Review article
Utility of serum periostin in combination with exhaled nitric oxide in the management of asthma

https://doi.org/10.1016/j.alit.2017.02.003Get rights and content
Under a Creative Commons license
open access

Abstract

Type-2/eosinophilic inflammation plays a pivotal role in asthma. The identification of severe type-2/eosinophilic asthma is important for improving the management of patients with asthma. Therefore, efforts to develop non-invasive biomarkers for type-2/eosinophilic airway inflammation have been made during this decade. Currently, fraction of exhaled nitric oxide (FeNO) and serum periostin levels are considered markers of type-2/eosinophilic inflammation in asthma. However, a single-marker approach has limited the ability to diagnose severe type-2/eosinophilic asthma accurately and predict disease outcomes precisely. The present article reviews the utility of FeNO and serum periostin levels in a single-marker approach and in a multiple-marker approach in identifying patients with severe type-2/eosinophilic asthma. Furthermore, based on a sub-analysis of the Kinki Hokuriku Airway disease Conference (KiHAC), geno-endo-phenotypes of patients were stratified into four groups according to the FeNO and serum periostin levels.

Graphical abstract

Frequency of asthma exacerbations over 2 years following enrollment and frequency of IL4RA rs8832GG genotype in patients belonging to the four groups stratified according to FeNO and serum periostin levels. FeNO, fractional exhaled nitric oxide.

Image 1
  1. Download : Download high-res image (118KB)
  2. Download : Download full-size image

Keywords

Asthma
Composite marker
Nitric oxide
Serum periostin
Type-2/eosinophilic inflammation

Abbreviations

FeNO
fraction of exhaled nitric oxide
FEV1
forced expiratory volume in 1 s
ICS
inhaled corticosteroid
IgE
immunoglobulin E
IL
interleukin
iNOS
inducible NO synthase
KiHAC
Kinki Hokuriku Airway disease Conference
TGF
transforming growth factor
TNF
tumor necrosis factor

Cited by (0)

Peer review under responsibility of Japanese Society of Allergology.

c

TN and HM equally contributed to this manuscript.