Association of severity of allergic rhinitis with neutrophil-to-lymphocyte, eosinophil-to-neutrophil, and eosinophil-to-lymphocyte ratios in adults

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Aydin Kant
Kadriye Terzioğlu


allergic rhinitis, eosinophil-to-lymphocyte ratio, eosinophil-to-neutrophil ratio


Background: Allergic rhinitis (AR) is characterized by chronic inflammation of the nasal mucosa. T-helper 2 lymphocytes, neutrophils, and eosinophils play an active role during the late-phase immune response after exposure to allergen.

Objective: We aimed to investigate the usefulness of inflammatory parameters of neutrophil-to-lymphocyte ratio (NLR), eosinophil-to-neutrophil ratio (ENR), and eosinophil-to- lymphocyte ratio (ELR) as markers for distinction between intermittent and persistent allergic rhinitis.

Material and Methods: This was a double-center, retrospective study. Patients were enrolled after diagnosed with AR according to the Allergic Rhinitis and Its Impact on Asthma guidelines. Individuals with an active infection were excluded. A cohort of healthy subjects acted as a control group. NLR, ENR, and ELR were calculated using the results obtained from the patients’ complete blood count. Descriptive statistical analysis was performed for all studied variables.

Results: In all, 205 AR patients and 49 healthy individuals were included. AR patients had significantly higher levels of absolute eosinophils, ENR, and ELR, and significantly lower levels of NLR than the healthy controls (P < 0.05). A total of 160 (78%) patients with persistent AR had significantly higher levels of absolute eosinophils, ENR, and ELR, and significantly lower levels of NLR than patients with intermittent AR (P < 0.05).

Conclusion: Currently, classification of severity of AR is based on the patient’s anamnesis. It has been shown in this study that serum eosinophil levels in persistent AR patients could be used as traceable parameters in evaluating severity of the disease by looking at the proportions of ENR and ELR. We anticipate that in the future this issue would be supported by a larger number of studies.

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