Disconnect of type 2 biomarkers in severe asthma; dominated by FeNO as a predictor of exacerbations and periostin as predictor of reduced lung function

Mansur, Adel; Srivastava, Shalini; Sahal, Adeel

doi:10.1016/j.rmed.2018.08.005

Cited by 41 publications

(37 citation statements)

References 44 publications

(52 reference statements)

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“…Allergic asthma is supported by type 2 inflammation and down-regulated type 1-response with reduced secretion of interferon-γ [1]. Type 2 inflammation is paradigmatically characterized by eosinophilic airway infiltration [2]. Actually, phenotyping and endotyping asthmatic patients is fundamental to tailor the most appropriated personalized therapy [3].…”

Section: Introductionmentioning

confidence: 99%

Tryptophan metabolic pathway and neopterin in asthmatic children in clinical practice

2019

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Tryptophan metabolic pathway is involved in pathogenic mechanisms of asthma. This study aimed to evaluate tryptophan metabolites and neopterin in a group of asthmatic children. Tryptophan metabolites and neopterin were measured in asthmatic children (121, 71 males, 50 females, mean age 11.6 + 3.2 years) and well-matched healthy controls (63, 32 males, 31 females, mean age 10.7 + 2.6 years). Tryptophan, kynurenine, and neopterin levels were significantly higher in asthmatic children than in healthy controls ( p < 0.01; p < 0.01; p = 0.0015 respectively). Tryptophan metabolites and neopterin are increased in asthmatic children; these mediators underline the complex mechanisms involved in the immune response in asthma.

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Section: Introductionmentioning

confidence: 99%

Tryptophan metabolic pathway and neopterin in asthmatic children in clinical practice

2019

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“…Vernal conjunctivitis is a chronic and severe allergic inflammatory disease in the eye, threatening sight (20). It has been reported that allergic rhinitis and vernal conjunctivitis substantially affect the quality of life in patients (14). A significant improvement was observed in the visual analog scores for rhinitis and the eye in these patients as a result of AIT.…”

Section: Discussionmentioning

confidence: 99%

“…Kanemitsu et al (13) monitored 224 patients with asthma for 4 years and found that high periostin levels (>95ng/ ml) were correlated with low FEV1 levels. Mansur et al (14) showed that periostin was significantly associated with reduced lung function as a biomarker of airway remodeling. Studies have shown that periostin is the best marker compared to serum IgE, tissue eosinophilia, FeNO and blood eosinophil level in eosinophilic airway inflammation (15,16).…”

Section: Introductionmentioning

confidence: 99%

The Effect of Allergen Immunotherapy on Serum Periostin Levels in Children with Allergic Rhinitis

Uçaryılmaz¹,

Emsen²,

Dikener³

et al. 2019

Asthma Allergy Immunol

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Objective: Periostin, an extracellular matrix protein, is related to the eosinophilic airway inflammation. There is no specific marker in allergen immunotherapy to evaluate clinical response. We aimed to investigate the serum periostin levels in the children who receive allergen immunotherapy. Materials and Methods:Sixteen patients between 8-18 years (12.7±2.8 years) with allergic rhinitis and/or asthma due to grass pollen hypersensitivity and 30 healthy subjects (11.7±2.6 years) were included. Demographic data, eosinophil counts, skin prick tests and the specific IgE levels of the patients are recorded. Symptom scores, visual analog scales, medication scores were determined and the serum periostin levels were measured in the beginning, 4th and 12th months of the allergen immunotherapy. Results:The symptom scores for rhinitis in the 4th month showed significant improvements in all of the patients (p<0.05). Nine patients with allergic rhinitis accompanied by asthma, showed significant improvements in 12th month symptom score for asthma (p=0.018). A significant correlation was detected between the initial serum periostin levels and the symptom scores for the eye (r=0.668, p=0.005). No significant difference was found in serum periostin levels between the patient and the control groups. There were no significant differences in serum periostin levels in 4 th and 12 th months compared to the ones in the beginning. Conclusion:In this study, there were no significant differences in serum periostin levels of children during the allergen immunotherapy. The association of serum periostin levels with symptom scores for the eye needs to be confirmed in more children with allergic rhinoconjunctivitis.

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“…The fraction of exhaled nitric oxide (FeNO) is mainly produced by inducible NO synthase in the airway epithelium. FeNO seems to be more related to respiratory symptoms [16] than to FAO [17].…”

Section: Introductionmentioning

confidence: 86%

Inflammatory patterns in fixed airflow obstruction are dependent on the presence of asthma

et al. 2020

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Rationale Fixed airflow obstruction (FAO) can complicate asthma. Inflammation is a proposed underlying mechanism. Objective Our aim in this cross-sectional investigation was to evaluate the blood leucocyte pattern and level of exhaled nitric oxide in asthmatics and non-asthmatics with or without FAO. Methods A total of 11,579 individuals aged ≥20 years from the US National Health and Nutrition Examination Survey were included. They were grouped as: controls without asthma and FAO (n = 9,935), asthmatics without FAO (n = 674), asthmatics with FAO (n = 180) and non-asthmatics with FAO (n = 790). FAO was defined as post-bronchodilator FEV1/FVC < lower limit of normal. Exhaled nitric oxide ≥ 25ppb, blood eosinophil levels ≥300 cells/μL, and blood neutrophil levels ≥5100 cells/μL were defined as elevated. Stratified analyses for smoking and smoking history were performed. Results Elevated blood eosinophil levels were more common in all groups compared to the controls, with the highest prevalence in the group with asthma and fixed airflow obstruction (p<0.01). In a multiple logistic regression model adjusted for potential confounders including smoking, the asthma groups had significantly higher odds ratios for elevated B-Eos levels compared to the control group (odds ratio 1.4, (confidence interval: 1.1–1.7) for the asthma group without fixed airflow obstruction and 2.5 (1.4–4.2) for the asthma group with fixed airflow obstruction). The group with fixed airflow obstruction without asthma had higher odds ratio for elevated blood neutrophil levels compared to the controls: 1.4 (1.1–1.8). Smoking and a history of smoking were associated to elevated B-Neu levels. Conclusion Fixed airflow obstruction in asthma was associated with elevated blood eosinophil levels, whereas fixed airflow obstruction without asthma was associated with elevated blood neutrophil levels.

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Disconnect of type 2 biomarkers in severe asthma; dominated by FeNO as a predictor of exacerbations and periostin as predictor of reduced lung function

Cited by 41 publications

References 44 publications

Tryptophan metabolic pathway and neopterin in asthmatic children in clinical practice

Tryptophan metabolic pathway and neopterin in asthmatic children in clinical practice

The Effect of Allergen Immunotherapy on Serum Periostin Levels in Children with Allergic Rhinitis

Inflammatory patterns in fixed airflow obstruction are dependent on the presence of asthma

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