Abstract
Although Th2 driven inflammation is present in COPD, it is not clearly elucidated which COPD patients are affected. Since periostin is associated with Th2 driven inflammation and inhaled corticosteroid (ICS)-response in asthma, it could function as a biomarker in COPD. The aim of this study was to analyze if serum periostin is elevated in COPD compared to healthy controls, if it is affected by smoking status, if it is linked to inflammatory cell counts in blood, sputum and endobronchial biopsies, and if periostin can predict ICS-response in COPD patients.Serum periostin levels were measured using Elecsys Periostin immunoassay. Correlations between periostin and inflammatory cell count in blood, sputum and endobronchial biopsies were analyzed. Additionally, the correlation between serum periostin levels and treatment responsiveness after 6 and 30 months was assessed using i.e. ΔFEV1% predicted, ΔCCQ score and ΔRV/TLC ratio. Forty-five COPD smokers, 25 COPD past-smokers, 22 healthy smokers and 23 healthy never-smokers were included. Linear regression analysis of serum periostin showed positive correlations age (B = 0.02, 95%CI 0.01–0.03) and FEV1% predicted (B = 0.01, 95%CI 0.01–0.02) in healthy smokers, but not in COPD patients In conclusion, COPD -smokers and -past-smokers have significantly higher periostin levels compared to healthy smokers, yet periostin is not suitable as a biomarker for Th2-driven inflammation or ICS-responsiveness in COPD.
Highlights
Th2 driven inflammation is present in COPD, it is not clearly elucidated which COPD patients are affected
The aim of this study was to investigate whether serum periostin levels are different in COPD patients compared to healthy controls and whether they are affected by smoking
We assessed to what extent serum periostin levels reflect inflammatory cell counts in blood, sputum and endobronchial biopsies in COPD and whether serum periostin levels predict airway wall remodeling and inhaled corticosteroid (ICS) responsiveness following treatment of 6 or 30 months
Summary
#: log transformed variable, *: statistically significant P < 0.05, BMI: Body Mass Index. Biomarker for ICS treatment in COPD patients are limited In this context, the findings of Park et al are of interest [15]. The findings of Park et al are of interest [15] They studied 130 COPD patients before and after three months of ICS/LABA treatment and found that a combination of high plasma periostin levels (> 23 ng/mL) and high blood eosinophil counts (> 260/μL) could predict a better improvement in FEV1. It is important to note that patients with this combination of high periostin and blood eosinophils already had a higher bronchodilator response at baseline and the better improvement might have been due to the LABA component alone. No correlation was detected between baseline periostin and change in extracellular matrix (lamina propria components stained area or density) after 30 months on ICS or placebo treated COPD patients (see Additional file 1)
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