Study of Some Hematological and Biochemical Parameters among Children with Asthma Attending Brak General Hospital in Brak Al-Shatti

Authors

DOI:

https://doi.org/10.51984/6tx1rh73

Keywords:

Asthma, Blood inflammatory markers, Complete blood count, Hematological and biochemical markers, Hematological parameters

Abstract

Background: Asthma is a chronic respiratory disease characterized by airway inflammation and hyperresponsiveness, with recurrent symptoms that may lead to repeated medical visits. In resource-limited settings, pulmonary function testing and advanced biomarkers may not be consistently available, increasing the value of simple and affordable laboratory indicators. This study evaluated the potential significance of selected complete blood count (CBC) parameters and derived inflammatory indices in children with asthma. Methods: A comparative cross-sectional study was conducted at Brak General Hospital, Libya, between December 2023 and January 2024. Sixty-seven children aged 2–14 years were included, with a mean age of 7.32 ± 3.364 years; 50 had asthma and 17 were clinically healthy controls. CBC and C-reactive protein (CRP) were measured in both groups, and asthma control was assessed in the patient group using the Asthma Control Test. Results: Several hematological and inflammatory parameters differed significantly between children with asthma and healthy controls. The asthma group showed higher white blood cell (8.00 ± 3.56 vs 5.06 ± 0.86; p < 0.001) and neutrophil counts (4.89 ± 3.09 vs 1.93 ± 0.43; p < 0.001) and increased inflammatory indices related to neutrophils and platelets, including the neutrophil-to-lymphocyte ratio (2.43 ± 1.89 vs 0.77 ± 0.22; p < 0.001) and the systemic immune-inflammation index (823.28 ± 603.7 vs 256.40 ± 89.61; p < 0.001). Conclusions: These findings indicate that routinely available blood parameters may provide supportive information about inflammatory status in pediatric asthma. However, these markers are nonspecific and should not be used alone to establish the diagnosis.

Downloads

Download data is not yet available.

Author Biographies

  • Sumaya Abobaker Alghnaei, Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Wadi Al-Shatti, Brak Al-Shatti

    .

  • Fatima Aejeeli M Abdu, Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Wadi Al-Shatti, Brak Al-Shatti

    .

  • Masoudah Othman Saeid, Department of Medical Laboratory Sciences, Faculty of Medical Technology, University of Wadi Al-Shatti, Brak Al-Shatti

    .

References

[1] Holgate ST. Pathogenesis of asthma. Clin Exp Allergy.

2008;38(6):872–97. doi:10.1111/j.1365-2222.2008.02971.x

[2] Hamid Q, Tulic M. Immunobiology of asthma. Annu Rev

Physiol. 2009;71:489–507.

doi:10.1146/annurev.physiol.010908.163200

[3] Akar-Ghibril N, Casale T, Custovic A, Phipatanakul W.

Allergic endotypes and phenotypes of asthma. J Allergy Clin

Immunol Pract. 2020;8(2):429–40.

doi:10.1016/j.jaip.2019.11.008

[4] The International Study of Asthma and Allergies in

Childhood (ISAAC) Steering Committee. Worldwide

variation in prevalence of symptoms of asthma, allergic

rhinoconjunctivitis, and atopic eczema: ISAAC. Lancet.

1998;351(9111):1225–32. doi:10.1016/S0140

6736(97)07302-9

[5] Trivedi M, Denton E. Asthma in children and adults—what

are the differences and what can they tell us about asthma?

Front Pediatr. 2019;7:256. doi:10.3389/fped.2019.00256

[6] World Health Organization. Global age-friendly cities: a

guide. Geneva: World Health Organization; 2007.

[7] Smith AM, Villareal M, Bernstein DI, Swikert DJ. Asthma

in the elderly: risk factors and impact on physical function.

Ann Allergy Asthma Immunol. 2012;108(5):305–10.

doi:10.1016/j.anai.2012.02.022

[8] Melén E, Pershagen G. Pathophysiology of asthma: lessons

from genetic research with particular focus on severe asthma.

J Intern Med. 2012;272(2):108–20. doi:10.1111/j.1365

2796.2012.02555.x

[9] King TE Jr. A new look at the pathophysiology of asthma. J

Natl Med Assoc. 1999;91(8 Suppl):9S–15S.

[10] Barrios RJ, Kheradmand F, Batts LK, Corry DB. Asthma:

pathology and pathophysiology. Arch Pathol Lab Med.

2006;130(4):447–51. doi:10.5858/2006-130-447-APAP

[11] Levy ML, Bacharier LB, Bateman E, Boulet LP, Brightling

C, Buhl R, et al. Key recommendations for primary care from

the 2022 Global Initiative for Asthma (GINA) update. NPJ

Prim Care Respir Med. 2023;33(1):7. doi:10.1038/s41533

023-00330-1

[12] Shero ST, Ammary-Risch NJ, Lomotan EA, Mardon RE,

Michaels M. Creating implementable clinical practice

guidelines: the 2020 focused updates to the National Heart,

Lung, and Blood Institute's asthma management guidelines.

Implement Sci Commun. 2023;4(1):36. doi:10.1186/s43058

023-00417-3

[13] Miller MR, Stanojevic S, Graham BL. Do American

Thoracic Society and European Respiratory Society journals

have a role in promoting official American Thoracic Society

and European Respiratory Society standards? Ann Am

Thorac Soc. 2023;20(12):1694–6.

doi:10.1513/AnnalsATS.202307-612VP

[14] Escamilla-Gil JM, Fernandez-Nieto M, Acevedo N.

Understanding the cellular sources of the fractional exhaled

nitric oxide (FeNO) and its role as a biomarker of type 2

inflammation in asthma. Biomed Res Int.

2022;2022:5753524. doi:10.1155/2022/5753524

[15] Shafiek H. Inhaled corticosteroids: benefits and risks. In:

Radenkovic M, editor. Updates on corticosteroids. London:

IntechOpen; 2023. doi:10.5772/intechopen.110753

[16] Faria N, Costa MI, Fernandes AL, Fernandes A, Fernandes

B, Machado DC, et al. Biologic therapies for severe asthma:

current insights and future directions. J Clin Med.

2025;14(9):3153. doi:10.3390/jcm14093153

[17] Pleșca DA, Ionescu M, Drăgănescu AC. Asthma prevention

and recent advances in management. Glob Pediatr.

2024;9:100209. doi:10.1016/j.gpeds.2024.100209

[18] Garg R, Piplani M, Upadhayay A, Singh Y, Bhateja P. A

review on comparison of allopathic medicines to other drug

therapies in the management of asthma. Infect Disord Drug

Targets. 2024;24(2):e201023222496.

doi:10.2174/0118715265249796231018050521

[19] Brusselle GG, Koppelman GH. Biologic therapies for severe

asthma. N Engl J Med. 2022;386(2):157–71.

doi:10.1056/NEJMra2032506

[20] Usatine RP, Smith MA, Mayeaux EJ Jr, Chumley HS. The

color atlas and synopsis of family medicine. 3rd ed. New

York: McGraw-Hill Education; 2019.

[21] Dogru M, Yesiltepe Mutlu RG. The evaluation of neutrophil

lymphocyte ratio in children with asthma. Allergol

Immunopathol (Madr). 2016;44(4):292–6.

doi:10.1016/j.aller.2015.09.005

[22] Batmaz A, et al. Could neutrophil-to-lymphocyte ratio and

platelet-to-lymphocyte ratio be used as inflammatory

markers for the evaluation of asthma control? Eur Rev Med

Pharmacol Sci. 2018;22(16):5189–95.

[23] Shi G, et al. Clinical significance of NLR and PLR in children

with asthma. Allergol Immunopathol (Madr).

2017;45(6):539–47.

[24] Sagmen SB, Kıral N. The evaluation of neutrophil-to

lymphocyte ratio and platelet-to-lymphocyte ratio in asthma

control. Rev Fr Allergol. 2020;60(1):20–3.

doi:10.1016/j.reval.2019.09.001

[25] Huang WJ, Huang GT, Zhan QM, Chen JL, Luo WT, Wu

LH, et al. The neutrophil to lymphocyte ratio as a novel

predictor of asthma and its exacerbation: a systematic review

and meta-analysis. Eur Rev Med Pharmacol Sci.

2020;24(22):11719–28.

doi:10.26355/eurrev_202011_23819

[26] Zhu X, Zhou L, Li Q, Pan R, Zhang J, Cui Y. Combined score

of C-reactive protein level and neutrophil-to-lymphocyte

ratio: a novel marker in distinguishing children with

exacerbated asthma. Int J Immunopathol Pharmacol.

2021;35:20587384211040641.

doi:10.1177/20587384211040641

[27] Nathan RA, Sorkness CA, Kosinski M, Schatz M, Li JT,

Marcus P, et al. Development of the asthma control test: a

survey for assessing asthma control. J Allergy Clin Immunol.

2004;113(1):59–65. doi:10.1016/j.jaci.2003.09.008

[28] Liu AH, Zeiger RS, Sorkness CA, Ostrom NK, Chipps BE,

Rosa K, et al. The Childhood Asthma Control Test:

retrospective determination and clinical validation of a cut

point to identify children with very poorly controlled asthma.

J Allergy Clin Immunol. 2010;126(2):267–73.e1.

doi:10.1016/j.jaci.2010.05.031

[29] Trivedi M, Denton E. Asthma in children and adults—what

are the differences and what can they tell us about asthma?

Front Pediatr. 2019;7:256. doi:10.3389/fped.2019.00256

[30] Chowdhury NU, Guntur VP, Newcomb DC, Wechsler ME.

Sex and gender in asthma. Eur Respir Rev.

Study of Some Hematological and Biochemical Parameters among Children with Asthma Attending Brak General… Alghnaei et al.

JOMS Vol.21 No. 2 2026 44

2021;30(162):210067. doi:10.1183/16000617.0067-2021

[31] Shah R, Newcomb DC. Sex bias in asthma prevalence and

pathogenesis. Front Immunol. 2018;9:2997.

doi:10.3389/fimmu.2018.02997

[32] Rodriguez Bauza DE, Silveyra P. Asthma, atopy, and

exercise: sex differences in exercise-induced

bronchoconstriction. Exp Biol Med (Maywood).

2021;246(12):1400–9. doi:10.1177/15353702211003858

[33] Silva AE, Ferrante G, Silveyra P, Custovic A, La Grutta S,

Forno E. Peripubertal changes in asthma. Am J Respir Crit

Care Med. 2026. Epub 2026 Jul 14.

doi:10.1093/ajrccm/aamag373

[34] Naeem A, Silveyra P. Sex differences in paediatric and adult

asthma. Eur Med J (Chelmsf). 2019;4(2):27–35.

[35] Ejaz S, Nasim FUH, Ashraf M, Ahmad S. Hematological and

biochemical profile of patients suffering from non-atopic

asthma. Insights Chest Dis. 2017;2(2):6. doi:10.21767/2577

0578.10033

[36] Zhu X, Zhou L, Li Q, Pan R, Zhang J, Cui Y. Combined score

of C-reactive protein level and neutrophil-to-lymphocyte

ratio: a novel marker in distinguishing children with

exacerbated asthma. Int J Immunopathol Pharmacol.

2021;35:20587384211040641.

doi:10.1177/20587384211040641

[37] Pan R, Ren Y, Li Q, Zhu X, Zhang J, Cui Y, et al. Neutrophil

lymphocyte ratios in blood to distinguish children with

asthma exacerbation from healthy subjects. Int J

Immunopathol Pharmacol. 2023;37:1–9.

doi:10.1177/03946320221149849

[38] Shi G, Zhao JW, Ming L. Clinical significance of peripheral

blood neutrophil-lymphocyte ratio and platelet-lymphocyte

ratio in patients with asthma. Nan Fang Yi Ke Da Xue Xue

Bao. 2017;37(1):84–8. doi:10.3969/j.issn.1673

4254.2017.01.15

[39] Giray D, Özdemir M. Evaluation of mean platelet volume

and other complete blood count parameters in children with

atopic asthma. Bezmialem Sci. 2018;6(3):181–5.

doi:10.14235/bs.2018.1759

[40] Dogru M, Yesiltepe Mutlu RG. The evaluation of neutrophil

lymphocyte ratio in children with asthma. Allergol

Immunopathol (Madr). 2016;44(4):292–6.

doi:10.1016/j.aller.2015.09.005

[41] Eltyeb EE, Gohal GA, Alhazmi SA, Alqassim MA, Hakami

EF, Moafa MH, et al. Neutrophil-to-lymphocyte ratio,

platelets-to-lymphocyte ratio, and red cell distribution width

as prognostic indicators for length of hospital stay in pediatric

asthma. Saudi Med J. 2025;46(2):143–9.

doi:10.15537/smj.2025.46.2.20240934

[42] Okuyan O, Dumur S, Elgormus Y, Uzun H. Could the

systemic immune-inflammation index be a new biomarker of

inflammation in children with asthma? Med Sci (Turkey).

2025;14(1):81–4. doi:10.5455/medscience.2024.11.137

[43] Fujisawa T, Iwai F. Biomarkers in pediatric asthma: clinical

maturity, intended use, and future directions. Allergol Int.

2026. Epub 2026 Aug 25. doi:10.1016/j.alit.2026.08.003

[44] Global Initiative for Asthma. Global strategy for asthma

management and prevention: 2025 update. Fontana (WI):

Global Initiative for Asthma; 2025.

[45] Licari A, Castagnoli R, Brambilla I, Marseglia A, Tosca MA,

Marseglia GL, et al. Asthma endotyping and biomarkers in

childhood asthma. Pediatr Allergy Immunol Pulmonol.

2018;31(2):44–55. doi:10.1089/ped.2018.0886

[46] Sysmex Corporation. XP-300 automated hematology

analyzer: product brochure. Kobe: Sysmex Corporation;

[date unknown].

[47] El Osta NM, Elmuzoughi A, Algazere M, Alshourif F, Abud

A. Comparative evaluation of C-reactive protein, blood gas

pH, and lymphocyte profiles in differentiating neonatal

sepsis from hyperbilirubinemia-associated leukocytosis: a

retrospective cohort study at Al-Jalaa Maternity Hospital,

Libya. J Med Sci (Sebha). 2026;21(2):4–10.

doi:10.51984/yt67hy91

[48] Ali AI, Nori W. The value of lymphocyte to C-reactive

protein ratio in asymptomatic COVID-19 cases in pregnant

versus non-pregnant women. J Med Sci (Sebha).

2023;18(3):20–4. doi:10.51984/JOMS.V18I3.2863

[49] Baled E, Mohamed IA. Cigarette smoking effects on

biochemical and hematological parameter in Brack city in

south Libya. J Med Sci (Sebha). 2023;18(1):42–8.

doi:10.51984/joms.v18i1.2637

Downloads

Published

2026-10-06

Issue

Section

Original Research Article

Categories

How to Cite

1.
Study of Some Hematological and Biochemical Parameters among Children with Asthma Attending Brak General Hospital in Brak Al-Shatti. J Med Sci (Sebha) [Internet]. 2026 Oct. 6 [cited 2026 Oct. 15];21(2):36-44. Available from: https://www.sebhau.edu.ly/journal/joms/article/view/4643

Similar Articles

1-10 of 34

You may also start an advanced similarity search for this article.