Relationships among aeroallergen sensitization, peripheral blood eosinophils, and periostin in pediatric asthma development

Abstract

Background Biomarkers, preferably non-invasive, that predict asthma inception children are lacking. Objective Little is known about biomarkers of type 2 inflammation in early life in relation to asthma inception. We evaluated aeroallergen sensitization, peripheral blood eosinophils and serum periostin as potential biomarkers of asthma in children. Methods Children enrolled in the Childhood Origins of ASThma (COAST) study were followed prospectively from birth. Blood samples were collected at ages 2, 4, 6, and 11 years, and serum-specific IgE, blood eosionophils and periostin were measured in 244 children. Relationships among these biomarkers, age and asthma were assessed. Results Serum periostin levels were approximately 2–3 fold higher in children than previously-observed adult levels. Levels were highest at 2 years (145 ng/mL), and did not change significantly between 4 and 11 years (128 and 130 ng/mL). Age 2 periostin≥150 ng/mL predicted asthma at age 6 [Odds Ratio (OR) 2.3 95%CI (1.3–4.4)]. Eosinophil count ≥300 cells/ul and aeroallergen sensitization at age 2 were each associated with increased risk of asthma at age 6 [OR 3.1(1.7–6.0) and 3.3(1.7–6.3)]. Children with any two of the biomarkers had significantly increased risk of developing asthma by school age [≥2 biomarkers vs. none OR= 6.6 (95%CI 2.7–16.0). Conclusion Serum periostin levels are significantly higher in children than adults, likely due to bone turnover, which impairs clinical utility in children. Early life aeroallergen sensitization and elevated blood eosinophils are robust predictors of asthma development. Children with evidence of activation of multiple pathways of type 2 inflammation in early life are at greatest risk for asthma development.

Baseline asthma burden, comorbidities, and biomarkers in omalizumab-treated patients in PROSPERO

“…The following cutoff points were used to stratify patients by biomarker status: FeNO 31 (<25 vs !25 ppb), eosinophils 32 (<300 vs !300 cells/mL), and periostin (<50 vs !50 ng/mL). 9 Because periostin measurements have been challenging to interpret in adolescents, owing to the confounding contributions of periostin produced by osteoblasts during growth, 33 no predefined cutoffs were specified for adolescents. Correlation coefficients were calculated among PROs, lung function, and biomarkers.…”

Serum Periostin Levels in Children with Positive or Negative Asthma Predictive Index and Healthy Age-Matched Subjects

“…Anderson и соавт. [11], возрастание числа эозинофилов крови более 300 кл/мкл и сенсибилизация к ингаляционным аллергенам в 2-летнем возрасте в среднем втрое увеличивают шансы развития БА к 6 годам жизни.…”

“…В качестве нового биомаркера -предиктора развития БА у детей -изучается сывороточный периостин, экспрес сируемый эпителиальными клетками, фибробластами и клетками гладкой мускулатуры бронхов под влиянием Th2-опосредованных цитокинов -ИЛ-4 и ИЛ-13 [13,14]. Обнаружена связь между уровнем сывороточного периос тина и риском формирования БА: двукратное повышение шансов развития в 6-летнем возрасте при содержании сывороточного периостина в первые 2 года жизни > 140 нг/мл [11]. Исследования возможности использования концентрации сывороточного периостина для оценки риска появления БА у детей с повторными эпизодами БОС единичны.…”

Advances in asthma in 2017: Mechanisms, biologics, and genetics

“…8 Increased periostin levels and a T H 1 airway signature regardless of asthma presence were found in children. 3,22 In sputum from asthmatic patients, numbers of IgE 1 B cells and plasma cells were increased. 12 Numbers of Breg cells were decreased in the circulation of asthmatic patients.…”