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Neutrophil-Lymphocyte Ratio in Children with Recurrent Wheezing
Congshan Jiang1,2, Hongchuan Yu3, Wenhua Zhu1,2
1Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, PR China.
Insights
Diagnosing pediatric recurrent wheezing can be subjective. This study found that elevated neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in blood tests can help identify this condition in children.
Area of Science:
- Pediatric Pulmonology
- Clinical Diagnostics
- Biomarker Discovery
Background:
- Pediatric recurrent wheezing is common and linked to asthma risk.
- Current diagnosis relies heavily on subjective physician evaluation.
- There is a need for objective, noninvasive diagnostic markers.
Purpose of the Study:
- To investigate the diagnostic potential of blood routine test parameters, specifically neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), for pediatric recurrent wheezing.
Main Methods:
- Retrospective analysis of blood routine tests in 143 wheezing children and 137 controls.
- Measurement of total IgE in plasma via ELISA.
- Utilized Receiver Operating Characteristic (ROC) curve analysis and Youden index to determine diagnostic accuracy and cutoff values.
Main Results:
- Wheezing children showed significantly increased neutrophils and decreased lymphocytes compared to controls.
- Elevated total IgE, NLR, and PLR were observed in patients with recurrent wheezing.
- NLR (AUC=0.647) and PLR (AUC=0.628) demonstrated ability to discriminate recurrent wheezing, with calculated cutoffs.
Conclusions:
- Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) show promise as noninvasive biomarkers for diagnosing pediatric recurrent wheezing.
- These ratios offer objective metrics to supplement subjective clinical assessments.
- Further validation may establish NLR and PLR as valuable tools in pediatric respiratory diagnostics.
Abstract:
Pediatric recurrent wheezing is a common disorder with potential asthma risk; however, its diagnosis much relies on physician's subjective evaluation. Hence, efficient noninvasive biomarkers are in great need. In this retrospective study, blood routine test was analyzed in 143 wheezing children and 137 control individuals, and various cell types were discriminated and counted. Total IgE in plasma was detected using enzyme-linked immunosorbent assay. Receiver operating characteristic curve was plotted and area under curve (AUC) was calculated to evaluate the clinical potential of both indexes for diagnosing pediatric recurrent wheezing. The theoretical cutoff values for both indexes were also calculated using a Youden index. The results showed that neutrophil significantly increased in wheezing children, whereas lymphocyte decreased sharply. Total IgE, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were significantly elevated in wheezing patients. Besides, NLR and PLR were found unchanged in different genders. The results showed that NLR (AUC = 0.647) and PLR (AUC = 0.628) were able to discriminate recurrent wheezing. Cutoff for NLR was 0.98 (Youden index 24.8%) and cutoff for PLR was 116.4 (Youden index 19.4%). The mentioned evidence supported NLR and PLR as potential diagnostic indexes for pediatric recurrent wheezing.
