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      Serum levels of periostin and exercise-induced bronchoconstriction in asthmatic children

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          Abstract

          Background

          Periostin is induced by IL-13 and has been studied as a biomarker of asthma. The present study explored the relationship between serum levels of periostin and exercise-induced bronchoconstriction (EIB) in asthmatic children.

          Methods

          The study population consisted of 86 children 6–15 years old divided into an asthmatic group ( n = 56) and healthy controls ( n = 30). We measured the levels of periostin in serum and performed pulmonary function tests including baseline measurements, post-bronchodilator inhalation tests, exercise bronchial provocation tests (BPTs), and mannitol BPTs.

          Results

          The 56 asthmatic children were divided into four groups: asthmatics with positive exercise BPT and positive mannitol BPT ( n = 30), asthmatics with positive exercise BPT but negative mannitol BPT ( n = 7), asthmatics with negative exercise BPT but positive mannitol BPT ( n = 10), and asthmatics with negative exercise BPT and negative mannitol BPT ( n = 9). Serum levels of periostin in asthmatic children with both positive exercise and mannitol BPT were significantly greater than those in asthmatic children with both negative exercise and mannitol BPT (95.0 [75.0–104.0] vs. 79.0 [68.0–82.5] ng/mL, P = 0.008) and controls (74.0 [69.75–80.0] ng/mL, P < 0.001). Periostin levels were significantly correlated with both the maximum decrease in %FEV 1 and mannitol PD 15 value.

          Conclusion

          Serum levels of periostin in asthmatic children with both positive exercise and mannitol BPT were significantly greater than those in asthmatic children with both negative exercise and mannitol BPT and also greater than in healthy controls.

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          Most cited references25

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          Mepolizumab for severe eosinophilic asthma (DREAM): a multicentre, double-blind, placebo-controlled trial.

          Ian D Pavord, Stephanie Korn, Peter Howarth … (2012)
          Some patients with severe asthma have recurrent asthma exacerbations associated with eosinophilic airway inflammation. Early studies suggest that inhibition of eosinophilic airway inflammation with mepolizumab-a monoclonal antibody against interleukin 5-is associated with a reduced risk of exacerbations. We aimed to establish efficacy, safety, and patient characteristics associated with the response to mepolizumab. We undertook a multicentre, double-blind, placebo-controlled trial at 81 centres in 13 countries between Nov 9, 2009, and Dec 5, 2011. Eligible patients were aged 12-74 years, had a history of recurrent severe asthma exacerbations, and had signs of eosinophilic inflammation. They were randomly assigned (in a 1:1:1:1 ratio) to receive one of three doses of intravenous mepolizumab (75 mg, 250 mg, or 750 mg) or matched placebo (100 mL 0·9% NaCl) with a central telephone-based system and computer-generated randomly permuted block schedule stratified by whether treatment with oral corticosteroids was required. Patients received 13 infusions at 4-week intervals. The primary outcome was the rate of clinically significant asthma exacerbations, which were defined as validated episodes of acute asthma requiring treatment with oral corticosteroids, admission, or a visit to an emergency department. Patients, clinicians, and data analysts were masked to treatment assignment. Analyses were by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT01000506. 621 patients were randomised: 159 were assigned to placebo, 154 to 75 mg mepolizumab, 152 to 250 mg mepolizumab, and 156 to 750 mg mepolizumab. 776 exacerbations were deemed to be clinically significant. The rate of clinically significant exacerbations was 2·40 per patient per year in the placebo group, 1·24 in the 75 mg mepolizumab group (48% reduction, 95% CI 31-61%; p<0·0001), 1·46 in the 250 mg mepolizumab group (39% reduction, 19-54%; p=0·0005), and 1·15 in the 750 mg mepolizumab group (52% reduction, 36-64%; p<0·0001). Three patients died during the study, but the deaths were not deemed to be related to treatment. Mepolizumab is an effective and well tolerated treatment that reduces the risk of asthma exacerbations in patients with severe eosinophilic asthma. GlaxoSmithKline. Copyright © 2012 Elsevier Ltd. All rights reserved.
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            T-helper type 2-driven inflammation defines major subphenotypes of asthma.

            Prescott G Woodruff, Barmak Modrek, David F Choy … (2009)
            T-helper type 2 (Th2) inflammation, mediated by IL-4, IL-5, and IL-13, is considered the central molecular mechanism underlying asthma, and Th2 cytokines are emerging therapeutic targets. However, clinical studies increasingly suggest that asthma is heterogeneous. To determine whether this clinical heterogeneity reflects heterogeneity in underlying molecular mechanisms related to Th2 inflammation. Using microarray and polymerase chain reaction analyses of airway epithelial brushings from 42 patients with mild-to-moderate asthma and 28 healthy control subjects, we classified subjects with asthma based on high or low expression of IL-13-inducible genes. We then validated this classification and investigated its clinical implications through analyses of cytokine expression in bronchial biopsies, markers of inflammation and remodeling, responsiveness to inhaled corticosteroids, and reproducibility on repeat examination. Gene expression analyses identified two evenly sized and distinct subgroups, "Th2-high" and "Th2-low" asthma (the latter indistinguishable from control subjects). These subgroups differed significantly in expression of IL-5 and IL-13 in bronchial biopsies and in airway hyperresponsiveness, serum IgE, blood and airway eosinophilia, subepithelial fibrosis, and airway mucin gene expression (all P < 0.03). The lung function improvements expected with inhaled corticosteroids were restricted to Th2-high asthma, and Th2 markers were reproducible on repeat evaluation. Asthma can be divided into at least two distinct molecular phenotypes defined by degree of Th2 inflammation. Th2 cytokines are likely to be a relevant therapeutic target in only a subset of patients with asthma. Furthermore, current models do not adequately explain non-Th2-driven asthma, which represents a significant proportion of patients and responds poorly to current therapies.
            Article 0 comments Cited 554 times – based on 0 reviews     Review now
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              Lebrikizumab treatment in adults with asthma.

              Jonathan Corren, Robert Lemanske, Nicola Hanania … (2011)
              Many patients with asthma have uncontrolled disease despite treatment with inhaled glucocorticoids. One potential cause of the variability in response to treatment is heterogeneity in the role of interleukin-13 expression in the clinical asthma phenotype. We hypothesized that anti-interleukin-13 therapy would benefit patients with asthma who had a pretreatment profile consistent with interleukin-13 activity. We conducted a randomized, double-blind, placebo-controlled study of lebrikizumab, a monoclonal antibody to interleukin-13, in 219 adults who had asthma that was inadequately controlled despite inhaled glucocorticoid therapy. The primary efficacy outcome was the relative change in prebronchodilator forced expiratory volume in 1 second (FEV(1)) from baseline to week 12. Among the secondary outcomes was the rate of asthma exacerbations through 24 weeks. Patient subgroups were prespecified according to baseline type 2 helper T-cell (Th2) status (assessed on the basis of total IgE level and blood eosinophil count) and serum periostin level. At baseline, patients had a mean FEV(1) that was 65% of the predicted value and were taking a mean dose of inhaled glucocorticoids of 580 μg per day; 80% were also taking a long-acting beta-agonist. At week 12, the mean increase in FEV(1) was 5.5 percentage points higher in the lebrikizumab group than in the placebo group (P = 0.02). Among patients in the high-periostin subgroup, the increase from baseline FEV(1) was 8.2 percentage points higher in the lebrikizumab group than in the placebo group (P = 0.03). Among patients in the low-periostin subgroup, the increase from baseline FEV(1) was 1.6 percentage points higher in the lebrikizumab group than in the placebo group (P = 0.61). Musculoskeletal side effects were more common with lebrikizumab than with placebo (13.2% vs. 5.4%, P = 0.045). Lebrikizumab treatment was associated with improved lung function. Patients with high pretreatment levels of serum periostin had greater improvement in lung function with lebrikizumab than did patients with low periostin levels. (Funded by Genentech; ClinicalTrials.gov number, NCT00930163 .).
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                Author and article information

                Contributors
                Ju Hwan Cho
                Kyubo Kim
                Jung Won Yoon
                Sun Hee Choi
                Youn Ho Sheen
                ManYong Han
                Junya Ono
                Kenji Izuhara
                Heysung Baek
                Journal
                Journal ID (nlm-ta): World Allergy Organ J
                Journal ID (iso-abbrev): World Allergy Organ J
                Title: The World Allergy Organization Journal
                Publisher: World Allergy Organization
                ISSN (Electronic): 1939-4551
                Publication date PMC-release: 26 January 2019
                Publication date Collection: 2019
                Publication date (Electronic): 26 January 2019
                Volume: 12
                Issue: 1
                Electronic Location Identifier: 100004
                Affiliations
                [a ]Comprehensive Cancer Center, Radiation Oncology, The Ohio State University, Columbus, OH, USA
                [b ]Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Kangdong Sacred Heart Hospital, Republic of Korea
                [c ]Department of Pediatrics, Myongji Hospital, Goyang, Republic of Korea
                [d ]Department of Pediatrics, Kyung Hee University School of Medicine, Seoul, Republic of Korea
                [e ]Department of Pediatrics, CHA University School of Medicine, Seoul, Republic of Korea
                [f ]Department of Pediatrics, CHA University School of Medicine, Seongnam, Republic of Korea
                [g ]The Shino-Test Corporation, Sagamihara, Japan
                [h ]Department of Biomolecular Sciences, Saga Medical School, Saga, Japan
                [i ]Department of Pediatrics, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea
                Author notes
                [∗ ]Corresponding author. Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, 150, Seongan-ro, Gangdong-gu, Seoul 05355, Republic of Korea. paviola7@ 123456gmail.com
                Article
                Publisher ID: S1939-4551(19)30049-3 Publisher ID: 100004
                DOI: 10.1016/j.waojou.2018.11.004
                PMC ID: 6439409
                SO-VID: e53c16f9-03f5-4eeb-83ed-662317621276
                Copyright © © 2019 The Authors
                License:

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                Date received : 4 July 2018
                Date revision received : 2 November 2018
                Date accepted : 13 November 2018
                Categories
                Subject: Article

                ScienceOpen disciplines: Immunology
                Data availability:
                ScienceOpen disciplines: Immunology

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