Serum periostin in patients hospitalized for COPD exacerbations

Abstract

Introduction: Periostin is a protein related to Th2 inflammatory response in asthma. Eosinophilic and Th2 inflammatory response has been documented in viral COPD exacerbations. Aim: The aim of the study was to measure serum Periostin levels in patients hospitalized for COPD exacerbation and to evaluate them as a potent prognostic biomarker. Methods: Serum samples from patients were collected on hospital admission, on discharge and on stable condition at least two months after hospitalization. During a follow-up of twelve months after hospital discharge, survival, COPD exacerbations and hospitalizations were recorded. Results: We included 135 patients [29 female, median age 73 years (IQR 67-80)]; there were 12 deaths during hospitalization and 20 during the 1-year follow-up. 49 subjects presented frequent exacerbations (≥2/year). Periostin levels on admission were elevated, compared to discharge and stable phase [34.4 (21.6-63.3) vs. 27.1 (15.4-45.2) vs. 30.1 (16.2-56.2) ng/mL, p=0.0013]. There was no difference in periostin levels between patients that were intubated and/or died during hospitalization. Subjects with longer hospitalization [>8 days (median value)] had lower serum periostin [32.4 (23.1-44.2) vs. 38.7 (26.3-61.1) ng/mL, p=0.084]. Periostin could not predict survival or time to next exacerbation during 1-year follow-up. Conclusions: Serum periostin is elevated on admission for COPD exacerbation and decreases on discharge. Periostin levels are associated to the length of hospitalization but cannot predict survival or new COPD exacerbations in the following year.