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Background Periostin has shown to be involved in the many aspects of allergic inflammation, such as acceleration of allergen-induced eosinophil recruitment, development of a Th2 phenotype, increased expression of inflammatory mediators, and airway remodeling and fibrosis in bronchial asthma and that fibrosis is one factor that causes steroid resistance or hyporesponsiveness in bronchial asthma. Aim This study aimed to evaluate the possible role of serum periostin as a biomarker for airway inflammation, for predicting the patient’s possible response to inhaled corticosteroids (ICS) after its regular use and its correlation with disease severity and control compared with functional and radiological findings. Patients and methods Sixty nonsmoker, asthmatic patients of at least 20 years of age and 20 control healthy nonsmokers with matched age and sex were included. Patients were then subclassified into two: first, according to the asthma severity into mild, moderate, and severe and then according to asthma control (controlled, poorly controlled, and uncontrolled). Serum periostin, spirometry, and multidetector computed tomography were performed for all included populations. Results There was significant statistical direct relation with increased serum periostin level and wall area and bronchial wall thickening (BWT) with asthma severity and all showed high significant increase among patients with uncontrolled than those with controlled asthma. Highly significant statistical direct correlation was found between BWT and serum periostin level. There was highly statistically significant decreased serum periostin level and BWT among the steroid-treated group of patients than in steroid-naive asthma (nonsteroid treated group of patients) which were significantly decreased after regular daily use of ICS for 6 months and also among uncontrolled patients after being adequately controlled than their baseline states. Conclusion Serum periostin marker and BWT had a significant, sensitive, accurate clinically relevant indicative value (especially when combined) as regards asthma control and severity and probable adequate response to ICS. Serum periostin not only could be a reliable biomarker for eosinophilic inflammation but also may contribute to the development of airway remodeling as assessed by multidetector computed tomography.

the egyptian journal of bronchology

Correlation between serum periostin biomarker, spirometric airflow limitation, and airway dimensions by multidetector computed tomography in bronchial asthma