Diagnosis of Bronchial Asthma in Children 3–6 Years Old by Using Serum Periostin and Surrogate Markers of Eosinophilic Inflammation (Blood Eosinophils and Total IgE): a Cross-Sectional Study

Abstract

Background. It is difficult to diagnose bronchial asthma (BA) in children under the age of 6 due to the limited ability to study respiratory function. Therefore, it is relevant to search for such diagnostic markers of BA that do not require the active participation of a child.Objective. Our aim was to assess the diagnostic value of serum periostin levels in comparison with surrogate markers of eosinophilic inflammation (total IgE and blood eosinophils) for the diagnosis of BA in preschool children.Methods. A cross-sectional study included children 3–6 years of age with BA and healthy peers. The levels of serum periostin (ELISA), total IgE (chemiluminescent method), blood eosinophils (counted on a hematological analyzer) were determined. To study the diagnostic value of peripheral blood parameters ROC-analysis was used.Results. Children with BA (n = 56) compared with the healthy group (n = 29) showed higher levels of serum periostin (median and quartile) — 5.7 (3.4, 8.0) and 2.7 (1, 7; 3.6) ng/ml (p < 0.001), total IgE — 180 (122; 622) and 55 (45; 87) IU/ml (p < 0.001), blood eosinophils — 6.1% (3.8; 8.0) and 3.6% (2.7; 4.1) (p < 0.001). The area under the ROC curve (AUC) for serum periostin was 0.81 (95% CI 0.73–0.89), for total IgE — 0.86 (95% CI 0.77–0.92), for blood eosinophils — 0.77 (95% CI 0.67–0.86). Independent predictors of serum periostin were total IgE and the number of exacerbations of BA over the past 12 months > 2 (R2 = 0.527).Conclusion. The level of serum periostin in preschool children with BA is higher than in their healthy peers. The diagnostic value of serum periostin in BA is in the range from moderate to good and is comparable to that for the levels of blood eosinophils and total IgE.