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Role of periostin in uncontrolled asthma in children. (DADO study)

Habernau Mena A1, Del Pozo Abejón V2,3, Rodríguez Vidigal FF1, Bobadilla González P4

1Departament of Biomedical Sciences. University Hospital, Badajoz (Spain)
2Department of Immunology, IIS-Fundación Jiménez Díaz, Madrid (Spain)
3CIBER de Enfermedades Respiratorias (CIBERES)
4Departament of Allergology. Hospital Infanta Cristina. University Hospital, Badajoz (Spain)

J Investig Allergol Clin Immunol 2017; Vol. 27(5)
doi: 10.18176/jiaci.0144

Introduction and objectives: Asthma is the most common chronic disease in children. Cases of severe asthma (SA) are underdiagnosed. Periostin is a biomarker for SA in adults, but its role in children is poorly understood. The aim of the study was to estimate the percentage of cases of uncontrolled severe asthma (UcSA) in children with poorly controlled asthma and evaluate the role of periostin as a biomarker.
Materials and methods: Observational study in children aged 5 to 14 years with poorly controlled asthma. Demographic and clinical information were collected in addition to the lung function test, the fraction of exhaled nitric oxide (FeNO), the skin prick test (SPT), total IgE, specific IgE, blood eosinophilia, serum periostin, treatment, asthma control and quality of life (QoL). Variables were compared between the group with UcSA and the other children.
Outcomes: Fifty children with poorly controlled asthma (72% male) were included. Nineteen children (38%) had UcSA. Most children had limitations in their activities of daily living, emergency visits and 38% required hospitalisation. The mean QoL was low. Only 42% of the children received appropriate treatment. The UcSA group (19 children, 38%) was more likely to have a total IgE >500 kU/ml (52.6% versus 19%, p = 0.02) and less likely to have a serum periostin >1,000 ng/ml (31.2% versus 63%, p = 0.04).
Conclusions: In our setting, 38% of children with poorly controlled asthma have UcSA, which is associated with higher levels of total serum IgE and lower levels of serum periostin.

Key words: Uncontrolled severe asthma, clinical practice guidelines, children, periostin.