Blood periostin/procalcitonin index and glomerular filtration rate in various types of bronchial asthma

Abstract

Introduction. The possibility of co-existence of chronic kidney disease (CKD) and bronchial asthma (BA) was shown earlier and we found that the mechanisms of the CKD development differ depending on the variant of the disease (allergic and nonallergic). New biomarkers of the activity of allergic (periostin) and infectious (procalcitonin) inflammation in BA have appeared. Evidence of the involvement of the periostin in the pathogenesis of the CKD was obtained, and an increase in the level of procalcitoninin CKD was also found. The purpose of the study is to evaluate the possible influence of periostin and procalcitonin on progression of creatinine clearance decrease regarding different BA phenotypes. Methods. 19 patients with BA (13 patients with an allergic variant, 6 patients with a nonallergic variant of the disease) were examined.The determination of blood periostin and blood procalcitonin was carried out by ELISA. The periostin/procalciton index was calculated, the resulting dimensionless value was subject to logarithming on the basis of 10. Results. It was found that the levels of periostin differ depending on the BA variant. With an allergic variant, the level of periostin is significantly higher than in nonallergic variant. The level of procalcitonin is much higher in a nonallergic variant of the disease, although the levels of this protein are on average within normal values in both variants of the disease. The glomerular filtration rate in the examined group of patients as a whole is within normal values. Factor analysis revealed that factor 1 reflects the relationship of the component characterizing the biomarkers of infectious inflammation (procalcitonin, ESR) with a negative factor load for bronchial asthma and the glomerular filtration rate with a positive factor load. The component of such an integral indicator as the periostin/procalcitonin index has the highest factor load; factor 2 reflects the negative impact of both biomarkers on the glomerular filtration rate; factor 3 reflects the characteristics of the eosinophilic IgE-mediated inflammation in bronchial asthma. Conclusion. Periostin and procalcitonin as biomarkers of allergic and infectious inflammation possibly influence the glomerular filtration rate in different variants of bronchial asthma. The activity of each biomarker may vary depending on BA type (allergic or nonallergic).