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Abstract

<b>Introduction:</b> Serum periostin is a potential biomarker of response to therapies which target a T-helper 2 (Th2) pattern of inflammation in asthma. <b>Aims:</b> To determine serum periostin levels in a random sample of adults with symptoms of airflow obstruction, its relationship with other variables, including other biomarkers of a Th2 pattern of disease, and the change in serum periostin levels with inhaled corticosteroid (ICS) treatment. <b>Methods:</b> Serum periostin levels were determined as part of the New Zealand Respiratory Health Survey, a cross-sectional study designed to explore phenotypes and biomarkers in individuals aged 40 to 75 who reported wheeze and breathlessness in the last 12 months (n=386). 49 steroid naïve subjects had repeat periostin testing after 12 weeks open label ICS (budesonide 800 mcg/day). <b>Results:</b> Serum periostin values ranged from 15.0ng/ml to 164.7ng/ml, with a right skewed distribution. Mean (SD) periostin was 57.3 (18.6), median (IQR) 54.0 (45.1 to 65.6). Periostin was positively correlated with exhaled nitric oxide (r=0.22, p&lt;0.001), blood eosinophils (r=0.21, p&lt;0.001), and total IgE (r=0.14, p=0.007). Atopy was associated with a higher mean periostin level (59.4 v 53.9, p=0.002; median 55.9 v 51.0). Gastro-oesophageal reflux was associated with a lower mean periostin (54.6 v 59.6, p=0.002; median 51.5 v 55.9). Twelve weeks of ICS therapy in steroid naïve participants was associated with a 10% reduction in mean periostin, from 52.9 to 47.6, median periostin reduced from 49.8 to 47.3. <b>Conclusion:</b> Serum periostin is a marker of a Th2 pattern of airways disease, and a course of ICS therapy leads to a mean reduction in serum periostin levels of 10%.