Increased Serum Periostin Levels and Eosinophils in Nasal Polyps Are Associated with the Preventive Effect of Endoscopic Sinus Surgery for Asthma Exacerbations in Chronic Rhinosinusitis Patients

Abstract

<b><i>Background:</i></b> Eosinophilic nasal polyps (NPs) are associated with the presence of asthma in chronic rhinosinusitis (CRS) patients. Serum periostin has been considered a relevant biomarker for unified airway diseases. <b><i>Objective:</i></b> To determine the utility of biomarkers including serum periostin that reflects reduction of exacerbations of comorbid asthma in CRS patients. <b><i>Methods:</i></b> We prospectively recruited 56 CRS patients who were subjected to undergo endoscopic sinus surgery (ESS) (20 with asthma) between October 2015 and December 2017 and followed them for 1 year after ESS. Blood eosinophil count, serum periostin, and fractional nitric oxide (FeNO) were measured at enrollment. How these type 2-driven biomarkers reflect comorbid asthma was determined using receiver operating characteristic (ROC) analysis. The frequency of asthma exacerbations during 1 year was counted both before and after ESS. Associations between preoperative biomarkers including eosinophils in NPs and asthma exacerbations were evaluated. <b><i>Results:</i></b> Blood eosinophil count, FeNO, and serum periostin levels were significantly higher in CRS patients with asthma than in those without (<i>p</i> < 0.01 for all) and discriminated comorbid asthma among CRS patients (<i>p</i> < 0.05; AUC > 0.80 for all). The increased preoperative serum periostin correlated with lower absolute number of postoperative exacerbations (ρ = −0.49, <i>p</i> = 0.03) and its relative reduction after ESS (ρ = 0.53, <i>p</i> = 0.03) in asthmatic patients. Increased eosinophils in NPs were also associated with reduced asthma exacerbations. <b><i>Conclusion:</i></b> Preoperative increased serum periostin and eosinophils in NPs are associated with the preventive effect of ESS for asthma exacerbations in CRS patients comorbid with asthma.

The diagnostic importance of periostin as a biomarker in chronic rhinosinusitis with nasal polyp

“…In a study by Kanemitsu et al . , serum periostin levels did not decrease at month 12 in 7 CRS patients who experienced recurrence after ESS and the authors stated that NP recurrence could be reflected by the change in serum periostin levels after ESS [ 32 ]. As a result of their study with 338 CRS patients, of which 278 had CRSwNP, Oka et al .…”

Postinfectious Olfactory Dysfunction: Oral Steroids and Olfactory Training versus Olfactory Training Alone: Is There any Benefit from Steroids?

“…The link between chronic rhinosinusitis and asthma is well-established, and it seems that olfactory dysfunction in the presence of asthma indicates similar inflammatory mechanisms in both the upper and lower airways. Kanemitsu et al [28] showed that sputum eosinophilia in asthmatic chronic rhinosinusitis patients was associated with olfactory dysfunction, which suggests that this impairment is a potential indicator of Th2-driven inflammation of the lower airways. In addition, although there were no such patients in the present study, it seems that a diagnosis of bronchiectasis may also be associated with chronic rhinosinusitis and olfactory loss [29].…”