Association of airway wall thickness with serum periostin in steroid-naive asthma

Periostin may be a useful biomarker of T-helper type 2 eosinophilic airway inflammation and has been linked to remodeling in asthma. However, the association between serum periostin and the magnitude of airway wall thickness remains unclear.

We examined the relationship between serum periostin and airway geometry in asthma.

Twenty-six patients with steroid-naive asthma, 30 patients with asthma treated with inhaled corticosteroids, and 46 aged-matched healthy controls were studied. Serum periostin levels, lung function, and inflammatory cell counts in sputum were measured. The following parameters of airway dimension were assessed by computed tomography: lumen area, wall area (WA), WA to total area ratio, and wall thickness.

Serum periostin levels were significantly elevated in patients with steroid-naive asthma compared with the controls (p < 0.01) and patients with asthma who were treated with steroids (p < 0.01). In patients who were steroid naive, serum periostin was correlated with air flow limitation (r = -0.62, p < 0.01) and the WA to body surface area (r = 0.71, p < 0.01), and sputum eosinophil percentage (r = 0.60, p < 0.01). Multivariate analysis showed that the percentage of predicted forced expiratory volume in 1 second, WA to body surface area, and sputum eosinophils were independent factors for high serum periostin.

Serum periostin may be a candidate for a novel biomarker for not only eosinophilic inflammation but as a marker for airway remodeling in asthma.