Association of serum periostin with aspirin-exacerbated respiratory disease.

Abstract

BACKGROUND: Recent studies recommend periostin as a systemic biomarker of

eosinophilic airway inflammation to predict responses to novel treatments that

targets eosinophilic TH2-driven inflammation in asthmatic patients. OBJECTIVE: To

investigate the clinical implications of serum periostin levels in patients with

aspirin-exacerbated respiratory disease (AERD) based on its overlapping

TH2-mediated pathogenesis with the eosinophilic asthma. METHODS: Serum periostin

levels were measured by human periostin enzyme-linked immunosorbent assay (ELISA)

in serum samples from 277 adults with asthma. Serum periostin levels were

compared between patients with AERD and aspirin tolerant asthma (ATA) with other

asthma phenotypes, such as severe or nonsevere asthma and eosinophilic or

noneosinophilic asthma. The association of serum periostin levels with clinical

parameters (including disease severity and comorbid condition) was analyzed.

RESULTS: Serum periostin levels were significantly higher in patients with AERD

vs ATA, patients with severe asthma vs nonsevere asthma, and patients with

eosinophilic asthma vs noneosinophilic asthma (P=.005, P=.02, and P=.001,

respectively). Multivariate regression analysis revealed serum periostin levels

as a significant parameter to predict AERD phenotype (P=.006) together with

severe asthma phenotype (P=.04). In addition, serum periostin levels correlated

with blood eosinophil counts (Spearman n = 0.244, P<.001) and sputum eosinophil

counts (Spearman n = 0.261, P < 0.001). Higher serum periostin levels were noted

in comorbid AERD patients with more severe chronic rhinosinusitis (Lund-Mackay

stages 3 and 4) than those with less severe chronic rhinosinusitis (Lund-Mackay

stages 1 and 2) (P = .03). CONCLUSION: Serum periostin levels are significantly

elevated in AERD patients and associated with AERD phenotype and disease

severity.