Systemic Inflammatory Indices as Predictors of Treatment Response in Allergic Rhinitis: A Prospective 6 Month Cohort...

Area of Science:

• Immunology
• Hematology
• Allergy and Clinical Immunology

Background:

• Allergic rhinitis (AR) is increasingly viewed as a systemic inflammatory condition.
• Objective biomarkers for predicting treatment outcomes in AR are limited, despite common use of symptom scores.
• Systemic inflammatory indices (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), eosinophil count, and total immunoglobulin E (IgE) were evaluated.

Purpose of the Study:

• To assess the utility of systemic inflammatory indices as objective biomarkers for monitoring disease activity and predicting treatment response in allergic rhinitis (AR).
• To evaluate the predictive value of baseline NLR, PLR, SII, eosinophil count, and IgE for treatment outcomes in AR patients over a 6-month follow-up period.

Main Methods:

• A prospective cohort study involving 105 patients with moderate-to-severe persistent AR and 92 healthy controls.
• Baseline and 6-month measurements included complete blood count-derived indices (NLR, PLR, SII), eosinophil count, and total serum IgE.
• Symptom severity was assessed using Total Nasal Symptom Score and visual analog scales; ROC analyses identified optimal cutoff values for predicting treatment response.

Main Results:

• AR patients exhibited significantly higher baseline NLR, PLR, SII, and eosinophil counts compared to controls (P < .001).
• These indices decreased significantly, correlating with symptom improvement, and were significantly greater in AR patients than controls.
• Baseline NLR >2.7 demonstrated the strongest predictive value for nonresponse (sensitivity 84%, specificity 76%), while elevated PLR, SII, eosinophils, and IgE also indicated increased nonresponse risk. Total IgE was not useful for short-term monitoring.

Conclusions:

• Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and eosinophil count are promising biomarkers for monitoring AR activity and predicting treatment response.
• NLR, in particular, may serve as a simple, cost-effective tool for early risk stratification in AR management.
• Integrating routine hematologic markers into the clinical management of allergic rhinitis is supported by these findings.