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ISSN: 1642-395X
Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii
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2/2020
vol. 37
 
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abstract:
Original paper

Serum periostin levels in asthma patients in relation to omalizumab therapy and presence of chronic rhinosinusitis with nasal polyps

Jakub Novosad
1
,
Irena Krčmová
1
,
Vladimír Bartoš
2
,
Marcela Drahošová
1
,
Petr Vaník
3
,
Olga Růžičková-Kirchnerová
4
,
Milan Teřl
4
,
Jan Krejsek
1

  1. Institute of Clinical Immunology and Allergy, University Hospital in Hradec Králové, Faculty of Medicine, Charles University in Prague, Czech Republic
  2. Department of Pulmonary Medicine, University Hospital in Hradec Králové, Faculty of Medicine, Charles University in Prague, Czech Republic
  3. Department of Respiratory Diseases, Hospital in České Budějovice, Faculty of Medicine in Pilsen, Charles University in Prague, Czech Republic
  4. Department of Pulmonary Medicine, University Hospital in Pilsen, Faculty of Medicine, Charles University in Prague, Czech Republic
Adv Dermatol Allergol 2020; XXXVII (2): 240–249
DOI: https://doi.org/10.5114/ada.2020.94842
Online publish date: 2020/05/06
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Introduction
The serum periostin level is a promising biomarker of type 2- high inflammation pattern of bronchial asthma. It has been proven that serum periostin levels decrease in response to systemic and inhaled corticosteroid (ICS) therapy. However, we have only limited knowledge about changes in serum periostin levels reflecting omalizumab (OMA) treatment and other variables, such as chronic rhinosinusitis with nasal polyps (CRSwNP).

Aim
To critically appraise clinically relevant parameters influencing periostin levels in asthma patients.

Material and methods
A pilot, cross-sectional, observational study to assess serum periostin levels of 48 asthma patients (38 treated by conventional therapy comprising ICS and 10 treated by ICS and OMA as an add-on therapy) with respect to asthma clinical traits, comorbidities and to other biomarkers of type 2-high asthma phenotype (total IgE, absolute and relative eosinophil count, eosinophilic cationic protein (ECP) and a fraction of exhaled NO (FeNO)).

Results
Serum periostin correlates with total IgE levels (Spearman rho = 0.364, p = 0.025) in a subgroup of conventionally treated patients, and with eosinophil count (Spearman rho = 0.401, p = 0.021) in a subgroup of patients with concurrent CRSwNP. Serum periostin levels were decreased in omalizumab-treated patients in comparison to conventionally treated patients (p = 0.025). This effect was remarkably apparent only if CRSwNP was not present (p = 0.005). Conversely, we measured elevated periostin levels in OMA-treated patients with concurrent CRSwNP (p = 0.017).

Conclusions
Serum periostin production is significantly associated with treatment modality (omalizumab vs. conventional) and presence of CRSwNP. These variables need to be taken into account to interpret periostin levels accurately.

keywords:

periostin, asthma phenotype, omalizumab, chronic rhinosinusitis with nasal polyps
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