Serum level of periostin and interleukin-38 in atopic asthma and their association with eosinophilic airway inflammatory response

The aim of the study is to evaluate the relationship between serum periostin (POSTN), thymus and activation-regulated chemokine (TARC), and thymic stromal lymphopoietin (TSLP) levels and disease severity and atopy in children with atopic dermatitis. Sixty children with atopic dermatitis and 31 healthy controls were included in the study. The disease severity was measured by SCORAD scores. Serum POSTN, TARC, and TSLP levels were measured in all participants. The demographic data were recorded, and skin prick tests were performed to evaluate atopy in children with atopic dermatitis. Serum POSTN, TARC, and TSLP levels were higher in children with atopic dermatitis than in healthy children (p = 0.041, p = 0.034, and p < 0.001, respectively). Serum POSTN levels were higher with atopy than without atopy in children with atopic dermatitis (p = 0.047). There was a positive moderate correlation between POSTN and the age and symptom duration in children with atopic dermatitis (r = 0.343, p = 0.007, r = 0.484, and p < 0.0001, respectively). In receiver operating characteristics (ROC) analysis, the area under the curve (AUC) was 0.789 (95% CI (0.694 - 0.883), p < 0.0001) for TSLP and the AUC was 0.636 (95% CI (0.522 - 0.750), p = 0.034) for TARC to predict severe atopic dermatitis. Serum POSTN, TARC, and TSLP were higher in children with atopic dermatitis. Serum TARC and TSLP levels might be used as biomarkers to predict severe atopic dermatitis and serum POSTN to predict atopy and disease chronicity.

BackgroundPeriostin levels are associated with airway eosinophilia and are suppressed by corticosteroid treatment in asthma. This study sought to determine the relationship between serum and sputum periostin, airway inflammatory phenotype and asthma control.MethodsAdults with poorly-controlled asthma (n = 83) underwent a clinical assessment, sputum induction and blood sampling. Dispersed sputum was used for a differential cell count and periostin assessment (ELISA). Serum periostin was determined by the Elecsys® immunoassay.ResultsPeriostin levels were significantly higher in serum (median (IQR) of 51.6 (41.8, 62.6) ng/mL) than in sputum (1.1 (0.5, 2.0) ng/mL) (p < 0.001). Serum and sputum periostin were significantly higher in patients with eosinophilic asthma (n = 37) compared with non-eosinophilic asthma. Both serum and sputum periostin levels were significantly associated with proportion of sputum eosinophils (r = 0.422, p < 0.001 and r = 0.364, p = 0.005 respectively) but were not associated with asthma control. In receiver operator characteristic curve analysis, the area under the curve (AUC) for serum periostin (n = 83) was 0.679, p = 0.007. Peripheral blood eosinophils assessed in 67 matched samples, had a numerically greater AUC of 0.820 compared with serum periostin, p = 0.086 for the detection of eosinophilic asthma.ConclusionIn poorly-controlled asthma, sputum and serum periostin levels are significantly related to sputum eosinophil proportions while their ability to predict the presence of eosinophilic asthma is modest.Electronic supplementary materialThe online version of this article (doi:10.1186/s12890-016-0230-4) contains supplementary material, which is available to authorized users.

BackgroundPeriostin and human chitinase-3-like protein 1 (YKL-40) have been suggested to be involved in the development of airway fibrosis and remodeling. This study aimed to investigate the relationship between serum periostin levels and airway hyperresponsiveness (AHR) and between serum YKL-40 levels and AHR in children with asthma, comparing periostin as a marker for Th2 inflammation and atopy with YKL-40. MethodsThe study involved children aged 6–15 years, comprising 75 with asthma and 29 healthy controls. We measured serum periostin and YKL-40 levels and performed exercise bronchial provocation tests, methacholine challenge tests, spirometry, and FeNO measurements. ResultsCompared to the healthy controls, asthmatic children exhibited significantly elevated levels of periostin (86.7 [71.0–104.0] vs 68.3 [56.0–82.0] ng/mL; P = 0.006) and YKL-40 (29.0 [15.0–39.5] vs 27.7 [14.0–34.1] ng/mL; P = 0.034). The subgroup analysis revealed that periostin levels were significantly higher in the atopic asthma group than in the healthy controls (P = 0.003), but not in the non-atopic asthma group. YKL-40 levels were elevated in both the atopic and non-atopic asthma groups compared to healthy controls (P = 0.012 and P = 0.001, respectively). Serum periostin levels were significantly correlated with the postexerceise maximum percentage decrease in forced expiratory volume (FEV1), as well as with fractional exhaled nitric oxide (FeNO) and blood eosinophil counts, but showed no significant correlation with overall lung function. Conversely, serum YKL-40 levels were significantly linked to the Z score of FEV1 and AHR to methacholine but not with AHR to exercise or FeNO or blood eosinophil count. ConclusionsPeriostin is linked to atopic asthma and correlates with exercise-induced bronchoconstriction, FeNO, and eosinophil counts, highlighting its role in Th2 inflammation. YKL-40 is a general asthma marker, indicating airway remodeling. These findings suggest that targeting these markers can improve personalized treatment strategies for pediatric asthma.

Background Smoking influences the nature of airway inflammation in patients with bronchial asthma though synthesis of certain cytokines. Patterns of bronchial asthma are differentiated clinically, functionally, and regarding inflammatory biomarkers. Aim The research aimed to study the clinical, functional, sputum cytological differences, and serum eotaxin-2 and periostin levels in asthmatic patients regarding smoking status. Patients and methods The research was a cross-sectional study. The collection of cases began in August 2018 and ended in January 2020 at the Chest Department, Assiut University Hospital. We studied 117 asthmatic patients who were classified regarding their smoking status (45 nonsmokers, 42 smokers, and 30 former smokers) for serum eotaxin-2 and periostin by enzyme-linked immunosorbent assay. The effects of smoking were analyzed on inflammatory cells including eosinophilic and neutrophilic percentages in sputum and serum eotaxin-2 and periostin levels. Results Smokers with asthma had worse clinical and functional outcomes. Asthmatic smokers had mainly neutrophilic phenotype. Serum eotaxin-2 level was higher in smokers compared with nonsmokers and former smokers. However, serum periostin level was higher in nonsmokers compared with smokers and former smokers. Serum eotaxin-2 had a positive correlation with smoking index and eosinophilic and neutrophilic count in sputum, whereas serum periostin was correlated negatively with smoking index and positively with eosinophilic count. Conclusion Asthmatic smokers had worse clinical and functional outcomes with increased neutrophils in the sputum. The inflammatory biomarkers seen in smokers with asthma showed low serum periostin and increased serum eotaxin-2 levels.

Background:Ossification of the posterior longitudinal ligament (OPLL), characterized by ectopic new bone formation in the spinal ligament, causes neurological impairment due to narrowing of the spinal canal. However, the etiology has not been fully elucidated yet. Several biomarkers may be related to the pathogenesis of OPLL. The present study focused on the serum level of periostin, which is recognized as an important bone formation regulator.Methods:This study included 92 patients with OPLL and 54 control patients without OPLL. For the case-control analysis, 54 age and sex-matched patients were randomly included in the OPLL group. The serum fibroblast growth factor-23 (FGF-23), creatinine, inorganic phosphate, calcium, alkaline phosphatase, and periostin levels were assessed. Furthermore, the calcium, creatinine, and inorganic phosphate levels in urine and the percentage of tubular reabsorption of phosphate were also analyzed. Moreover, the relationship between the biomarkers and the extent of OPLL was analyzed. The data were compared between patients with OPLL progression (the progression group) and without OPLL progression (the non-progression group).Results:The mean serum FGF-23 and periostin levels in the OPLL group were higher than that in the control group. The serum inorganic phosphate level in the OPLL group was lower than that in the control group. No correlation was found between any of the biomarkers and the extent of ossification. The serum periostin level in the progression group was higher than that in the non-progression group. No significant difference in the serum FGF-23 level was noted between the progression and non-progression groups. Moreover, no correlation was found between serum periostin and FGF-23 levels.Conclusions:The serum periostin level is related to OPLL progression.Level of Evidence:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Phthalates can cause respiratory and immunological disorders. However, little is known about the role of serum periostin and YKL-40 levels in mediating the effects of phthalates. We investigated the mediating role of these biomarkers in the relationship between phthalates and airway dysfunction. A total of 487 children (aged 10-12years old) were examined. Four high-molecular-weight phthalate (HMWP) [Σ4 HMWP] metabolites and 3 low-molecular-weight phthalate (LMWP) [Σ3 LMWP] metabolites in urine samples were measured. Serum periostin and YKL-40 levels were measured. Airway function was measured using impulse oscillometry. A mediation model was used to quantify the mediating effects of periostin and YKL-40 on airway dysfunction. After adjustment for height, gender, BMI z-score, aeroallergen sensitization, secondary smoking, and vitamin D level, the level of urinary Σ3 LMWP metabolites was significantly associated with respiratory system resistance at 5Hz (Rrs5; adjusted β: 0.020, 95% CI: 0.005-0.034; p=.010). The levels of urinary Σ4 HMWP and Σ3 LMWP metabolites were significantly associated with periostin level, but not with YKL-40 level. In addition, the periostin level was associated with Rrs5 (adjusted β: 0.048, 95% CI: 0.015-0.081; p=.005) and Rrs20-5 (adjusted β: 0.040, 95% CI: 0.011-0.069; p=.007). Serum periostin level had a significant effect in mediating the relationship between Σ3 LMWP and Rrs5 (13.9%, 95% CI: 10.7-77.0; p<.001). Exposure to LMWPs was significantly associated with airway dysfunction, and this effect was partially attributable to increased serum periostin level.

The differences in molecular mechanisms during stable period and the changes in the inflammatory responses during exacerbations between distinct severe asthma phenotypes remain unclear. In this study, we aimed to characterize stable and exacerbation period serum cytokine and periostin levels of 5 different pre-defined severe asthma phenotypes with real-life data. Changes in the viral infection-induced exacerbations were also analyzed. Serum levels of 8 cytokines and periostin were measured from the sera obtained from the adult patients with five different severe asthma phenotypes based on the presence/absence of aeroallergen sensitivity, peripheral eosinophilia and chronic rhinosinusitis with nasal polyposis (CRSwNP) during stable and exacerbation periods, and from the matched controls. Serum IL-13, IL-25, TSLP and periostin levels were similar between the patient and the control groups during stable and exacerbation periods. Serum IL-25 and TSLP levels, and peripheral eosinophil count and periostin level showed a strong correlation. Stable period periostin levels were significantly higher in eosinophilic patients and eosinophilic patients without long-term systemic steroid therapy had higher IL-13 levels. Compared to stable period, exacerbation period serum periostin levels found significantly lower [5853 (2309-8427) pg/mL vs. 4479 (2766-6495) pg/mL; p=0.05] and periostin levels were much more lower in viral infection-induced exacerbations [2913 (893-4770) pg/mL vs. 7094 (4782-9596) pg/mL; p=0.022]. Our study showed that serum periostin levels were decreased in viral infection-induced exacerbations and increased in the presence of eosinophilia independent from atopy and it can help to differentiate eosinophilia even if the patient is under long-term systemic steroid therapy. Also, serum IL-13 levels may reflect peripheral eosinophilia in patients without long term systemic steroid use.

The differences in molecular mechanisms during a stable period and the changes in the inflammatory responses during exacerbations between distinct severe asthma phenotypes remain unclear. In this study, we aimed to characterize stable and exacerbation period serum cytokine and periostin levels of 5 different predefined severe asthma phenotypes with real-life data. Changes in the viral infection-induced exacerbations were also analyzed. Serum levels of 8 cytokines and periostin were measured from the sera obtained from the adult patients with five different severe asthma phenotypes based on the presence/absence of aeroallergen sensitivity, peripheral eosinophilia and chronic rhinosinusitis with nasal polyposis (CRSwNP) during stable and exacerbation periods, and from the matched controls. Serum IL-13, IL-25, TSLP, and periostin levels were similar between the patient and the control groups during stable and exacerbation periods. Serum IL-25 and TSLP levels, and peripheral eosinophil count and periostin level showed a strong correlation. Stable period periostin levels were significantly higher in eosinophilic patients, and eosinophilic patients without long-term systemic steroid therapy had higher IL-13 levels. Compared to stable period, exacerbation period serum periostin levels found significantly lower [5853 (2309-8427) pg/mL vs. 4479 (2766-6495) pg/mL; p = 0.05] and periostin levels were much lower in viral infection-induced exacerbations [2913 (893-4770) pg/mL vs. 7094 (4782-9596) pg/mL; p = 0.022]. Our study showed that serum periostin levels were decreased in viral infection-induced exacerbations and increased in the presence of eosinophilia independent from atopy and it can help to differentiate eosinophilia even if the patient is under long-term systemic steroid therapy. Also, serum IL-13 levels may reflect peripheral eosinophilia in patients without long-term systemic steroid use.

Serum periostin and carcinoembryonic antigen (CEA) are markers of type 2 inflammation. However, their role in diagnosing and monitoring treatment responses in allergic bronchopulmonary aspergillosis (ABPA) remains uncertain. The objective of the study was to assess the diagnostic performance of serum CEA and periostin in distinguishing ABPA from asthma. We also evaluate their usefulness in monitoring treatment responses. We enrolled consecutive subjects with ABPA (cases) and asthmatic patients without ABPA (controls). Serum periostin and CEA levels were measured at baseline and again 2 months after oral prednisolone. We constructed receiver operating characteristic (ROC) curves and determined sensitivity and specificity using the optimal cut-off derived from Youden's index. We enrolled 112 and 108 subjects with ABPA and asthma (median age: 34 years) respectively. At baseline, the median serum periostin (22.03 vs 16.36 ng/mL; P < 0.001) and CEA levels (4.80 vs 2.35 ng/mL; P < 0.001) were significantly higher in the ABPA group than in the controls. CEA (AUROC = 0.77) showed better diagnostic accuracy than serum periostin (AUROC = 0.64) in differentiating asthma from ABPA. After 2 months of treatment, median serum CEA (4.8 ng/mL vs 3.7 ng/mL) and periostin levels (22.03 vs 17.74 ng/mL) declined significantly. However, 34% and 30% of subjects exhibited increased periostin and CEA levels following treatment. While serum CEA and periostin exhibit modest diagnostic performance in differentiating ABPA from asthma, they are suboptimal for monitoring treatment responses. Further studies are required to validate our findings.

Aims/Background Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by synovial inflammation, pannus formation, and neovascularization. Reliable biomarkers for monitoring RA activity are needed to optimize treatment strategies. Periostin (POSTN) and vascular endothelial growth factor (VEGF) contribute to tissue remodeling and angiogenesis in various diseases, but their combined role and clinical significance in RA remain underexplored. This study aimed to evaluate serum POSTN and VEGF levels in RA patients and their correlation with disease activity. Methods Serum levels of POSTN and VEGF were quantified using enzyme-linked immunosorbent assay (ELISA) in 86 RA patients, 36 osteoarthritis (OA) patients, and 40 healthy volunteers (HV) enrolled between January 2022 and December 2024 at Jinhua Municipal Central Hospital. RA patients were categorized into active (Disease Activity Score-28 [DAS28] >2.6) and stable (DAS28 ≤2.6) subgroups. Serum POSTN and VEGF levels were compared across the three study groups and between RA activity subgroups. Correlations between these biomarkers and clinical/laboratory parameters, including DAS28, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), were analyzed. Results Serum POSTN and VEGF levels were significantly higher in RA patients [(125.21 ± 35.17) ng/mL, (106.45 ± 29.54) pg/mL] compared to OA patients [(98.41 ± 30.09) ng/mL, (82.28 ± 23.18) pg/mL] and healthy controls [(75.86 ± 22.81) ng/mL, (71.24 ± 11.72) pg/mL] (all p < 0.001). Furthermore, POSTN and VEGF levels in the active RA group [(144.68 ± 29.98) ng/mL, (121.75 ± 27.49) pg/mL] were significantly higher than those in the inactive group [(100.62 ± 24.23) ng/mL, (87.33 ± 19.12) pg/mL] (all p < 0.001). Spearman's or Pearson's correlation analyses revealed a positive correlation between POSTN and VEGF in RA patients (r = 0.708, p < 0.001). Serum POSTN levels were positively correlated with DAS28, CRP, and ESR (rDAS28 = 0.753, rCRP = 0.623, rESR = 0.437, p < 0.001) so was VEGF (rDAS28 = 0.720, rCRP = 0.433, rESR = 0.623, all p < 0.001). Conclusion POSTN and VEGF levels are elevated in RA patients, correlate with disease activity markers, and may serve as complementary biomarkers for assessing RA activity.

BackgroundSingle nucleotide polymorphisms (SNPs) in the interleukin 13 (IL13) gene are associated with vulnerability to allergic diseases, such as asthma and allergic conjunctivitis (AC). Periostin, as an IL13-induced protein, has emerged as a novel biomarker in several allergic diseases. Data among Egyptian patients are still scarce.AimTo find out the association of IL13 rs20541 gene polymorphism and serum levels of periostin with asthma and AC among Egyptian patients.Patients and MethodsEighty-one Egyptian allergic patients with asthma, AC, and both asthma and AC (27 each), were enrolled in this case–control study. Twenty-seven age and gender-matched healthy volunteers served as controls. All participants were tested for IL13 rs20541 SNP by real-time polymerase chain reaction, TaqMan method. Serum levels of periostin and IL13 were assessed by ELISA.ResultsCompared to healthy subjects, asthmatic patients had a higher frequency of the homozygous adenine/adenine (AA) genotype at IL13 rs20541 SNP (14.8% vs 3.7%) and a lower frequency of the guanosine/guanosine (GG) genotype (51.9% vs 55.6%), while AC patients had higher GG genotype (70.4% vs 55.6%) with no AA genotype detected, yet no significant difference was noticed (p = 7.053). A significantly higher serum periostin in asthmatic patients compared to controls was found (p = 0.005). Higher levels of serum periostin, although nonsignificant, were recorded in AC patients compared to controls (22.88 ± 10.01ng/mL and 17.51 ± 3.17ng/mL, respectively). Periostin was significantly higher in patients with IL13 AA and GA genotypes compared to those with GG genotype (p = 0.016). A significant positive correlation between serum periostin and serum IL13 among allergic patients was recorded (r = 0.352, p < 0.001).ConclusionAmong Egyptian patients, serum level of periostin is significantly associated with asthma and positively correlates with IL13 level supporting its utility as a diagnostic biomarker. IL13 rs20541 gene polymorphism does not seem to play an obvious role in asthma and AC, which requires further evaluation.

Background: The roles of periostin in patients with severe obstructive sleep apnea (OSA) remain unclear. Aims and objectives Serum periostin is a marker of type-2 inflammation and tends to increase in non-obese patients with asthma. Meanwhile‚ several in vitro studies suggest that impaired glycolipid metabolism, mechanical stress and hypoxia upregulate expression of periostin. Here‚ we aimed to clarify roles of periostin in patients with OSA‚ who are often obese but accompanied by these conditions. Methods: In patients diagnosed as having OSA‚ we examined associations between serum periostin levels and clinical indices‚ such as severity of OSA‚ body mass index (BMI)‚ and blood glucose and lipids. Assessments were done at baseline and after 3 months of continuous positive airway pressure (CPAP) treatment. Results: In 96 patients with OSA‚ serum periostin levels positively correlated with age and blood glucose and tended to correlate with BMI negatively (p = 0.055). When adjusted for BMI‚ severe OSA (apnea hypopnea index ≥ 30) tended to associate with elevated serum periostin (p = 0.07). Among 53 patients with severe OSA‚ patients with high serum periostin levels (highest quartile‚ ≥ 85ng⁄mL, n = 13) showed higher free fatty acid‚ fasting blood glucose and frequency of micro⁄overt albuminuria than those with severe OSA alone. In patients with severe OSA and high serum periostin‚ serum periostin and urinary albumin levels were significantly decreased after 3 months of CPAP treatment. Conclusions Serum periostin levels tend to increase in severe OSA‚ when adjusted for BMI. Elevated serum periostin in patients with severe OSA may indicate the risk of albuminuria‚ which could be reduced with CPAP treatment.

Introduction: Periostin is a mesenchymal protein involved in subepithelial fibrosis and airway remodeling in asthma, which is also related to Th2 inflammatory response. Aim: The aim of the study was to measure Periostin levels in serum and induced sputum supernatant of asthmatic patients and healthy subjects and to associate them to inflammatory mediators and disease severity. Methods: 73 patients were enrolled (50 female, median age 58 years [IQR: 45-64]), 41 with severe refractory asthma (SRA) and 32 with mild-to moderate disease. 10 healthy volunteers were also included. Serum samples were collected for Periostin and eosinophil count measurements. Induced sputum was collected for cell count calculation and measurement of Periostin, IFN-γ and ΙL-13 in supernatant. Results: Serum Periostin levels were significantly increased in asthmatics compared to healthy volunteers (28[20-40] vs 19[15-25], p 2 =0.21 and 0.29 respectively, p 2 =0.33, p=0.007). A negative relation was observed between serum Periostin and sputum IFN-γ levels (r 2 =0.26, p Conclusions: Serum Periostin is elevated in asthmatic patients, is associated to disease severity and represents a candidate biomarker of systemic eosinophilic inflammation and airways Th2 inflammatory response.

Combined Assessment of Serum Periostin and YKL-40 May Identify Asthma-COPD Overlap

An effective serum biomarker may improve cholangiocarcinoma (CCA) management. Periostin (PN) has been demonstrated to be associated with aggressive CCA. The current study evaluated PN in blood serum for its diagnostic and prognostic potential in patients with CCA. Sera of 68 patients with CCA were collected prior to treatment, and PN levels were measured using an ELISA. Sera from 50 normal controls, 6 patients with benign liver diseases, 2 with hepatocellular carcinoma and 21 with breast cancer were analyzed. Immunohistochemistry of PN in CCA tissues was also investigated. The data were analyzed using the Mann-Whitney U test, Kaplan-Meier log rank tests, Cox proportional hazard regression models and Fisher's exact tests. The median serum PN level in patients with CCA was significantly increased compared with that in healthy controls, patients with benign liver diseases and patients with breast cancer (all P<0.05). Using an optimal threshold value of 94 ng/ml PN, the diagnostic values for CCA compared with other conditions demonstrated a sensitivity level of 0.38 [95% confidence interval (CI), 0.27–0.51], specificity of 0.90 (95% CI, 0.81–0.96), accuracy of 0.66 (95% CI, 0.58–0.74), positive predictive value of 0.76 (95% CI, 0.59–0.89) and negative predictive value of 0.63 (95% CI, 0.53–0.72) (P<0.001). Furthermore, PN stain in stromal fibroblasts in CCA tissues was associated with serum PN levels (P=0.001), and patients with CCA were classified as low (≤94 ng/ml) or high PN (>94 ng/ml) accordingly. High serum and tissue PN levels were significantly associated with reduced survival rate (P<0.001 and P=0.033, respectively). Serum PN was an independent prognostic factor with a hazard ratio of 3.197 (P=0.001). In conclusion, serum PN may be used to divide patients with intrahepatic CCA into high and low PN groups. Elevated serum PN may be utilized as a marker of poor prognosis in patients with CCA.