title: Periostin as a biomarker for the diagnosis of pediatric asthma.
abstract: There are some biomarkers for asthma diagnosis but they are often difficult in clinical use, particularly in pediatric cases. Periostin is an extracellular matrix protein, upregulated in response to IL-4 or IL-13. Serum periostin is expected to be used as a non-invasive biomarker for asthma diagnosis and management.
  
  
  
  Twenty-eight children with asthma (BA) and 27 children without asthma (patients with pectus excavatum, etc. as control group) aged 6-16 years were included. Bronchial asthma was diagnosed according to International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Fractional exhaled nitric oxide (FeNO), lung function, blood eosinophil counts, total immunoglobulin E (IgE) levels, and serum periostin levels were assessed. Results were compared between BA and controls. Asthma diagnostic accuracies were calculated using receiver operating characteristics (ROC) curve analyses.
  
  
  
  Serum periostin levels in the BA group were significantly higher than those in the control group [medians (with interquartile ranges), 134.0 (116.3-166.3) vs. 112.0 (97.0-132.0) ng/ml; p = 0.012]. The area under the ROC curve (AUC) for periostin, FeNO, and eosinophil counts were 0.70, 0.72, and 0.84, respectively. After the exclusion of controls with pectus excavatum, AUC for periostin, forced expiratory volume in 1 s (FEV1 ), and maximum mid-expiratory flow rate (MMF) were 0.75, 0.74, and 0.80, respectively.
  
  
  
  Serum periostin levels were significantly higher in children with asthma. ROC AUC values for periostin were equivalent to conventional biomarkers, including FeNO levels and lung function testing, indicating the utility of serum periostin levels in diagnosing asthma in children.
authors.affiliation: Department of Pediatrics, Jikei University Daisan Hospital, Tokyo, Japan.|Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Inoue
authors.affiliation: Department of Pediatrics, Jikei University Daisan Hospital, Tokyo, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Akashi
authors.affiliation: Department of Pediatrics, Jikei University Daisan Hospital, Tokyo, Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Central Clinical Laboratory, Jikei University Hospital, Tokyo, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ikeda
authors.affiliation: Department of Surgery, Division of Pediatric Surgery, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ashizuka
authors.affiliation: Department of Pediatrics, Jikei University Daisan Hospital, Tokyo, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Motoki
authors.affiliation: Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Ryohei
authors.initials: R
authors.lastname: Suzuki
authors.affiliation: Department of Pediatrics, Jikei University School of Medicine, Tokyo, Japan.
authors.forename: Nagatoshi
authors.initials: N
authors.lastname: Sagara
authors.affiliation: Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Yanagida
authors.affiliation: Department of Allergy, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Sakura
authors.initials: S
authors.lastname: Sato
authors.affiliation: Department of Allergy, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Ebisawa
authors.affiliation: Department of Laboratory Medicine, Saga Medical School, Saga, Japan.
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Ohta
authors.affiliation: Shino-Test Corporation, Kanagawa, Japan.
authors.forename: Jyunya
authors.initials: J
authors.lastname: Ono
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: Department of Pediatrics, Jikei University Daisan Hospital, Tokyo, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Katsunuma
mesh_terms: D000293:Adolescent; D000951:Antigens, Neoplasm / Q000097:blood; D001249:Asthma / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood* / Q000378:metabolism; D015815:Cell Adhesion Molecules / Q000097:blood*; D002648:Child; D004804:Eosinophils / Q000166:cytology; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D018793:Interleukin-13 / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism; D015843:Serpins / Q000097:blood; D013147:Spirometry
chemical_list: D000951:Antigens, Neoplasm; D015415:Biomarkers; D015815:Cell Adhesion Molecules; D018793:Interleukin-13; C512835:POSTN protein, human; D015843:Serpins; C051072:squamous cell carcinoma-related antigen; D015847:Interleukin-4; D009569:Nitric Oxide; D007073:Immunoglobulin E
keywords: FeNO; ROC curve; asthma; biomarker; children; lung function; periostin