Periostin as a biomarker in chronic rhinosinusitis: A contemporary systematic review

Abstract

Background The role of periostin, a matricellular protein encoded by the POSTN gene, in chronic rhinosinusitis with nasal polyposis (CRSwNP) is reviewed. Periostin is considered a potential biomarker of endotype and may be useful for evaluating response to treatment. Methods Search terms in PubMed and Web of Science (1990–March 2022) included: ((periostin) OR (POSTN)) AND ((sinusitis) OR (nasal polyp) OR (CRSwNP) OR (CRS). The primary outcomes were differences in tissue, serum, and nasal lavage between CRSwNP and CRS without NP (CRSsNP) or controls. Associated factors reported to affect periostin expression, data regarding participants’ clinical characteristics, disease endotypes, laboratory methods, and samples’ origin were also pooled. Studies on <10 patients were excluded. Results Out of 101 records harvested through database searching, 29 prospective cross‐sectional or case‐control studies were eligible for review and qualitative analysis. Tissue sample origin, concurrent infection, current and past medication, primary or recurrent disease, allergic rhinitis, and smoking status should be considered as confounding factors for periostin levels. Periostin and POSTN messenger RNA (mRNA) levels were consistently and significantly higher in CRSwNP than CRSsNP and controls. Despite the distinctly different inflammation patterns among CRSwNP endotypes, periostin‐related remodeling patterns seemed to be similar. Conclusion Tissue and serum periostin levels, and POSTN expression appear elevated in CRSwNP, especially in eosinophilic inflammation, compared to CRSsNP and controls. Disease severity and comorbidities are also reflected in periostin and POSTN values. Carefully designed prospective studies may establish the role of periostin as a biomarker in CRSwNP and allow its incorporation in clinical practice.

Systematic Review of Protein Biomarkers in Adult Patients With Chronic Rhinosinusitis

“…This review summarizes the expression pattern among CRS phenotypes of 143 biomarkers identified from studies of nasal tissue, nasal secretions, nasal lavage fluid, serum, or Previous systematic reviews have concentrated on specific biomarkers alone, such as periostin 92 or matrix metalloproteinases 93 while this review integrates findings from all available biomarkers. Additionally, this review is not limited to one specific CRS phenotype but compares data across multiple phenotypes.…”

“…Previous systematic reviews have concentrated on specific biomarkers alone, such as periostin 92 or matrix metalloproteinases 93 while this review integrates findings from all available biomarkers. Additionally, this review is not limited to one specific CRS phenotype but compares data across multiple phenotypes.…”

Skin, gut, and lung barrier: Physiological interface and target of intervention for preventing and treating allergic diseases

“…[164][165][166] Consistently elevated levels of periostin, an extracellular matrix protein secreted in response to IL-4 and IL-13, have been found in patients with CRSwNP relative to those with CRSsNP and healthy controls, and correlate with disease severity. 167 P-glycoprotein is upregulated in T2 inflammation, with secretion levels increased in the mucus of patients with CRS, and higher levels associated with CRSwNP and greater disease severity. 168…”

Perspectives in Therapy of Chronic Rhinosinusitis

“…Nowadays, in order to establish endotype dominance and to choose the most effective treatment, phenotype of CRS, markers (eosinophils, periostin, IgE in blood or tissue), and treatment response should be considered [ 2 ]. Tissue and serum periostin levels appear elevated in CRSwNP, especially in eosinophilic inflammation, compared to CRSsNP and controls [ 42 ].…”