Key result
Serum periostin links to sputum eosinophils but shows only modest ability to predict eosinophilic asthma.
Why the study?
The relationship between serum and sputum periostin levels, airway inflammatory phenotype, and asthma control in poorly-controlled asthma was unclear.
Do serum and sputum periostin levels predict eosinophilic inflammation in adults with poorly-controlled asthma?
Cross-Sectional (n=83)
Yes
Do serum and sputum periostin levels predict eosinophilic inflammation in adults with poorly-controlled asthma?
Effect estimate: AUC 0.679
p-value: p=0.007
In poorly-controlled asthma, serum and sputum periostin levels correlate with sputum eosinophils but have only modest utility in predicting eosinophilic asthma compared to peripheral blood eosinophils.
Serum and sputum periostin associate with eosinophilic asthma but predict phenotype only modestly; leaves open utility beyond blood eosinophils in poorly-controlled disease.
BACKGROUND: Periostin levels are associated with airway eosinophilia and are suppressed by corticosteroid treatment in asthma. This study sought to determine the relationship between serum and sputum periostin, airway inflammatory phenotype and asthma control. METHODS: Adults with poorly-controlled asthma (n = 83) underwent a clinical assessment, sputum induction and blood sampling. Dispersed sputum was used for a differential cell count and periostin assessment (ELISA). Serum periostin was determined by the Elecsys® immunoassay. RESULTS: Periostin levels were significantly higher in serum (median (IQR) of 51.6 (41.8, 62.6) ng/mL) than in sputum (1.1 (0.5, 2.0) ng/mL) (p < 0.001). Serum and sputum periostin were significantly higher in patients with eosinophilic asthma (n = 37) compared with non-eosinophilic asthma. Both serum and sputum periostin levels were significantly associated with proportion of sputum eosinophils (r = 0.422, p < 0.001 and r = 0.364, p = 0.005 respectively) but were not associated with asthma control. In receiver operator characteristic curve analysis, the area under the curve (AUC) for serum periostin (n = 83) was 0.679, p = 0.007. Peripheral blood eosinophils assessed in 67 matched samples, had a numerically greater AUC of 0.820 compared with serum periostin, p = 0.086 for the detection of eosinophilic asthma. CONCLUSION: In poorly-controlled asthma, sputum and serum periostin levels are significantly related to sputum eosinophil proportions while their ability to predict the presence of eosinophilic asthma is modest.
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Simpson et al. (2016) conducted a cross-sectional in Poorly-controlled asthma (n=83). Serum periostin vs. Non-eosinophilic asthma was evaluated on Detection of eosinophilic asthma (AUC 0.679, p=0.007). Serum periostin levels were significantly associated with sputum eosinophil proportions but had only modest ability to predict the presence of eosinophilic asthma (AUC 0.679).
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