Study of Some Hematological and Biochemical Parameters among Children with Asthma Attending Brak General Hospital in Brak Al-Shatti
DOI:
https://doi.org/10.51984/6tx1rh73Keywords:
Asthma, Blood inflammatory markers, Complete blood count, Hematological and biochemical markers, Hematological parametersAbstract
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.
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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
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