Using Exhaled Nitric Oxide and Serum Periostin as a Composite Marker to Identify Severe/Steroid-Insensitive Asthma

Nagasaki, Tadao; Matsumoto, Hisako; Kanemitsu, Yoshihiro; Izuhara, Kenji; Tohda, Yuji; Horiguchi, T.; Kita, Hideo; Tomii, Keisuke; Fujimura, Masaki; Yokoyama, Akihito; Nakano, Yasutaka; Hozawa, Soichiro; Ito, Isao; Oguma, Tsuyoshi; Izuhara, Yumi; Tajiri, Tomoko; Iwata, Toshiyuki; Ono, Junya; Ohta, Shoichiro; Yokoyama, Tetsuji; Niimi, Akio; Mishima, Michiaki

doi:10.1164/rccm.201407-1290le

Cited by 53 publications

(37 citation statements)

References 15 publications

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“…FeNO, another surrogate biomarker for type 2 immunity, is also correlated with serum periostin 4144. Nagasaki et al44 showed that the correlation between FeNO and serum periostin is much stronger in patients with severe asthma.…”

Section: Introductionmentioning

confidence: 99%

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Using Periostin as a Biomarker in the Treatment of Asthma

Izuhara

Ohta

Ono

2016

Allergy Asthma Immunol Res

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Periostin acts both as an extracellular matrix protein belonging to the fasciclin family and as a matricellular protein functioning in cell activation by binding to its receptors on the cell surface. It has been established that periostin is a downstream molecule of interleukin (IL)-13, a signature type 2 cytokine, and that periostin plays an important role in the pathogenesis of allergic diseases, including asthma. Based on these findings, much attention has been paid to periostin as a biomarker useful in the treatment of asthma. Periostin is a surrogate biomarker for type 2 immunity; it has been shown that serum periostin can predict the efficacy of anti-IL-13 antibodies (lebrikizumab) and anti-IgE antibodies (omalizumab), and that this usefulness can be potentially expanded to other type 2 antagonists. Moreover, it has been shown that periostin is not a simple surrogate biomarker for type 2 immunity; periostin-high asthma patients have several unique characteristics, including eosinophilia, high fraction of nitric oxide, aspirin intolerance, nasal disorders, and late onset. These characteristics are likely to be correlated with the involvement of periostin in the tissue remodeling of asthma. Periostin is also associated with hyporesponsiveness to inhaled corticosteroids, probably reflecting tissue remodeling. Thus, periostin has 2 characteristics as a biomarker for early diagnosis of asthma: surrogate biomarkers for type 2 immunity and tissue remodeling. Based on these characteristics, we will be able to apply serum periostin to treatment of asthma.

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Section: Introductionmentioning

confidence: 99%

“…Nagasaki et al44 showed that the correlation between FeNO and serum periostin is much stronger in patients with severe asthma.…”

Section: Introductionmentioning

confidence: 99%

Using Periostin as a Biomarker in the Treatment of Asthma

Izuhara

Ohta

Ono

2016

Allergy Asthma Immunol Res

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“…49 Additionally, we have recently found that FeNO was moderately to strongly associated with serum periostin in step 4/5 patients, but only weakly in the overall patients. 50 As mentioned before, FeNO is another biomarker of type 2 immune responses. 51,52 Taken together, these results verified that serum periostin is a surrogate biomarker of type 2 immune responses.…”

Section: Periostin As a Surrogate Biomarker Of Type 2 Immune Responsesmentioning

confidence: 92%

Recent developments regarding periostin in bronchial asthma

Izuhara

Matsumoto

Ohta

et al. 2015

Allergology International

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Although it is currently recognized that bronchial asthma is not a single disease but a syndrome, we have not yet made use of our new understanding of this heterogeneity as we treat asthma patients. To increase the efficacy of anti-asthma drugs and to decrease costs, it is important to stratify asthma patients into subgroups and to develop therapeutic strategies for each subgroup. Periostin has recently emerged as a biomarker for bronchial asthma, unique in that it is useful not in diagnosis but in categorizing asthma patients. We first found that periostin is a novel component of subepithelial fibrosis in bronchial asthma downstream of IL-13 signals. Thereafter, it was shown that periostin can be a surrogate biomarker of type 2 immune responses, the basis of the notion that a detection system of serum periostin is potentially a companion diagnostic for type 2 antagonists. Furthermore, we have recently shown that serum periostin can predict resistance or hyporesponsiveness to inhaled corticosteroids, based on its contribution to tissue remodeling or fibrosis in bronchial asthma. Thus, serum periostin has two characteristics as a biomarker for bronchial asthma: it is both a surrogate biomarker of type 2 immune responses and a biomarker reflecting tissue remodeling or fibrosis. We can take advantage of these characteristics to develop stratified medicine in bronchial asthma.

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“…Serum periostin levels also correlated with fractional exhaled nitric oxide (FE NO ) and with airway hyperresponsiveness to methacholine and mannitol in asthmatic children [24]. More importantly, high serum periostin in patients with high FE NO was a risk for subsequent asthma exacerbations despite taking high-dose ICS, independent of known risks including low FEV 1 [25]. Importantly, circulating periostin levels seemed to be stable within subjects at 3 measurements in a 5-week period [21].…”

Section: Introductionmentioning

confidence: 93%

Circulating periostin level in asthmatic pregnancy

et al. 2016

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Objective: Asthma often complicates pregnancy and represents a risk for complications.Periostin is considered as a biomarker of asthma; however, as it also plays a role in normal gestation, pregnancy may influence circulating periostin levels. This is the first study assessing periostin in asthmatic pregnancy.Methods: Plasma periostin levels were investigated in asthma (asthmatic non-pregnant, ANP; N = 19) and asthmatic pregnancy (AP; N = 14), compared to healthy non-pregnant controls (HNP; N = 12) and healthy pregnant women (HP; N = 17). The relationship between periostin levels and asthma control determinants was also evaluated. The diagnostic efficacy of periostin to detect uncontrolled asthma was analyzed using ROC analysis. (54.02 [44.30-74.94] ng/mL, p = 0.0346 vs. ANP). Periostin levels of the two pregnant groups were similar (p > 0.05). In AP women periostin correlated negatively with FEV 1 (r = -0.5516) and positively with Raw (r = 0.5535; both p < 0.05).Conclusions: Pregnancy itself increases circulating periostin levels and this elevation is detectable in asthmatic pregnancy as well. Although periostin correlates with lung function in asthmatic pregnancy, periostin as a biomarker has to be handled with caution in pregnant patients due to the influence of pregnancy on its plasma level.

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Using Exhaled Nitric Oxide and Serum Periostin as a Composite Marker to Identify Severe/Steroid-Insensitive Asthma

Cited by 53 publications

References 15 publications

Using Periostin as a Biomarker in the Treatment of Asthma

Using Periostin as a Biomarker in the Treatment of Asthma

Recent developments regarding periostin in bronchial asthma

Circulating periostin level in asthmatic pregnancy

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