Relationships among aeroallergen sensitization, peripheral blood eosinophils, and periostin in pediatric asthma development - 19/04/17
, Robert F. Lemanske, MD a, Joseph R. Arron, MD, PhD b, Cecile T.J. Holweg, PhD b, Victoria Rajamanickam, MS c, Ronald E. Gangnon, PhD c, James E. Gern, MD a, Daniel J. Jackson, MD aAbstract |
Background |
Biomarkers, preferably noninvasive, that predict asthma inception in children are lacking.
Objective |
Little is known about biomarkers of type 2 inflammation in early life in relation to asthma inception. We evaluated aeroallergen sensitization, peripheral blood eosinophils, and serum periostin as potential biomarkers of asthma in children.
Methods |
Children enrolled in the Childhood Origins of ASThma study were followed prospectively from birth. Blood samples were collected at ages 2, 4, 6, and 11 years, and serum-specific IgE levels, blood eosionophil counts, and periostin levels were measured in 244 children. Relationships among these biomarkers, age, and asthma were assessed.
Results |
Serum periostin levels were approximately 2- to 3-fold higher in children than previously observed adult levels. Levels were highest at 2 years (145 ng/mL), and did not change significantly between 4 and 11 years (128 and 130 ng/mL). Age 2 year periostin level of 150 ng/mL or more predicted asthma at age 6 years (odds ratio [OR], 2.3; 95% CI, 1.3-4.4). Eosinophil count of 300 cells/μL or more and aeroallergen sensitization at age 2 years were each associated with increased risk of asthma at age 6 years (OR, 3.1; 95% CI, 1.7-6.0 and OR, 3.3; 95% CI, 1.7-6.3). Children with any 2 of the biomarkers had a significantly increased risk of developing asthma by school age (≥2 biomarkers vs none: OR, 6.6; 95% CI, 2.7-16.0).
Conclusions |
Serum periostin levels are significantly higher in children than in adults, likely due to bone turnover, which impairs clinical utility in children. Early life aeroallergen sensitization and elevated blood eosinophils are robust predictors of asthma development. Children with evidence of activation of multiple pathways of type 2 inflammation in early life are at greatest risk for asthma development.
Le texte complet de cet article est disponible en PDF.Key words : Biomarkers, children, asthma development, periostin, aeroallergen sensitization, peripheral blood eosinophils
Abbreviations used : COAST, GM, OR
Plan
| Disclosure of potential conflict of interest: H. M. Anderson receives research support from the National Heart, Lung, and Blood Institute (NHLBI) and travel support from the AAAAI FIT Travel Scholarship. R. F. Lemanske, Jr is an employee of the University of Wisconsin, receives research support from NHLBI and Pharmaxis; serves as a consultant for Merck, Sepracor, SA Boney and Associates, GlaxoSmithKline, American Institute of Research, Genetech, Double Helix Development, Health Star Communications, and Boerhinger Ingelheim; receives speaker fees from Michigan Public Health, Allegheny General Hospital, AAP, West Allegheny Health, California Chapter 4, Colorado Allergy Society, Pennsylvania Allergy Society, Howard Pilgrim Health, California Society of Allergy, NYC Allergy Society, World Allergy Organization, APAPARI, Western Society of Allergy, Asthma and Immunology, Kuwait Allergy Society, Lurie Childrens Hospital, Boston Children's Hospital, LA Children's Hospital, Northwestern University, Asthma and Allergy Foundation of America, Alaska Chapter, and Egyptian Allergy Society; payment for manuscript preparation from the AAAAI; and Royalties from Elsevier and UpToDate. J. R. Arron is an empoyee of Genentech, Inc; has a patent with Genentech, Inc; and holds stock with the Roche Group. C. T. J. Holweg is an employee of Genetech Inc. V. Rajamanickam receives research funding from the University of Wisconsin, Madison. R. E. Gangnon receives research support from the NHLBI. J. E. Gern receives research support from the National Institutes of Health and GlaxoSmithKline; serves as a consultant for Genetech, Amgen, Novartis, PREP Biopharm, Inc, Janssen, Regeneron, and GlaxoSmithKline; receives payment for the development of educational presentations from Boehringer Ingelheim; and receives travel support from Boehringer Ingelheim. D. J. Jackson receives grant funding from the National Institutes of Health and serves as a consultant for Vectura. |
Vol 139 - N° 3
P. 790-796 - mars 2017 Retour au numéro
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