Correlation of hemogram-derived inflammatory ratios with serum immunoglobulin E levels in patients with uncontrolled asthma

BACKGROUND: Bronchial asthma is a multifactorial inflammatory disorder with heterogeneous triggers, immune responses, and disease severity. Hemogram-derived inflammatory cell ratios are simple markers of systemic inflammation. While ratios such as the eosinophil-to-lymphocyte ratio (ELR) and neutrophil-to-lymphocyte ratio (NLR) have been studied in chronic inflammatory conditions, their relevance in uncontrolled asthma, particularly in relation to serum immunoglobulin E (IgE), remains limited. OBJECTIVES: To evaluate hemogram-derived inflammatory cell ratios in patients with uncontrolled bronchial asthma and assess their correlation with serum IgE levels. METHODS: This cross-sectional study included 43 patients with uncontrolled asthma defined according to the Global Initiative for Asthma (2022 criteria. Complete blood counts were performed to obtain absolute leukocyte and differential counts, and inflammatory cell ratios were calculated. Total serum IgE levels were measured using an enzyme-linked immunosorbent assay and correlated with inflammatory ratios. RESULTS: The cohort comprised 55.8% females and 44.2% males. The mean total leukocyte count was 8.74 ± 2.58 × 10 3 cells/μL, and the mean absolute eosinophil count (AEC) was 0.56 ± 0.84 × 10 3 cells/μL. ELR showed a very strong correlation with AEC (rho = 0.92, P < 0.001) and a moderate positive correlation with serum IgE (rho = 0.46, P = 0.002). Mean serum IgE was 618.04 ± 457.52 IU/mL, with elevated levels in 90.7% of patients. CONCLUSIONS: Uncontrolled asthma is commonly associated with elevated eosinophil counts and IgE levels. ELR correlates significantly with IgE but appears best suited as an adjunctive, exploratory marker rather than a standalone diagnostic tool.