چکیده (انگلیسی):

Although it is currently recognized that bronchial asthma is not a single disease but a syndrome, we have
not yet made use of our new understanding of this heterogeneity as we treat asthma patients. To increase
the efficacy of anti-asthma drugs and to decrease costs, it is important to stratify asthma patients into
subgroups and to develop therapeutic strategies for each subgroup. Periostin has recently emerged as a
biomarker for bronchial asthma, unique in that it is useful not in diagnosis but in categorizing asthma
patients. We first found that periostin is a novel component of subepithelial fibrosis in bronchial asthma
downstream of IL-13 signals. Thereafter, it was shown that periostin can be a surrogate biomarker of type
2 immune responses, the basis of the notion that a detection system of serum periostin is potentially a
companion diagnostic for type 2 antagonists. Furthermore, we have recently shown that serum periostin
can predict resistance or hyporesponsiveness to inhaled corticosteroids, based on its contribution to
tissue remodeling or fibrosis in bronchial asthma. Thus, serum periostin has two characteristics as a
biomarker for bronchial asthma: it is both a surrogate biomarker of type 2 immune responses and a
biomarker reflecting tissue remodeling or fibrosis. We can take advantage of these characteristics to
develop stratified medicine in bronchial asthma.