# Erythropoietic indices in asthma patients on controller medications: a comparative analysis

## TL;DR

This study compares erythropoietic responses in asthma patients with and without controller medications, finding that corticosteroids may suppress erythropoiesis.

## Contribution

The novel finding is that inhaled corticosteroids may suppress erythropoiesis in asthma patients, as indicated by a negative correlation between EPO and reticulocyte counts.

## Key findings

- Treatment-naive asthmatics showed elevated reticulocyte counts and EPO levels, indicating enhanced erythropoiesis.
- Asthmatics on controller medications exhibited a negative correlation between EPO levels and reticulocyte counts.
- Controller medications, particularly corticosteroids, may suppress erythropoietic responses in asthma patients.

## Abstract

A key feature of asthma is hypoxia, which triggers erythropoietin (EPO) production to stimulate erythropoiesis and compensate for oxygen deficits. This study investigates the impact of asthma controller medications on erythropoietic response by evaluating serum EPO levels and reticulocyte counts among asthma patients at Murtala Muhammad Specialist Hospital, Kano.

This study is a comparative cross-sectional study involving 180 participants, comprising 60 asthmatics on controller medications, 60 treatment-naive patients with asthma, and 60 apparently healthy controls. Serum EPO levels were determined by ELISA, while complete blood count (CBC) and reticulocyte count were determined by automated hematology analyzer and manual method, respectively.

The study revealed significant differences in EPO levels (p = 0.00001), reticulocyte counts (p = 0.0004), and hematological parameters (p = 0.009) among the three groups. Treatment-naive asthmatics exhibited elevated reticulocyte counts (2.50 (IQR: 3.50)) and EPO levels (38.88 mIU/mL (IQR: 25.6 mIU/mL)), suggesting enhanced erythropoiesis in response to hypoxia. In contrast, asthmatics on controller medications showed a negative correlation (ϱ = - 0.564) between EPO levels and reticulocyte counts, indicating a potential suppressive effect of corticosteroids on erythropoiesis.

Asthma is associated with increased erythropoietin production; it is however suppressed by inhaled corticosteroid therapy.