title: Phenotype of asthma related with high serum periostin levels.
abstract: BACKGROUND
  Asthma is a heterogeneous disease composed of various phenotypes. Periostin, a molecule inducible with interleukin (IL)-4 or IL-13 in bronchial epithelial cells, is a biomarker of "TH2-high" asthma. The objective of this study is to examine whether the serum periostin concentrations are correlated with the severity, specific phenotype(s), or comorbidity of asthma.
  
  
  METHODS
  Serum concentrations of periostin were measured in 190 Japanese asthmatic patients and 11 healthy controls. The protocol was registered under UMIN 000002980 in the clinical trial registry.
  
  
  RESULTS
  The serum concentrations of periostin were significantly higher (P = 0.014) in asthmatics [70.0 (54.0-93.5) ng/ml] than in healthy subjects [57.0 (39.0-63.0) ng/ml], though we found no correlation between serum periostin concentrations and treatment steps required to control asthma. To characterize "high-periostin" phenotype(s), the patients with asthma were divided among tertiles based on the serum concentrations of periostin. The high-periostin group was older at onset of asthma (P = 0.04), had a higher prevalence of aspirin intolerance (P = 0.04) or concomitant nasal disorders (P = 0.03-0.001), higher peripheral eosinophil counts (P < 0.001), and lower pulmonary function (P = 0.02-0.07). The serum concentrations of periostin were particularly high in asthmatic patients complicated by chronic rhinosinusitis with nasal polyps and olfactory dysfunction. In contrast, neither atopic status, control status of asthma, nor quality of life were related with the "high-periostin" phenotype.
  
  
  CONCLUSIONS
  Elevated periostin concentrations in serum were correlated with a specific phenotype of eosinophilic asthma, late-onset and often complicated by obstructive pulmonary dysfunction and nasal disorders.
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Matsusaka
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan; Kawasaki Municipal Hospital, Kanagawa, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kabata
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Fukunaga
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Suzuki
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan.
authors.forename: Katsunori
authors.initials: K
authors.lastname: Masaki
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Mochimaru
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Tokai University Hachioji Hospital, Tokyo, Japan; Department of Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Sakamaki
authors.affiliation: Department of Medicine, National Tokyo Medical Center, Tokyo, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Oyamada
authors.affiliation: Department of Medicine, Sanokousei General Hospital, Tochigi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Kawasaki Municipal Hospital, Kanagawa, Japan; Division of Pulmonary Medicine, Department of Medicine, Tokai University, School of Medicine, Kanagawa, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Oguma
authors.affiliation: Kawasaki Municipal Hospital, Kanagawa, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Sayama
authors.affiliation: Department of Medicine, Saiseikai Utsunomiya Hospital, Tochigi, Japan; Department of Medicine, Tachikawa Kyosai Hospital, Tokyo, Japan.
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Koh
authors.affiliation: Department of Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan; Department of Medicine, Eiju General Hospital, Tokyo, Japan.
authors.forename: Morio
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Department of Medicine, Shioya Hospital, International University of Health and Welfare, Tochigi, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Umeda
authors.affiliation: Shino-Test Corporation, Tokyo, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Ono
authors.affiliation: Department of Laboratory Medicine, Saga Medical School, Saga, Japan.
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Ohta
authors.affiliation: Division of Medical Biochemistry, Department of Biomolecular Sciences, Saga Medical School, Saga, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Izuhara
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan; Division of Pulmonary Medicine, Department of Medicine, Tokai University, School of Medicine, Kanagawa, Japan. Electronic address: ko-asano@tokai-u.jp.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Asano
authors.affiliation: Division of Pulmonary Medicine, Department of Medicine, Keio University, School of Medicine, Tokyo, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Betsuyaku
mesh_terms: D000328:Adult; D044466:Asian People; D001241:Aspirin; D001249:Asthma / Q000097:blood* / Q000276:immunology / Q000503:physiopathology; D015815:Cell Adhesion Molecules / Q000097:blood*; D016207:Cytokines / Q000097:blood; D004361:Drug Tolerance; D004804:Eosinophils / Q000166:cytology; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000097:blood; D010641:Phenotype; D012220:Rhinitis / Q000097:blood; D012720:Severity of Illness Index; D012852:Sinusitis / Q000097:blood; D014797:Vital Capacity
chemical_list: D015815:Cell Adhesion Molecules; D016207:Cytokines; C512835:POSTN protein, human; D007073:Immunoglobulin E; D001241:Aspirin
keywords: Chronic rhinosinusitis; Eosinophils; Nasal polyp; Olfactory dysfunction; T(H)2-high asthma