期刊
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
卷 132, 期 2, 页码 305-+出版社
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2013.04.050
关键词
Asthma; inhaled corticosteroids; lung function decline; periostin; POSTN gene polymorphism; sinusitis; treatment step
资金
- Ono Pharm
- Novartis
- AstraZeneca
- Kyorin
- GlaxoSmithKline
- Teijin Pharm
- Merk Sharp Dohme
- Boehringer Ingelheim
- Astellas
- Nippon Boehringer Ingelheim
- Sanofi Aventis
- Grants-in-Aid for Scientific Research [25293224, 23591117, 22249031, 24659405, 24591466] Funding Source: KAKEN
Background: Periostin, an extracellular matrix protein, contributes to subepithelial thickening in asthmatic airways, and its serum levels reflect airway eosinophilic inflammation. However, the relationship between periostin and the development of airflow limitation, a functional consequence of airway remodeling, remains unknown. Objective: We aimed to determine the relationship between serum periostin levels and pulmonary function decline in asthmatic patients on inhaled corticosteroid (ICS) treatment. Methods: Two hundred twenty-four asthmatic patients (average age, 62.3 years) treated with ICS for at least 4 years were enrolled. Annual changes in FEV1, from at least 1 year after the initiation of ICS treatment to the time of enrollment or later (average, 16.2 measurements over 8 years per individual), were assessed. At enrollment, clinical indices, biomarkers that included serum periostin, and periostin gene polymorphisms were examined. Associations between clinical indices or biomarkers and a decline in FEV1 of 30 mL or greater per year were analyzed. Results: High serum periostin levels (>= 95 ng/mL) at enrollment, the highest treatment step, higher ICS daily doses, a history of admission due to asthma exacerbation, comorbid or a history of sinusitis, and ex-smoking were associated with a decline in FEV1 of 30 mL or greater per year. Multivariate analysis showed that high serum periostin, the highest treatment step, and ex-smoking were independent risk factors for the decline. Polymorphisms of periostin gene were related to higher serum periostin levels (rs3829365) and a decline in FEV1 of 30 mL or greater per year (rs9603226). Conclusions: Serum periostin appears to be a useful biomarker for the development of airflow limitation in asthmatic patients on ICS.
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