Roles of Periostin in Respiratory Disorders

Abstract

Periostin is a matricellular protein that has been implicated in many disease states. It interacts with multiple signaling cascades to modulate the expression of downstream genes that regulate cellular interactions within the extracellular matrix. This review focuses on the role of periostin in respiratory diseases, including asthma and idiopathic pulmonary fibrosis, and its potential to help guide treatment or assess prognosis. Epithelial injury is a common feature of many respiratory diseases, resulting in the secretion, among others, of periostin, which is subsequently involved in airway remodeling and other aspects of pulmonary pathophysiology. In asthma, periostin is recognized as a biomarker of type 2 inflammation; POSTN gene expression is up-regulated in bronchial epithelial cells by IL-13 and IL-4. Serum periostin has been evaluated for the identification of patients with increased clinical benefit from treatment with anti-IL-13 (lebrikizumab, tralokinumab) and anti-IgE (omalizumab) therapy and may be prognostic for increased risk of asthma exacerbations and progressive lung function decline. Furthermore, in asthma, periostin may regulate subepithelial fibrosis and mucus production and may serve as a systemic biomarker of eosinophilic airway inflammation. Periostin is also highly expressed in the lungs of patients with idiopathic pulmonary fibrosis, and its serum levels may predict clinical progression. Overall, periostin contributes to multiple pathogenic processes across respiratory diseases, and peripheral blood levels of periostin may have utility as a biomarker of treatment response and disease progression.

Potential Role of Serum Periostin in the Early Detection of Bronchial Asthma in Children

“…С учетом убедительных данных последних лет, показав-ших, что уровень сывороточного периостина может слу-жить в качестве системного биомаркера эозинофильного воспаления дыхательных путей, Th2-ассоциированного воспаления в респираторном тракте [61,62], а также что его уровень значительно повышен у детей с БА [63], следует продолжить исследование этого индикатора у детей с различными фенотипами свистящего дыхания. Возможно, оценка уровня сывороточного периостина позволит прогнозировать развитие БА при различных фенотипах свистящего дыхания или же с большей вероят-ностью диагностировать БА в раннем возрасте, посколь-ку есть данные, что у детей с БА экспрессия периостина эпителиальными клетками в 3,7 раза выше, чем у здоро-вых детей и детей с атопией, но без астмы [64].…”

Periostin as a biomarker of airway inflammation

“…4 Periostin gene expression and protein synthesis is dynamic and rapidly turned over. It is induced by IL-4, IL-13, tumor growth factor (TGF)-β1,…”

“…Periostin is a recognized biomarker in asthma, 3 and is useful for identification of patients with increased clinical benefit from treatment with anti-interleukin (IL)-13 and anti-immunoglobulin-E (IgE) therapy, 3 and may be prognostic for increased risk of asthma exacerbations and progressive lung function decline. 4 It is also a nascent biomarker in chronic obstructive pulmonary disease (COPD). 5 There is a need for further studies in asthma phenotypes and COPD, and in this issue of Polish Archives of Internal Medicine (Pol Arch Med Wewn), Katarzyna Górska et al 6 have extended the evaluation of periostin to include steroid-naive, mild-to-moderate asthma as well as COPD.…”

Periostin Levels do not Distinguish Chronic Obstructive Pulmonary Disease Patients with Frequent and Infrequent Exacerbations

“…1 Eosinophilic inflammation within the airways is usually considered as a hallmark of patients with asthma and it was found that the exacerbation rate was significantly reduced in patients with high levels of periostin. 2 While, to date, most studies have focused on periostin in asthma, its role in COPD is less clear and no information has been reported on blood levels of periostin in COPD patients in the context of exacerbation rates.…”

“…Matching criteria included age, body mass index (BMI) and disease severity according to FEV 1 . Smoking was considered as additional confounder in the analysis because it has been reported recently that periostin may be repressed by smoking.…”