Airway periostin may have a role in identifying patients with severe asthma who will respond to biologic therapy, suggest the authors of a study published in the journal Chest.
The study enrolled 25 patients with severe type 2 (T2) endotype asthma, 15 with severe non-T2 endotype asthma, 21 with mild-moderate asthma, and 15 healthy control individuals. All participants underwent exhaled breath condensate (EBC) and sputum collection, eosinophil blood count, fractional exhaled nitric oxide and IgE measurement. Periostin was assessed by enzyme-linked immunosorbent assay of EBC and induced sputum (IS) supernatant.
EBC and IS periostin levels were higher in those with severe asthma compared to those with mild-moderate asthma (P<.05) and compared with control individuals (P<.01). Furthermore, EBC periostin levels were increased in T2 endotype compared with non-T2 endotype (0.88 ±0.46 vs 0.52±0.46 ng/mL; P<.05). The association was also seen in IS samples (0.69±0.19 vs 0.39±0.16 ng/mL; P<.05).
The T2 endotype of severe asthma is gaining increasing interest because of its susceptible to biologic treatments. The authors of this new study suggest airway periostin is a useful marker of severe eosinophilic asthma and may help to phenotype patients that will respond to the biologic agents.
Senior investigator, Dr. Peter J. Barnes from the National Heart and Lung Institute at Imperial College London, said. “The newly developed biological treatments have the potential to transform the quality of life of patients with T2 severe asthma. This study suggests that airways periostin is the expression of T2 severe asthma and if validated, could be a useful biomarker to apply stratified medicine for severe asthma, and could transform the quality of life of these patients.”
