Combined assessment of serum periostin and YKL-40 may identify asthma-COPD overlap

Publication date: Available online 6 July 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Toshihiro Shirai, Keita Hirai, Yasuhiro Gon, Shuichiro Maruoka, Kenji Mizumura, Mari Hikichi, Cecile Holweg, Kunihiko Itoh, Hiromasa Inoue, Shu Hashimoto

Abstract:

Background

Asthma-COPD overlap (ACO) has been proposed as a different diagnosis from asthma and COPD. However, little is known about the role of serum biomarkers in ACO.

Objective

To evaluate serum periostin, a type 2 biomarker, and serum YKL-40, a useful biomarker for COPD, in Japanese patients with asthma, ACO, or COPD, and investigate the role of these biomarkers in identifying ACO.

Methods

Subjects included Japanese patients with asthma (n = 177), ACO (n = 115), or COPD (n = 61). Serum periostin, YKL-40, and total IgE, blood eosinophils, and FeNO were measured and compared among the patients.

Results

Serum periostin was high in both asthma and ACO, but not in COPD, whereas serum YKL-40 was high in both COPD and ACO, but not in asthma. Serum periostin levels correlated weakly with eosinophil counts in asthma, ACO, and COPD. Multivariate linear regression analysis revealed that older age, lower BMI, higher eosinophil counts, higher total IgE, and the absence of the diagnosis of COPD were significantly associated with higher periostin levels. Based on cutoff values derived by ROC analysis (periostin: 55.1 ng/mL; YKL-40: 61.3 ng/mL), patients were classified into high or low groups. The proportion of patients with both high serum periostin and YKL-40 levels was significantly higher in ACO than in asthma or COPD.

Conclusion

Serum periostin levels were comparable between asthma and ACO, while YKL-40 was comparable between ACO and COPD. Combined assessment of serum periostin and YKL-40 may identify ACO.