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Journals / Turkish Journal of Veterinary Research / 2026 / Volume: 10 Issue: 2

The Significance of the Cellular Immune Response and Inflammatory Indices (NLR, PLR, and LMR) in the Clinical Evaluation of Calves with Pneumonia

Merve Öztürk(NECMETTİN ERBAKAN ÜNİVERSİTESİ, VETERİNER FAKÜLTESİ, KLİNİK BİLİMLER (VETERİNER FAK.) BÖLÜMÜ, VETERİNERLİK İÇ HASTALIKLARI ANABİLİM DALI)0000-0002-8500-7599
Nuri Altuğ(NECMETTİN ERBAKAN ÜNİVERSİTESİ, VETERİNER FAKÜLTESİ, KLİNİK BİLİMLER (VETERİNER FAK.) BÖLÜMÜ, VETERİNERLİK İÇ HASTALIKLARI ANABİLİM DALI)0000-0001-5805-0340
Pages
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Publication Date
2026-10-24
DOI
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

The combined assessment of these parameters may provide a practical and readily accessible approach to support clinical management and improve prognostic evaluation.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: This study aimed to evaluate the relationships between clinical symptom scores, hematological parameters, and systemic inflammatory indices in calves with pneumonia.
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Key Findings & Data:Results: All clinical symptom scores were significantly higher in the pneumonia group than in the healthy control group (p < 0.001).
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Conclusion & Impact:The combined assessment of these parameters may provide a practical and readily accessible approach to support clinical management and improve prognostic evaluation.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Calf · hematological index · clinical scoring

Abstract

Objective: This study aimed to evaluate the relationships between clinical symptom scores, hematological parameters, and systemic inflammatory indices in calves with pneumonia. Materials and Methods: The study population consisted of calves diagnosed with pneumonia and healthy control calves. Clinical lesion scores (respiratory score, lethargy, cough, nasal discharge, ocular discharge, and ear position) were recorded, and complete blood count analyses were performed. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) were calculated from the hematological data. Results: All clinical symptom scores were significantly higher in the pneumonia group than in the healthy control group (p < 0.001). Respiratory score showed strong positive correlations with nasal discharge (r = 0.880), cough (r = 0.791), and lethargy (r = 0.683). Hematological analysis revealed significantly lower lymphocyte (LYM; 4.31 ± 0.18), mean corpuscular hemoglobin (MCH; 10.85 ± 0.24), mean corpuscular hemoglobin concentration (MCHC; 32.92 ± 0.18), mean platelet volume (MPV; 5.47 ± 0.05), platelet distribution width (PDW; 14.00 ± 0.05), and lymphocyte-to-monocyte ratio (LMR; 2.78 ± 0.13) values in the pneumonia group (p < 0.001). In contrast, red cell distribution width-coefficient of variation (RDW-CV; 21.70 ± 0.41%), neutrophil-to-lymphocyte ratio (NLR; 2.06 ± 0.13), and platelet-to-lymphocyte ratio (PLR; 227.26 ± 11.81) were significantly increased (p < 0.05). RDW-CV demonstrated very strong positive correlations with both PLR (r = 0.877) and NLR (r = 0.832). Conclusion: Lymphopenia, increased RDW-CV, elevated NLR and PLR, and decreased LMR emerged as hematological markers associated with disease severity in calves with pneumonia. The combined assessment of these parameters may provide a practical and readily accessible approach to support clinical management and improve prognostic evaluation.

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Cite This Article

Öztürk, M., Altuğ, N. (2026). The Significance of the Cellular Immune Response and Inflammatory Indices (NLR, PLR, and LMR) in the Clinical Evaluation of Calves with Pneumonia. Turkish Journal of Veterinary Research, Volume: 10 Issue: 2. https://ajindex.com/articles/1668196

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References (50)

  1. Aktaş MS, Eren E, Aydın Ö, et al. Research on hematology, inflammatory and antimicrobial peptide levels according to clinical scoring in calves with Bovine Respiratory Disease (BRD). Van Veterinary Journal. 2024; 35(3):196-201.
  2. Altinbas O, Mete AO, Demiryurek S, et al. Relationships between NT-proBNP and novel biochemical parameters and increased cardiovascular risk in COVID-19. Ann Clin Anal Med. 2021; 12(4):529-533.
  3. Antosiak-Cyrak K, Demuth A, Czerniak U, et. al. The impact of dietary nutrient intake on red blood cell distribution width-coefficient of variation in pregnant women: a cross-sectional observational pilot study. Nutrients. 2025; 17(21):3396.
  4. Aydın Ö. İshalli buzağılarda nötrofil/lenfosit oranı, lenfosit/monosit oranı ve yangısal marker olarak serum demir düzeylerinin değerlendirilmesi. Fırat Üniv Sağ Bil Vet Derg. 2024; 38(1):082-091.
  5. Barasovich SD, Stanislavovich TA, Dzhabrailovna OG, et al. Nasal congestion and its relationship with hypoxia: pathophysiological mechanisms, clinical correlates, and therapeutic perspectives. International Journal of Innovative Medicine. 2025; (3):19-23.
  6. Baruch J, Cernicchiaro N, Cull CA, et al. Assessment of bovine respiratory disease progression in calves challenged with bovine herpesvirus 1 and Mannheimia haemolytica using point-of-care and laboratory-based blood leukocyte differential assays. Transl Anim Sci. 2021; (5):1-13.
  7. Bassel LL, Tabatabaei S, Caswell JL. Host tolerance to infection with the bacteria that cause bovine respiratory disease. Vet Clin North Am Food Anim Pract. 2020; 36(2):349-359.
  8. Berman J. Literature review of the principal diagnostic tests to detect bovine respiratory disease in pre-weaned dairy and veal calves. Animals. 2024; 14(2):329.
  9. Buczinski S, Forté G, Francoz D, et al. Comparison of thoracic auscultation, clinical score, and ultrasonography as indicators of bovine respiratory disease in preweaned dairy calves. J Vet Intern Med. 2014; 28(1):234-242.
  10. Chauhan RS, Malik YS, Saminathan M, et al. Immunopathology of pneumonia in animals. In: Essentials of Veterinary Immunology and Immunopathology. Singapore: Springer Nature; 2024. pp.169-215.
  11. Cramer MC, Ollivett TL, Stanton AL. Associations of behavior-based measurements and clinical disease in preweaned, group-housed dairy calves. J Dairy Sci. 2016; 99(9):7434-7443.
  12. Davies O, Szladovits B, Polton G, et al. Prognostic significance of clinical presentation, induction and rescue treatment in 42 cases of canine centroblastic diffuse large B‐cell multicentric lymphoma in the United Kingdom. Vet Comp Oncol. 2018; 16(2):276-287.
  13. Dörtkardeş AB, Şahinduran Ş. Determination of serum amyloid A, haptoglobin and hepcidin levels in calves with endemic viral pneumonia. Ankara Üniversitesi Veteriner Fakültesi Dergisi, 2020; 67(2), 127-131.
  14. Dubrovsky SA, Van Eenennaam AL, Karle BM, et al. Epidemiology of bovine respiratory disease (BRD) in preweaned calves on California dairies: The BRD 10K study. J Dairy Sci. 2019; 102(8):7306-7319.
  15. Dugăeşescu M, Andrei-Bitere I, Baciu MR, et al. Hematological inflammatory markers and chronic diseases: Current evidence and future perspectives. Hemato. 2025; 6(4):42.
  16. Emami Ardestani M, Alavi‐Naeini N. Evaluation of the relationship of neutrophil‐to lymphocyte ratio and platelet‐to‐lymphocyte ratio with in‐hospital mortality in patients with acute exacerbation of chronic obstructive pulmonary disease. Clin Respir J. 2021; 15(4):382-388.
  17. Esin Ç. Relationship between viral load and reticulocyte/lymphocyte, neutrophil/lymphocyte and platelet/lymphocyte ratios in dogs with parvoviral enteritis. Pakistan Vet J. 2025; 45(2):834-842
  18. Fei Y, Wang X, Zhang H, et al. Reference intervals of systemic immune-inflammation index, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, mean platelet volume to platelet ratio, mean platelet volume and red blood cell distribution width-standard deviation in healthy han adults in wuhan region in central China. Scand J Clin Lab Invest. 2020; 80(6):500-507.
  19. Feng Y, Zhang X. Association between red cell distribution width-coefficient of variation (rdw-cv) and bacterial vaginosis: a cross-sectional study and external validation. Int J Womens Health. 2026; (18):582841.
  20. Gardner IA, Greiner M. Receiver-operating characteristic curves and likelihood ratios: improvements over traditional methods for the evaluation and application of veterinary clinical pathology tests. Vet Clin Pathol. 2006; 35:8-17.
  21. Gülersoy E, Balıkçı C, Günal İ, Şahan A. Haematological alterations in calves with acute respiratory distress syndrome due to aspiration pneumonia: a prospective study. Archives of Veterinary Medicine. 2023; 16(1), 69-85.
  22. Islam MM, Satici MO, Eroglu SE. Unraveling the clinical significance and prognostic value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index, and delta neutrophil index: An extensive literature review. Turk J Emerg Med. 2024; 24(1):8-19.
  23. Ismael M, El-Sayed MS, Metwally AM, et al. Clinical and haematobiochemical evaluation of pneumonia in calves with special reference to oxidant/antioxidant indices. AJVS. 2017; 54(2):40-44.
  24. Kaura R, Dorbek-Kolin E, Loch M, et al. Association of clinical respiratory disease signs and lower respiratory tract bacterial pathogens with systemic inflammatory response in preweaning dairy calves. J Dairy Sci. 2024; 107(8):5988-5999.
  25. Kerr CL, Teixeira‐Neto FJ. Respiratory physiology and pathophysiology. In: Veterinary Anesthesia and Analgesia. 6th ed. New Jersey: John Wiley & Sons; 2024. pp.697-749.
  26. Kumar A, Bhatt S, Kumar A, et al. Respiratory problems. In: Periparturient Diseases of Cattle. New Jersey: John Wiley & Sons; 2024. pp.257-267.
  27. Leigh LY, Vannelli P, Crow HC, et al. Diseases of the respiratory tract. In: Burket's Oral Medicine. Hoboken: John Wiley & Sons; 2021. pp.469-504.
  28. Liu Y, Zou Y, Liu X, et al. Stratified assessment of platelets in sepsis: from dynamic counts to functional phenotypes. Front Immunol. 2026; 17:1783001.
  29. Marín Hernández C, Piñero Madrona A, Gil Vázquez PJ, et al. Usefulness of lymphocyte-to-monocyte, neutrophil-to-monocyte and neutrophil-to-lymphocyte ratios as prognostic markers in breast cancer patients treated with neoadjuvant chemotherapy. Clin Transl Oncol. 2018: 20(4):476-483.
  30. McGuirk SM, Peek SF. Timely diagnosis of dairy calf respiratory disease using a standardized scoring system. Anim Health Res Rev. 2014; 15(2):145-147.
  31. Moisá SJ, Aly SS, Lehenbauer TW, et al. Association of plasma haptoglobin concentration and other biomarkers with bovine respiratory disease status in pre-weaned dairy calves. J Vet Diagn Invest. 2019; 31:40-46.
  32. Moon SM. Sex/gender differences in infectious diseases. In: Sex/Gender-Specific Medicine In Clinical Areas. Singapore: Springer; 2024. pp.311-324.
  33. Moreno-Torres V, Sanchez-Chica E, Castejon R, et al. Red blood cell distribution width as a marker of hyperinflammation and mortality in COVID-19. Ann Palliat Med. 2022; 11(8):2609621-2602621.
  34. Peek SF, Ollivett TL, Divers TJ. Respiratory diseases. In: Rebhun's diseases of dairy cattle. St. Louis, Missouri; 2018. pp.94.
  35. Pierini A, Gori E, Lippi I, et al. Neutrophil-to-lymphocyte ratio, nucleated red blood cells and erythrocyte abnormalities in canine systemic inflammatory response syndrome. Res Vet Sci. 2019; (126):150-154.
  36. Pokludová L. Cattle. In: Antimicrobials in Livestock 2: Choices of Prevention and Treatment: A European Perspective. Singapore: Springer; 2025. pp.215-318.
  37. Probo M, Veronesi MC. Clinical scoring systems in the newborn calf: an overview. Animals. 2022; 12(21):3013.
  38. Robsha O, Girma S, Teshome T, Kanko T. Red cell distribution width and associated factors among hypertensive patients attending Arba Minch General Hospital, Southern Ethiopia: A comparative cross-sectional study. PLoS One. 2025; 20(11):e0336409.
  39. Shivakumar BG, Gosavi S, Rao AA, et al. Neutrophil-to-lymphocyte, lymphocyte-to-monocyte, and platelet-to-lymphocyte ratios: prognostic significance in COVID-19. Cureus. 2021; 13(1):e12622.
  40. Somayaji R, Chalmers JD. Just breathe: a review of sex and gender in chronic lung disease. Eur Respir Rev. 2022; 31(163): 210111.
  41. Stanton, AL. An evaluation of the impact of management practice on the health and welfare of dairy heifer calves. [Doctoral Thesis]. University of Guelph; 2011.
  42. Stark K, Massberg S. Interplay between inflammation and thrombosis in cardiovascular pathology. Nat Rev Cardiol. 2021; 18(9):666-682.
  43. Todd CG. An evaluation of meloxicam as supportive therapy for neonatal calf diarrhea complex. [Doctoral Thesis] University of Guelph; 2007.
  44. Tudurachi BS, Anghel L, Tudurachi A, et al. Assessment of inflammatory hematological ratios (NLR, PLR, MLR, LMR and Monocyte/HDL–Cholesterol Ratio) in acute myocardial infarction and particularities in young patients. Int J Mol Sci. 2023; 24(18):14378.
  45. Wang X, Li X, Shang Y, et al. Ratios of neutrophil-to-lymphocyte and platelet-to-lymphocyte predict all-cause mortality in inpatients with coronavirus disease 2019 (COVID-19): a retrospective cohort study in a single medical centre. Epidemiol Infect. 2020; 148,e211:1-8.
  46. Yang Y, Wang Q, Gao L, et al. Promising applications of red cell distribution width in diagnosis and prognosis of diseases with or without disordered iron metabolism. Cell Biol Int. 2023; 47(7):1161-1169.
  47. Yuriy Alekhin YA, Zhukov M, Morgunova V, et al. The effect of the red blood cell system disorders on the further development and productivity of holstein calves that had bronchopneumonia. Vet Arhiv. 2021; 91(5):473-481.
  48. Yüksek N. Solunum sistemi hastalıkları. In: Prof. Dr. Nuri Altuğ, ed. Veteriner Reçete -Sığır. Ankara: Güneş Tıp Kitapevi; 2024. pp.203-256.
  49. Zhang C, Xiao J, Gao X, et al. The role of red blood cell distribution width in prognosis prediction among critically ill patients with obstructive sleep apnea: Insights from the MIMIC-IV database. Sci Rep. 2026; 16(1):12126.
  50. Bassel LL, Tabatabaei S, Caswell JL. Host tolerance to infection with the bacteria that cause bovine respiratory disease. Vet Clin North Am Food Anim Pract. 2020; 36(2):349-359.