Combined Assessment of Serum Periostin and YKL-40 May Identify Asthma-COPD Overlap

Shirai, Toshihiro; Hirai, Keita; Gon, Yasuhiro; Maruoka, Shuichiro; Mizumura, Kenji; Hikichi, Mari; Holweg, Cécile; Itoh, Ken; Inoue, Hiromasa; Hashimoto, Shigeo

doi:10.1016/j.jaip.2018.06.015

Cited by 55 publications

(56 citation statements)

References 31 publications

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“…Periostin is secreted as a 93.3-kDa extracellular matrix protein [11]. Consistent with previous studies on patients with asthma and the general population [12][13][14][15][16], the present study showed that the serum periostin level was negatively associated with BMI, albeit marginally. This precluded us from using serum periostin as a simple marker to predict severe OSA.…”

Section: Discussionsupporting

confidence: 92%

“…Serum periostin, which is an extracellular matrix protein, is a robust marker of T helper type 2 (Th2) inflammation, particularly in asthma [10][11][12]. Interestingly, several recent studies on asthma and the general population have revealed that serum periostin was negatively associated with body mass index (BMI) [12][13][14][15][16] and serum leptin [15]. In addition to Th2 inflammation, periostin has been shown by in vitro studies to be upregulated under several stimulations, including mechanical stress [17] and hypoxic stimulation [18], which are major features of OSA [19].…”

Section: Introductionmentioning

confidence: 99%

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Role of serum periostin in severe obstructive sleep apnea with albuminuria: an observational study

et al. 2020

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Background: Periostin is a matricellular protein and is a useful marker in respiratory diseases. However, the roles of periostin in patients with obstructive sleep apnea (OSA) remain unclear. Several in vitro studies have suggested that mechanical stress, hypoxia, impaired metabolism, and kidney injury, which often accompany OSA, may upregulate the expression of periostin. Meanwhile, serum periostin level has been negatively associated with body mass index (BMI) in the general population. In this study, we hypothesized that a high level of serum periostin despite being overweight/ obese may discriminate severe OSA or OSA with comorbidities from mild OSA with obesity alone. We aimed to clarify the roles of periostin in patients with OSA to assist in elucidating the heterogeneity of OSA with comorbidities. Methods: Among patients diagnosed as OSA, we examined the associations between serum periostin levels and clinical indices, including the severity of OSA, BMI, and comorbidities, using a multifaceted approach. The serum periostin levels and clinical indices were assessed after 3 months of continuous positive airway pressure (CPAP) treatment. Results: In 96 patients with OSA, serum periostin level was negatively correlated with BMI, albeit marginally, and tended to be higher in severe OSA than in others when adjusted for BMI. Cluster analysis identified four clusters, including two severe OSA clusters, one of which was characterized by high serum periostin levels and the presence of comorbidities, including albuminuria. In a comparative analysis of severe OSA cases (n = 53), the level of serum-free fatty acids and the frequency of albuminuria were higher in patients with high serum periostin level of ≥87 ng/mL, which was the highest quintile among all participants, than in those with low serum periostin levels (< 87 ng/mL, n = 41). In patients with severe OSA and high serum periostin levels, the levels of serum periostin and urinary albumin significantly decreased after 3 months of CPAP treatment. Conclusions: Elevated serum periostin in patients with OSA despite being overweight/obese may be an indicator of severe OSA with comorbidities, particularly albuminuria.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Role of serum periostin in severe obstructive sleep apnea with albuminuria: an observational study

et al. 2020

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“…66 Patients with asthma and ACO had higher levels of periostin but not in COPD, whereas YKL-40 was high in COPD and ACO but not in asthma. 66 Future studies need to explore ways to ensure more appropriate selection of patients, using clinical traits and biomarkers to identify responders.…”

Section: Pharmacologic Treatment Of Severe Aco Biologicsmentioning

confidence: 90%

“…63 These traits include biomarkers, such as those used for the selection of biologicals in asthma, but they also may include respiratory symptoms, radiographic characteristics, comorbid conditions, history of exacerbations or infections, and others, 65 for example, using the combination of 2 biomarkers, periostin and Chitinase-3-like protein 1 (YKL-40), Shirai and colleagues 66 were able to better characterize 3 populations of patients with chronic airway disease. 66 Patients with asthma and ACO had higher levels of periostin but not in COPD, whereas YKL-40 was high in COPD and ACO but not in asthma. 66 Future studies need to explore ways to ensure more appropriate selection of patients, using clinical traits and biomarkers to identify responders.…”

Section: Pharmacologic Treatment Of Severe Aco Biologicsmentioning

confidence: 99%

Management of asthma COPD overlap

Maselli

Hanania

2019

Annals of Allergy, Asthma & Immunology

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Asthma-COPD Overlap (ACO) is not a distinct disease entity but a term applied to patients with clinical features of both asthma and COPD. Asthma-COPD Overlap is associated with greater morbidity than asthma and COPD alone and with relative treatment refractoriness, but information is sparse about its course and optimal treatment. Current treatment recommendations are based on consensus because most clinical studies in asthma and COPD have excluded patients with ACO. Initial management approach should include addressing environmental triggers as well as identifying and treating underlying comorbidities. In selecting pharmacologic therapies, patients with ACO should be treated early with an ICS and 1 or more long-acting bronchodilator. In patients with severe disease, every effort should be made to address and target the patient's treatable traits. A better understanding of the molecular mechanisms and drivers of airway inflammation in patients with ACO as well as the identification of novel biomarkers may lead to a more precise treatment approach for important unmet needs.

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“…COPD and ACO such as sRAGE, periostin, YKL-40 or IL-5, in different biofluids. [6][7][8] Nevertheless, the field of miRNAs as biomarkers for these diseases is still scarce, since it has only been described that COPD, ACO and asthma show higher sputum levels of miR-145 and miR-338 compared with healthy subjects. 9 Here, we show that serum miRNAs are promising biomarkers of respiratory diseases, with high values of sensitivity and specificity.…”

Section: Until Now Several Biomarkers Have Been Investigated In Asthmamentioning

confidence: 99%

Circulating miRNAs as diagnostic tool for discrimination of respiratory disease: Asthma, asthma‐chronic obstructive pulmonary disease (COPD) overlap and COPD

Rodrigo‐Muñoz

Rial

Sastre

et al. 2019

Allergy

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Combined Assessment of Serum Periostin and YKL-40 May Identify Asthma-COPD Overlap

Cited by 55 publications

References 31 publications

Role of serum periostin in severe obstructive sleep apnea with albuminuria: an observational study

Role of serum periostin in severe obstructive sleep apnea with albuminuria: an observational study

Management of asthma COPD overlap

Circulating miRNAs as diagnostic tool for discrimination of respiratory disease: Asthma, asthma‐chronic obstructive pulmonary disease (COPD) overlap and COPD

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