چکیده (انگلیسی):

Patients with asthma show a steeper age-related decline in pulmonary function than healthy subjects, which is
often alleviated after the initiation of treatment with inhaled corticosteroids (ICS). However, there still are patients
who develop irreversible airflow limitations despite receiving adequate ICS treatment. The identification
of the characteristics of such patients and biomarkers of progression for airflow limitation, a functional consequence
of airway remodeling, is considered important in the management of asthma.
A variety of biomarkers are associated with the forced expiratory volume in 1 s (FEV1) in asthma in a crosssectional
fashion. However, few biomarkers are known to reflect the decline in pulmonary function, particularly
in patients with asthma who receive ICS treatment. Recently periostin, a matricellular protein that prolongs
Th2eosinophilic inflammation and reflects airway remodeling, was reported to be detected in serum. In a Kinki
Hokuriku Airway disease Conference multicenter cohort study, we demonstrated that among several serum
markers, high serum periostin level, particularly 95 ngmL, was the only marker associated with a greater annual
decline in FEV1 and a decline in FEV1 of 30 mL?yr−1. A variant (rs9603226) of the POSTN gene that encodes
periostin was also involved in the frequency of a decline in FEV1 of30 mL?yr−1.
Our results suggest that the serum periostin level is a useful marker reflecting pulmonary function decline in
patients with asthma receiving ICS.