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Role of Periostin in Uncontrolled Asthma in Children (DADO study)
A Habernau Mena1, V Del Pozo Abejón2,3, F F Rodríguez Vidigal1
1Departament of Biomedical Sciences, University Hospital, Badajoz, Spain.
Insights
Thirty-eight percent of children with poorly controlled asthma have uncontrolled severe asthma (UcSA). This severe asthma is linked to high total IgE and low periostin levels in children.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Biomarker Research
Background:
- Asthma is a common chronic childhood illness, with severe asthma (SA) often underdiagnosed.
- Periostin is a known biomarker for SA in adults, but its role in pediatric populations requires further investigation.
Purpose of the Study:
- To determine the prevalence of uncontrolled severe asthma (UcSA) among children with poorly controlled asthma.
- To assess the utility of periostin as a biomarker for UcSA in children.
Main Methods:
- An observational study involving 50 children aged 5–14 years with poorly controlled asthma.
- Data collected included demographics, clinical history, lung function, fractional exhaled nitric oxide, allergy testing, IgE levels, blood eosinophils, serum periostin, treatment, asthma control, and quality of life.
Main Results:
- 38% of participants were diagnosed with UcSA, experiencing significant limitations in daily activities, emergency visits, and hospitalizations.
- Children with UcSA showed higher total IgE levels (>500 kUA/mL) and lower serum periostin levels (>1000 ng/mL) compared to other children.
- Inadequate treatment was noted in over half of the children studied.
Conclusions:
- Uncontrolled severe asthma affects a substantial proportion (38%) of children with poorly controlled asthma.
- Elevated total serum IgE and reduced serum periostin levels are associated with UcSA in this pediatric cohort.
Background And Objective:
Asthma is the most common chronic disease in children. Cases of severe asthma (SA) are underdiagnosed. Periostin is a biomarker for SA in adults, but its role in children is poorly understood. Objectives: The aims of the study were to estimate the percentage of cases of uncontrolled severe asthma (UcSA) in children with poorly controlled asthma and to evaluate the role of periostin as a biomarker.
Material And Methods:
We performed an observational study in children aged 5 to 14 years with poorly controlled asthma. Demographic and clinical data were collected in addition to the results of the lung function test, the fraction of exhaled nitric oxide, the skin prick test, total IgE, specific IgE, blood eosinophil count, serum periostin, treatment, asthma control, and quality of life. Variables were compared between the group with UcSA and the other children.
Results:
Fifty children with poorly controlled asthma (72% male) were included. Nineteen children (38%) had UcSA. Most children had limitations in their activities of daily living and had visited the emergency department. In addition, 38% were hospitalized. Quality of life was poor. Only 42% of the children received appropriate treatment. The UcSA group was more likely to have a total IgE >500 kUA/mL (52.6% vs 19%, P=.02) and less likely to have serum periostin >1000 ng/mL (31.2% vs 63%, P=.04).
Conclusions:
In our setting, 38% of children with poorly controlled asthma have UcSA, which is associated with higher levels of total serum IgE and lower levels of serum periostin.
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