Thomson Neil C, Chaudhuri Rekha, Spears Mark, Haughney John, McSharry Charles
Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, UK.
Respiratory Medicine, Forth Valley Royal Hospital, Larbert, UK.
Respir Med. 2015 Jun;109(6):708-15. doi: 10.1016/j.rmed.2015.03.009. Epub 2015 Apr 3.
Elevated serum periostin is associated with airway eosinophilia and may predict response to therapies targeting Th2 inflammation. Smoking in asthma is generally associated with non-eosinophilic airway inflammation and corticosteroid insensitivity. We determined the effect of smoking status on serum periostin in asthma.
Serum periostin (ELISA; Aviscera Bioscience) was measured in 107 patients with stable asthma of different disease severity and 45 healthy controls. The effects on serum periostin of clinical indices including smoking status and of inflammatory biomarkers including sputum eosinophil count were analysed. Serum periostin was measured before and after two weeks of oral corticosteroids in a separate group of 33 non-smokers and smokers with stable asthma.
Serum periostin (median [IQR], ng/mL) was reduced in smokers with asthma compared to never smokers with asthma; 9 (9, 307) versus 233 (34, 1108) respectively, p = 0.017. Periostin was not influenced by disease severity (p = 0.786) or atopic status (p = 0.144). There was a weak correlation between serum periostin and sputum eosinophil count in smokers with asthma (r = 0.315, p = 0.020). The proportion of patients with an elevated serum periostin concentration was greater in never smokers with asthma compared to smokers with asthma [65% versus 39% respectively, p = 0.003]. Oral steroid treatment reduced serum periostin (p = 0.030) in non-smokers with asthma.
Despite lower median serum periostin concentrations in smokers with asthma compared to never smokers with asthma, approximately forty percent of this group had a high level. The potential value of a raised serum periostin concentration in predicting a beneficial response to therapies targeting Th2 inflammation in smokers with asthma requires to be investigated.
血清骨膜蛋白升高与气道嗜酸性粒细胞增多有关，可能预测针对Th2炎症的治疗反应。哮喘患者吸烟通常与非嗜酸性气道炎症和皮质类固醇不敏感有关。我们确定了吸烟状态对哮喘患者血清骨膜蛋白的影响。
对107例不同疾病严重程度的稳定期哮喘患者和45名健康对照者测量血清骨膜蛋白（酶联免疫吸附测定法；Aviscera生物科学公司）。分析了包括吸烟状态在内的临床指标以及包括痰嗜酸性粒细胞计数在内的炎症生物标志物对血清骨膜蛋白的影响。在另一组33名稳定期哮喘非吸烟者和吸烟者中，在口服皮质类固醇两周前后测量血清骨膜蛋白。
与从不吸烟的哮喘患者相比，吸烟的哮喘患者血清骨膜蛋白（中位数[四分位间距]，ng/mL）降低；分别为9（9，307）和233（34，1108），p = 0.017。骨膜蛋白不受疾病严重程度（p = 0.786）或特应性状态（p = 0.144）影响。吸烟的哮喘患者血清骨膜蛋白与痰嗜酸性粒细胞计数之间存在弱相关性（r = 0.315，p = 0.020）。与吸烟的哮喘患者相比，从不吸烟的哮喘患者血清骨膜蛋白浓度升高的患者比例更高[分别为65%和39%，p = 0.003]。口服类固醇治疗可降低哮喘非吸烟者的血清骨膜蛋白（p = 0.030）。
尽管吸烟的哮喘患者血清骨膜蛋白浓度中位数低于从不吸烟的哮喘患者，但该组中约40%的患者骨膜蛋白水平较高。血清骨膜蛋白浓度升高在预测吸烟的哮喘患者对针对Th2炎症的治疗产生有益反应方面的潜在价值有待研究。
