Occupational Asthma Reference

Mansur AH, Srivastava S, Sahal A, Disconnect of type 2 biomarkers in severe asthma; dominated by FeNO as a predictor of exacerbations and periostin as predictor of reduced lung function, Respir Med, 2018;143:31-38,https://doi.org/10.1016/j.rmed.2018.08.005.

Keywords: Severe asthma; Type 2 inflammation; FeNO; Blood eosinophils; Periostin; Lung function; Exacerbations; Asthma control

Known Authors

If you would like to become a known author and have your picture displayed along with your papers then please get in touch from the contact page. Known authors can choose to receive emails when their papers receive comments.

Abstract

Background
biomarkers of Type 2 (T2) inflammation may predict asthma control and exacerbation risk. However, the relationships between individual T2 biomarkers to exacerbations and lung function in severe asthma remain uncertain.

Objectives
to explore the roles played by T2 biomarkers individually and as a composite score in predicting clinical outcomes in severe asthma.

Methods
unselected severe asthma patients were enrolled in this cross sectional real life study. Participants were clinically characterised and the following measurements were obtained: the frequency of exacerbations requiring oral corticosteroids (OCS), asthma control (Juniper ACQ6-7), lung function, Fraction exhaled Nitric Oxide (FeNO), peripheral blood eosinophils (PBE), and serum periostin.

Results
A total of 115 patients were recruited [mean age 45 years (range 18–70), 80 (69.6%) females, mean forced expiratory volume in first second (FEV1) %predicted was 68%?±?24.7, mean inhaled corticosteroids (ICS) 1.96?±?0.82?mg/day. FeNO correlated significantly with PBE (r?=?0.35, p?=?0.0004), but not with periostin (r?=?0.22, p?=?0.065) and there was no significant correlation between PBE and periostin. FeNO correlation with exacerbations (r?=?0.42, p?=?0.0008) was stronger than PBE and periostin. A composite score of the 3 biomarkers correlated with exacerbations in a dose-dependent manner but multiple regression analysis did not confirm an added benefit. Only periostin demonstrated a significant correlation with FEV1% predicted (r?=?-0.34, p?=?0.004) with ROC-AUC 0.7.

Conclusion
FeNO demonstrated stronger correlation with asthma exacerbations than PBE or periostin with no definite added benefit from a composite score of the 3 biomarkers. Only periostin showed significant association with reduced lung function raising its potential as a biomarker of airway remodeling.

Plain text: Background biomarkers of Type 2 (T2) inflammation may predict asthma control and exacerbation risk. However, the relationships between individual T2 biomarkers to exacerbations and lung function in severe asthma remain uncertain. Objectives to explore the roles played by T2 biomarkers individually and as a composite score in predicting clinical outcomes in severe asthma. Methods unselected severe asthma patients were enrolled in this cross sectional real life study. Participants were clinically characterised and the following measurements were obtained: the frequency of exacerbations requiring oral corticosteroids (OCS), asthma control (Juniper ACQ6-7), lung function, Fraction exhaled Nitric Oxide (FeNO), peripheral blood eosinophils (PBE), and serum periostin. Results A total of 115 patients were recruited [mean age 45 years (range 18-70), 80 (69.6%) females, mean forced expiratory volume in first second (FEV1) %predicted was 68%?+-?24.7, mean inhaled corticosteroids (ICS) 1.96?+-?0.82?mg/day. FeNO correlated significantly with PBE (r?=?0.35, p?=?0.0004), but not with periostin (r?=?0.22, p?=?0.065) and there was no significant correlation between PBE and periostin. FeNO correlation with exacerbations (r?=?0.42, p?=?0.0008) was stronger than PBE and periostin. A composite score of the 3 biomarkers correlated with exacerbations in a dose-dependent manner but multiple regression analysis did not confirm an added benefit. Only periostin demonstrated a significant correlation with FEV1% predicted (r?=?-0.34, p?=?0.004) with ROC-AUC 0.7. Conclusion FeNO demonstrated stronger correlation with asthma exacerbations than PBE or periostin with no definite added benefit from a composite score of the 3 biomarkers. Only periostin showed significant association with reduced lung function raising its potential as a biomarker of airway remodeling.

Full Text

Full text of this reference not available

Please Log In or Register to add the full text to this reference

Associated Questions

There are no associations for this paper.

Please Log In or Register to put forward this reference as evidence to a question.

Comments

Please sign in or register to add your thoughts.


Oasys and occupational asthma smoke logo