{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T03:13:01Z","timestamp":1785208381071,"version":"3.55.0"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T00:00:00Z","timestamp":1609459200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Taihu Lake talent plan","award":["2020THRC-GD-7"],"award-info":[{"award-number":["2020THRC-GD-7"]}]},{"name":"The Primary Research & Development Plan of Jiangsu Province","award":["BE2018627"],"award-info":[{"award-number":["BE2018627"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Immunopathol Pharmacol"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Both C-reactive protein (CRP) level and neutrophil-to-lymphocyte ratio (NLR) are commonly elevated in patients with asthma. It is necessary to develop a novel marker, the combined score of CRP level and NLR (C-NLR score) based on cutoff points of CRP and NLR, and apply it in asthma diagnosis. The aim of this study was to explore whether C-NLR could distinguish children with exacerbated asthma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Children suffering from exacerbated asthma were regarded as the asthmatic group ( n = 86), which was divided into three groups: mild ( n = 54), moderate ( n = 17), and severe ( n = 15). The control group consisted of children without any allergic disease and infection ( n = 38). To compare CRP level and NLR between the asthmatic group and control group, a receiver-operating characteristic curve was constructed to determine area under the curve (AUC) and optimal cutoff point. Thereafter, the C-NLR score was classified as follows: C-NLR score of 2 with an elevated CRP level and high NLR, a C-NLR score of 1 with one of these abnormalities, and a C-NLR score of 0 with a normal CRP level and low NLR. The C-NLR score was then compared among different asthma groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the control group, the CRP level and NLR were 1.9 (0.5\u20132.6) mg\/L and 1.01 (0.69\u20131.31), respectively. In the asthmatic group, the CRP level and NLR were 7.3 (3.2\u201314.2) mg\/L and 3.08 (1.73\u20135.34), respectively, which were higher than those in the control group ( p &lt; 0.001 for CRP and p &lt; 0.001 for NLR). The AUC of CRP was 0.86, and the optimal cutoff point was 3.6\u00a0mg\/L. The AUC of NLR was 0.86, and the optimal cutoff point was 1.72. The AUC of the C-NLR score was 0.94, and the optimal cutoff point was 1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>C-NLR, a novel inflammatory marker, was applied here for the exacerbated asthma for the first time. Our study has shown C-NLR is a promising marker to distinguish children with exacerbated asthma from healthy children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/20587384211040641","type":"journal-article","created":{"date-parts":[[2021,9,13]],"date-time":"2021-09-13T05:03:18Z","timestamp":1631509398000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":23,"title":["Combined score of C-reactive protein level and neutrophil-to-lymphocyte ratio: A novel marker in distinguishing children with exacerbated asthma"],"prefix":"10.1177","volume":"35","author":[{"given":"Xuming","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Wuxi People\u2019s Hospital Affiliated to Nanjing Medical University, Wuxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Wuxi Children\u2019s Hospital Affiliated to Nanjing Medical University, Wuxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingqing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Wuxi People\u2019s Hospital Affiliated to Nanjing Medical University, Wuxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruilin","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Wuxi People\u2019s Hospital Affiliated to Nanjing Medical University, Wuxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Wuxi People\u2019s Hospital Affiliated to Nanjing Medical University, Wuxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7736-8012","authenticated-orcid":false,"given":"Yubao","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Wuxi People\u2019s Hospital Affiliated to Nanjing Medical University, Wuxi, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,9,13]]},"reference":[{"key":"bibr1-20587384211040641","doi-asserted-by":"publisher","DOI":"10.4168\/aair.2019.11.3.394"},{"key":"bibr2-20587384211040641","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2019.00246"},{"issue":"17","key":"bibr3-20587384211040641","first-page":"547","volume":"60","author":"Centers for Disease Control and Prevention (CDC)","year":"2011","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"bibr4-20587384211040641","doi-asserted-by":"publisher","DOI":"10.5415\/apallergy.2020.10.e7"},{"issue":"5","key":"bibr5-20587384211040641","first-page":"6935","volume":"17","author":"Liu C","year":"2018","journal-title":"Molecular Medicine Reports"},{"issue":"4","key":"bibr6-20587384211040641","first-page":"698","volume":"20","author":"Paone G","year":"2016","journal-title":"European Review for Medical Pharmacological Sciences"},{"key":"bibr7-20587384211040641","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/8841002"},{"key":"bibr8-20587384211040641","doi-asserted-by":"publisher","DOI":"10.9758\/cpn.2020.18.1.32"},{"key":"bibr9-20587384211040641","doi-asserted-by":"publisher","DOI":"10.1016\/j.aller.2015.09.005"},{"issue":"5","key":"bibr10-20587384211040641","first-page":"540","volume":"43","author":"Cui Y","year":"2020","journal-title":"Chinese Journal of Laboratory Medicine"},{"key":"bibr11-20587384211040641","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2018.01302"},{"key":"bibr12-20587384211040641","doi-asserted-by":"publisher","DOI":"10.2478\/jomb-2019-0012"},{"issue":"1","key":"bibr13-20587384211040641","first-page":"37","volume":"7","author":"Monadi M","year":"2016","journal-title":"Caspian Journal of Internal Medicine"},{"key":"bibr14-20587384211040641","doi-asserted-by":"publisher","DOI":"10.1159\/000232572"},{"key":"bibr15-20587384211040641","doi-asserted-by":"publisher","DOI":"10.17219\/acem\/65691"},{"key":"bibr16-20587384211040641","doi-asserted-by":"publisher","DOI":"10.3343\/alm.2019.39.4.345"},{"key":"bibr17-20587384211040641","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-020-6698-6"},{"key":"bibr18-20587384211040641","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0101242"},{"issue":"1","key":"bibr19-20587384211040641","first-page":"47","volume":"34","author":"Nayyar AS","year":"2012","journal-title":"The Malaysian journal of pathology"},{"key":"bibr20-20587384211040641","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S180301"},{"key":"bibr21-20587384211040641","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2012.08.003"},{"key":"bibr22-20587384211040641","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000001702"},{"key":"bibr23-20587384211040641","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2018.11.029"}],"container-title":["International Journal of Immunopathology and Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20587384211040641","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/20587384211040641","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/20587384211040641","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:00:02Z","timestamp":1777456802000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/20587384211040641"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1]]},"references-count":23,"alternative-id":["10.1177\/20587384211040641"],"URL":"https:\/\/doi.org\/10.1177\/20587384211040641","relation":{},"ISSN":["0394-6320","2058-7384"],"issn-type":[{"value":"0394-6320","type":"print"},{"value":"2058-7384","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1]]},"article-number":"20587384211040641"}}