Tracking Systemic Inflammation in Allergic Rhinitis with Immune-Inflammation Markers

Allergic rhinitis (AR) is an inflammatory disorder of the nasal mucosa in allergen-sensitized individuals. Beyond local inflammation, AR also promotes systemic inflammatory responses. This study aimed to evaluate biomarkers reflecting systemic inflammation like neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), pan-immune-inflammation value (PIV), and serum SCUBE levels in the diagnosis and treatment monitoring of AR.

In this prospective, controlled study, 88 patients with AR and 50 healthy controls were enrolled. All AR patients received nasal corticosteroid (NCS) therapy; however, only 42 patients returned for follow-up. Symptom severity was assessed using the Visual Analogue Scale (VAS) and the Control of Allergic Rhinitis and Asthma Test (CARAT). Laboratory measurements included NLR, PLR, SII, PIV, and serum SCUBE1 and SCUBE2 levels. Intergroup and pre-posttreatment comparisons were performed.

Compared with controls, AR patients exhibited significantly higher PLR, SII, and PIV values (p < 0.05 for all), whereas SCUBE1 or SCUBE2 levels showed no difference. Following treatment, significant clinical improvement was observed in VAS and CARAT scores (p < 0.001). In addition, NLR, PLR, and SII values significantly decreased compared with baseline (p < 0.05 for all). The area under the curve values were 0.655 (95% CI: 0.562-0.747) for PIV, 0.611 (95% CI: 0.512-0.711) for SII, and 0.607 (95% CI: 0.512-0.702) for PLR.

PLR, SII, and PIV were significantly elevated in patients with AR, while NLR, PLR, and SII improved following 1 month of NCS therapy. These findings highlight that the systemic inflammatory burden of AR should not be underestimated and suggest that novel, easily accessible biomarkers such as SII and PIV may provide additional value in the assessment and monitoring of inflammation in AR.