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Τρίτη 11 Ιουνίου 2019

Elevated serum levels of periostin in patients with Allergic Bronchopulmonary Aspergillosis
Ge Wu  Xun Meng  Peiyan Zheng  X H Douglas Zhang  Lu Li  Haisheng Hu  Baoqing Sun
First published: 07 June 2019 https://doi.org/10.1111/myc.12957
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/myc.12957
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Abstract
Background
Serum periostin levels have been reported to be an indicator of Th2 inflammation in asthmatic patients.

Objective
This study aimed to investigate serum levels of periostin in patients with Allergic bronchopulmonary aspergillosis (ABPA) and to evaluate its diagnostic and monitoring value in the disease.

Methods
Patients with ABPA (n=19) and asthma (n=24), including severe asthma with fungal sensitization (SAFS, n=11) and severe asthma without fungal sensitization (SAwFS, n=13), were enrolled. Serum levels of periostin were analyzed by Enzyme‐linked immunosorbent assay. Serum total IgE and Aspergillus fumigatus specific IgE, IgG were measured by ImmunoCAP. Levels of cytokines (IFN‐γ, IL‐4, IL‐5, IL‐8, IL‐10, IL‐13 and IL‐17A) were measured by Meso Scale Discovery (MSD).

Results
Serum levels of periostin in ABPA patients (85.55 ng/mL, [68.28‐166] ng/mL) were higher than those in SAFS (50.99 ng/mL, [32.02‐71.80] ng/mL) (p<0.01). Among the analyzed cytokines, IL‐5 levels in ABPA (1.55 pg/mL, [0.96‐3.33] pg/mL) were higher than those in SAFS (0.31 pg/mL, [0.26‐0.56] pg/mL) (p<0.05) or SAwFS (0.34 pg/mL, [0.21‐0.56] pg/mL) (p<0.01). Serum periostin levels was positively associated with total IgE levels (r=0.319, p<0.05), serum IL‐5 levels (r=0.484, p<0.01) and blood eosinophil counts (r=0.428, p<0.05). In ROC analysis, the clinical reference value of periostin was 68.8 ng/mL for differential diagnosis of ABPA and SAFS, with the areas under the curves (AUC) of 0.81. Longitudinally, serum periostin levels did not change significantly after treatment in ABPA.

Conclusions
These findings suggested that serum levels of periostin were up‐regulated in ABPA patients, which may be associated with eosinophilic inflammation.

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