Serum periostin in asthma: A potential biomarker for stratification in severe treatment-resistant asthma

Rupani, Hitasha, Lau, Laurie, Ono, Junya, Ohta, Shoichiro, Barber, Clair, Elliott, Scott P, Brown, Tom, Kurukulaaratchy, Ramesh, Chauhan, Anoop, Izuhara, Kenji and Howarth, Peter (2014) Serum periostin in asthma: A potential biomarker for stratification in severe treatment-resistant asthma. European Respiratory Journal, 44 (Suppl 58), [P3986].

Abstract

Rationale: Serum periostin has been proposed as a biomarker of Th2 airway inflammation in asthma. We thus measured serum periostin in a large cohort of patients with severe asthma as well as in those with milder asthma and healthy controls, to gain insight into the value of this biomarker in asthma stratification. Methods: Serum samples from 126 healthy controls (HC), 93 non-steroid treated mild asthmatics (MA), 35 asthmatics on low dose corticosteroids +/- LABA (ModA) and 276 severe treatment-resistant asthmatics (SA) were assayed for serum periostin by ELISA (Shino-Test Corporation, Kanagawa, Japan) and the results related to clinical and inflammatory markers. Results: Group median serum periostin levels were significantly (p<0.0001) lower in both the steroid treated asthma groups (ModA and SA) than the HC or MA groups, although there was greater spread in SA with 21% of values ± the normal range. Tertile analysis of the SA serum periostin identified that those in the upper tertile (≥79 ng/ml) had significantly higher sputum eosinophils (p=0.001), peripheral blood eosinophilia (p=0.002), FeNO (p=0,001) and total IgE (p=0.01) as well as lower FEV1 % predicted (p=0.02) than those in the lowest tertile (≤58ng/ml). Serum periostin measures did not appear related to age, BMI or atopic status. Conclusion: Steroid treatment in asthma is associated with significantly lower serum periostin measures than in non-steroid treated asthma, although a sub-population of severe asthmatics have levels that associate with eosinophilic inflammation. Funding: WSAC was funded by the Medical Research Council UK.

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Contributors

Author: Clair Barber

Author: Ramesh Kurukulaaratchy

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