Assessment of neutrophil/lymphocyte percentage in bronchial asthma

Background Neutrophil/lymphocyte percentage is a helpful test for evaluation of systemic inflammation. This study aimed to investigate neutrophil/lymphocyte percentage as an evidence of control status in bronchial asthma. Patients and methods The study included 45 (20 males and 25 females) patients and 45 apparently healthy subjects. Full clinical evaluation, complete blood count (CBC) with differential white blood cell count, Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and total IgE measurement were done for participants. Results Neutrophil/lymphocyte percentage and CRP were higher in asthmatics than controls (statistically significant difference), and they were significantly increased with uncontrolled asthma. Neutrophil/lymphocyte percentage could predict uncontrolled asthma with a sensitivity of 66.7%, specificity of 75.6%, positive predictive value of 73.2%, negative predictive value of 69.4% and accuracy of 71.1%. Neutrophil/lymphocyte percentage increased in asthmatics with asthma control test (ACT) less than 20 versus patients with ACT of at least 20 (statistically significant difference), whereas neutrophil/lymphocyte percentage did not differ significantly among the patients with asthma regarding sex and smoking. Neutrophil/lymphocyte percentage had direct proportional relation with CRP and ACT, whereas the relations between neutrophil/lymphocyte percentage and age, eosinophils, IgE, Forced expiratory volume in first second (FEV1%), duration of the disease, or number of attacks per year were nonsignificant. No significant correlation was found between controlled and uncontrolled cases regarding total leukocyte count (TLC), duration, and onset of the disease. The number of attacks was significantly higher in uncontrolled cases than controlled ones. Conclusion Neutrophil/lymphocyte percentage could predict uncontrolled asthma with high sensitivity and specificity. Neutrophil/lymphocyte percentage is a rapid, inexpensive method with routine CBC analysis and could be a useful predictor of asthma control