期刊
RESPIRATORY MEDICINE
卷 143, 期 -, 页码 31-38出版社
W B SAUNDERS CO LTD
DOI: 10.1016/j.rmed.2018.08.005
关键词
Severe asthma; Type 2 inflammation; FeNO; Blood eosinophils; Periostin; Lung function; Exacerbations; Asthma control
资金
- charitable BRSAS, Heartlands Hospital Charity, Birmingham UK
Background: biomarkers of Type 2 (T2) inflammation may predict asthma control and exacerbation risk. However, the relationships between individual T2 biomarkers to exacerbations and lung function in severe asthma remain uncertain. Objectives: to explore the roles played by T2 biomarkers individually and as a composite score in predicting clinical outcomes in severe asthma. Methods: unselected severe asthma patients were enrolled in this cross sectional real life study. Participants were clinically characterised and the following measurements were obtained: the frequency of exacerbations requiring oral corticosteroids (OCS), asthma control (Juniper ACQ6-7), lung function, Fraction exhaled Nitric Oxide (FeNO), peripheral blood eosinophils (PBE), and serum periostin. Results: A total of 115 patients were recruited [mean age 45 years (range 18-70), 80 (69.6%) females, mean forced expiratory volume in first second (FEV1) %predicted was 68% +/- 24.7, mean inhaled corticosteroids (ICS) 1.96 +/- 0.82 mg/day. FeNO correlated significantly with PBE (r = 0.35, p = 0.0004), but not with periostin (r = 0.22, p = 0.065) and there was no significant correlation between PBE and periostin. FeNO correlation with exacerbations (r = 0.42, p = 0.0008) was stronger than PBE and periostin. A composite score of the 3 biomarkers correlated with exacerbations in a dose-dependent manner but multiple regression analysis did not confirm an added benefit. Only periostin demonstrated a significant correlation with FEV1 %predicted (r = -0.34, p = 0.004) with ROC-AUC 0.7. Conclusion: FeNO demonstrated stronger correlation with asthma exacerbations than PBE or periostin with no definite added benefit from a composite score of the 3 biomarkers. Only periostin showed significant association with reduced lung function raising its potential as a biomarker of airway remodeling.
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