Diagnostic utility of serum periostin for house dust mite sublingual immunotherapy response in allergic rhinitis

Abstract

<b>Background:</b> House dust mite (HDM) sublingual immunotherapy (SLIT) is a treatment option for allergic rhinitis (AR), but its efficacy varies across patients. Periostin is one of matricellular protein and is the downstream molecule of IL-13, a biomarker reflecting type 2 inflammation. <b>Aims and objective:</b> To evaluate the relationship between serum periostin levels and clinical outcomes before and after HDM SLIT. <b>Methods:</b> One hundred eleven subjects with HDM-induced AR were randomized to receive either standardized quality (SQ)-HDM SLIT plus pharmacotherapy or pharmacotherapy alone, for 48 weeks. At enrollment and the end of study, biomarkers that included serum periostin, HDM-specific IgE (s-IgE), total IgE, blood eosinophil counts and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) were measured. <b>Results:</b> High serum periostin levels (&gt;30.2 ng/mL) were associated with an effective response to SLIT, and the change in RQLQ score was correlated with the level of periostin. The sensitivity and specificity based on receiver operating characteristic analysis for periostin were higher than those of s-IgE. Multivariate regression analysis showed that serum periostin was independent factor for SLIT responders. <b>Conclusions:</b> Serum periostin shows a useful biomarker for predicting the response to HDM SLIT in patients with AR.