic Spontaneous Urticaria
Indian Journal of Dermatology
biomarker
csu
h1-antihistamine
refractory
neutrophil/lymphocyte ratio
title Neutrophil/Lymphocyte Ratio as a Biomarker of Response to H1-Antihistamine Therapy in Patients with Chronic Spontaneous Urticaria
title_full Neutrophil/Lymphocyte Ratio as a Biomarker of Response to H1-Antihistamine Therapy in Patients with Chronic Spontaneous Urticaria
title_fullStr Neutrophil/Lymphocyte Ratio as a Biomarker of Response to H1-Antihistamine Therapy in Patients with Chronic Spontaneous Urticaria
title_full_unstemmed Neutrophil/Lymphocyte Ratio as a Biomarker of Response to H1-Antihistamine Therapy in Patients with Chronic Spontaneous Urticaria
title_short Neutrophil/Lymphocyte Ratio as a Biomarker of Response to H1-Antihistamine Therapy in Patients with Chronic Spontaneous Urticaria
title_sort neutrophil lymphocyte ratio as a biomarker of response to h1 antihistamine therapy in patients with chronic spontaneous urticaria
topic biomarker
csu
h1-antihistamine
refractory
neutrophil/lymphocyte ratio
url https://journals.lww.com/10.4103/ijd.ijd_558_22
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AT qiaoran neutrophillymphocyteratioasabiomarkerofresponsetoh1antihistaminetherapyinpatientswithchronicspontaneousurticaria
AT juanjuanpan neutrophillymphocyteratioasabiomarkerofresponsetoh1antihistaminetherapyinpatientswithchronicspontaneousurticaria
AT guozhentan neutrophillymphocyteratioasabiomarkerofresponsetoh1antihistaminetherapyinpatientswithchronicspontaneousurticaria