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Serum Periostin Predicts Wheezing Exacerbation: A Prospective Study in Preschool Children with Recurrent Wheezing
Pailin Yooma1, Wiparat Manuyakorn1, Adithep Sawatchai1
1Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Insights
Serum periostin levels are higher in preschool children with recurrent wheezing. Elevated periostin may predict future acute wheezing exacerbations in young children.
Area of Science:
- Pediatric Pulmonology
- Biomarker Discovery
- Respiratory Health
Background:
- Wheezing is a prevalent issue in preschool-aged children.
- Currently, reliable biomarkers to predict future wheezing episodes in this age group are lacking.
Purpose of the Study:
- To compare serum periostin levels in preschool children with and without recurrent wheezing.
- To evaluate serum periostin's utility in predicting acute wheezing exacerbations.
Main Methods:
- Enrolled children aged 2-5 years with recurrent wheezing and healthy controls.
- Measured serum periostin levels at enrollment.
- Conducted a 1-year prospective follow-up to monitor wheezing episodes.
Main Results:
- Children with recurrent wheezing (n=80) had significantly higher median serum periostin levels (1,122.32 pg/mL) than controls (n=40) (<10 pg/mL), p=0.006.
- Children experiencing wheezing exacerbations within 1 year had higher median periostin levels (5,321 pg/mL) than those without, p=0.014.
- Serum periostin >1,200 pg/mL showed 78.9% sensitivity and 64.6% specificity (AUC=0.701, p=0.009) for predicting exacerbations.
Conclusions:
- Preschool children with recurrent wheezing exhibit elevated serum periostin levels compared to healthy children.
- Serum periostin shows potential as a valuable biomarker for predicting acute wheezing exacerbations in the upcoming year.
Introduction:
Wheezing is a common problem in preschool children. Currently, there are no reliable biomarkers that can predict subsequent wheezing in preschool children. This study aimed to compare serum periostin levels between preschool children with and without recurrent wheezing and investigate its utility for predicting acute wheezing exacerbation.
Methods:
Children aged 2-5 years with recurrent wheezing and healthy control children were enrolled. They were evaluated for serum periostin level at enrollment and subsequently followed for wheezing episodes in a 1-year prospective study.
Results:
A total of 122 children were enrolled. Children in the recurrent wheezing group (n = 80) had a greater median serum periostin level (1,122.32 pg/mL [<10-6,978.93]) than that of the healthy control group (n = 40) (<10 pg/mL [<10-2,116.69]), p value = 0.006. After 1-year follow-up, subjects who experienced subsequent wheezing exacerbation episodes had a greater median of periostin level (5,321 pg/mL) compared with those with no exacerbation (<10 pg/mL), p value = 0.014. ROC curve analysis revealed that the level of serum periostin >1,200 pg/mL, corresponding to 78.9% sensitivity and 64.6% specificity, with an AUC of 0.701, p value = 0.009, could be a predictor for acute wheezing exacerbation within 1 year. Besides, subjects with serum periostin >1,200 pg/mL had greater odds of subsequent wheezing episodes compared with those with lower levels of serum periostin (adjusted odds ratio 10.0, 95% confidence interval: 2.3-43.5).
Conclusions:
Preschool children with recurrent wheezing have a greater serum periostin level than healthy control. Serum periostin may be a valuable biomarker for predicting acute wheezing exacerbations in the following year.
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