D1.317 - Systemic inflammatory indices in relation to anaphylaxis symptoms in adults with food allergy

There is an increasing focus on research into systemic inflammation indices in various pathological conditions, including allergy and hypersensitivity. These indices include: SII (systemic immune-inflammation index), SIRI (systemic inflammation response index), MLR (monocyte/lymphocyte ratio), NLR (neutrophil/lymphocyte ratio), ELR (eosinophil/lymphocyte ratio) and BLR (basophil/lymphocyte ratio). The aim of this study was to assess systemic inflammatory indices in adults with food allergies and to relate their values to the intensity of food-induced allergic reactions.

In total, 87 adults were included in this retrospective study. The study group included 57 patients (32 female). The median age was 38 years (range 19–77). The healthy control (HC) group consisted of 30 age- and sex-matched individuals. The study included adults with clinically confirmed IgE-mediated food allergies as per available medical records. Routine complete blood counts (CBC) were performed during follow-up in outpatient specialized setting, minimum 4 weeks after last occurrence of food-induced allergic symptoms and during a stable period of concomitant atopic and other conditions, whenever applicable. Subjects with concomitant diseases and/or on treatment potentially affecting the CBC (as judged by investigators) were excluded. The World Allergy Organization (WAO) systemic allergic reaction five-point grading system (2020) was used to determine the severity of post-food reactions.

The majority of reactions (74%) were reported after consuming various nuts. Grade I reactions were observed in 20 patients (35%), grade II – in 9 (16%), grade III – 19 (33%), grade IV – 6 (11%) and grade V – in 3 patients (5%). A positive correlation was observed between the severity of the anaphylactic reaction and SII (rho = 0.412; p = 0.001) and SIRI (rho = 0.345; p = 0.008) indices. There was a statistically significant difference regarding ELR value, which was lower in HC compared to study group (median 0.073 vs. 0.095; p = 0.02). Regarding other indices, no significant differences or correlations were observed.

CBC-derived markers of systemic inflammation may be a useful tool during clinical assessment of subjects with a history of food-induced IgE-mediated reactions. However, their utility remains to be determined in further studies.