• Yoshihiro Kanemitsu, Hisako Matsumoto, Kenji Izuhara, Yuji Tohda, Hideo Kita, Takahiko Horiguchi, Kazunobu Kuwabara, Keisuke Tomii, Kojiro Otsuka, Masaki Fujimura, Noriyuki Ohkura, Katsuyuki Tomita, Akihito Yokoyama, Hiroshi Ohnishi, Yasutaka Nakano, Tetsuya Oguma, Soichiro Hozawa, Tadao Nagasaki, Isao Ito, Tsuyoshi Oguma, Hideki Inoue, Tomoko Tajiri, Toshiyuki Iwata, Yumi Izuhara, Junya Ono, Shoichiro Ohta, Mayumi Tamari, Tomomitsu Hirota, Tetsuji Yokoyama, Akio Niimi, and Michiaki Mishima.
• Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
• J. Allergy Clin. Immunol. 2013 Aug 1;132(2):305-12.e3.

BackgroundPeriostin, an extracellular matrix protein, contributes to subepithelial thickening in asthmatic airways, and its serum levels reflect airway eosinophilic inflammation. However, the relationship between periostin and the development of airflow limitation, a functional consequence of airway remodeling, remains unknown.ObjectiveWe aimed to determine the relationship between serum periostin levels and pulmonary function decline in asthmatic patients on inhaled corticosteroid (ICS) treatment.MethodsTwo hundred twenty-four asthmatic patients (average age, 62.3 years) treated with ICS for at least 4 years were enrolled. Annual changes in FEV1, from at least 1 year after the initiation of ICS treatment to the time of enrollment or later (average, 16.2 measurements over 8 years per individual), were assessed. At enrollment, clinical indices, biomarkers that included serum periostin, and periostin gene polymorphisms were examined. Associations between clinical indices or biomarkers and a decline in FEV1 of 30 mL or greater per year were analyzed.ResultsHigh serum periostin levels (≥ 95 ng/mL) at enrollment, the highest treatment step, higher ICS daily doses, a history of admission due to asthma exacerbation, comorbid or a history of sinusitis, and ex-smoking were associated with a decline in FEV1 of 30 mL or greater per year. Multivariate analysis showed that high serum periostin, the highest treatment step, and ex-smoking were independent risk factors for the decline. Polymorphisms of periostin gene were related to higher serum periostin levels (rs3829365) and a decline in FEV1 of 30 mL or greater per year (rs9603226).ConclusionsSerum periostin appears to be a useful biomarker for the development of airflow limitation in asthmatic patients on ICS.Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

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