Association and predictive value of SII, SIRI and CD4/CD8 ratio with acute onset of bronchial asthma

1. Introduction

Bronchial asthma is a common chronic respiratory inflammatory disease in children. Its main characteristics are airway inflammation or hyperresponsiveness, and its clinical manifestations are shortness of breath, wheezing, cough, chest tightness, etc., which has a serious impact on the respiratory system function of children [1]. Although the symptoms of wheezing can be delayed by drug treatment, there is still a risk of recurrence [2]. Therefore, it is of great clinical significance to find a simple and reliable biological indicator to predict the prognosis of children with asthma.

Relevant studies have shown that inflammatory response is closely related to the occurrence and persistence of airway hyperreactivity in children [3]. Systemic immunoinflammatory index and Systemic inflammatory response index (SIRI) are two new clinical inflammatory markers [4]. They are relatively simple to obtain, provide important information for diseases related to inflammation response, and currently have significant advantages as markers of disease diagnosis and prognosis. Additionally, they can better reflect the severity of the disease [5]. CD4⁺ represents T helper cells to activate and regulate immune function, and CD8⁺ represents T suppressor cells to inhibit immune function [6]. Studies have shown that the imbalance of CD4⁺/CD8⁺ ratio is an important link in the occurrence of bronchial asthma [7]. This study aims to investigate the association between these three indicators and bronchial asthma, and the results are reported as follows.

2. Materials and methods

3. Results

4. Discussion

Asthma is a chronic airway inflammatory disease caused by T lymphs, eosinophils (EOS), neutrophils, mast cells and other cellular and multicellular components under the joint action of environmental and genetic factors [10]. It is often accompanied by airway hyperresponsive and reversible airflow limitation. Lead to repeated episodes of wheezing, shortness of breath, chest tightness, cough and other symptoms, generally aggravated in the morning or at night [11]. With repeated illness, it can induce physiological characteristics such as airway hyperresponsiveness and increased airway mucus secretion, aggravate respiratory dysfunction, and even cause irreversible damage to the respiratory system, seriously affecting the health of children [12].

The Systemic Immunoinflammatory Index (SII) is a novel biomarker for malignancies and inflammatory diseases that brings together counts of three inflammatory peripheral cells, including neutrophils, lymphocytes and platelets [13]. The Systemic Inflammatory Response Index (SIRI), a collection of neutrophil, lymphocyte and monocyte counts that indicate a balance between inflammatory response and immune status, is calculated from simple laboratory parameters and can be considered a cost-effective indicator for practical applications [14]. In our study, the expression levels of SII and SIRI were significantly increased in children with bronchial asthma, and their expression was also significantly increased in children with poor prognosis, highlighting the role of neutrophils, platelets and lymphocytes in the pathogenesis of asthma, which are closely associated with increased risk of asthma.

The imbalance of CD4⁺/CD8⁺ ratio is considered to be an important link in the occurrence and development of bronchial asthma [15]. Our study found that the CD4⁺/CD8⁺ ratio was significantly reduced in children with asthma, and in children with poor prognosis, the CD4⁺/CD8⁺ ratio was also significantly decreased. CD4⁺ T cell is a kind of effector T cell produced by differentiation of initial T cells in peripheral lymphoid tissue after being attacked by antigens [16]. It is mainly involved in cellular immunity and plays a chemotactic and activation role in other lymphocyte functions and inflammatory cells. CD8⁺ T cell refers to cytotoxic T lymphocytes, representing T suppressor cells to suppress immune function [17], and the decrease of CD4⁺/CD8⁺ ratio reflects the impaired immune function of the body, which is closely related to the onset and progression of asthma [18].

There are also many shortcomings in this study, mainly as follows: (1) This study is a single-center retrospective study, the number of included samples is limited, and the three indicators in the study are affected by many factors such as emotions and eating habits, so the results are inevitably biased, and a large-scale multi-center clinical study is required if necessary.

5. Conclusions

SII, SIRI and CD4⁺/CD8⁺ are closely related to children with acute attack of bronchial asthma. Both SII and SIRI prove to be effective in predicting disease progression. These indicators deserve further attention in clinical practice.

Availability of data and materials

The authors declare that all data supporting the findings of this study are available within the paper and any raw data can be obtained from the corresponding author upon request.

Author contributions

FQX—designed the study and carried them out; supervised the data collection. FQX, QZ, FZC—analyzed the data; prepared the manuscript for publication and reviewed the draft of the manuscript. FQX, QZ—interpreted the data. All authors have read and approved the manuscript.

Ethics approval and consent to participate

Ethical approval was obtained from the Ethics Committee of Anhui Provincial Children’s Hospital (Approval no. EYLL-2022-010). Written informed consent was obtained from a legally authorized representative for anonymized patient information to be published in this article.

Acknowledgment

Not applicable.

Funding

This research received no external funding.

Conflict of interest

The authors declare no conflict of interest.