Role of Periostin in Uncontrolled Asthma in Children (DADO study).

BACKGROUND AND OBJECTIVE: 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. Objectives: The aims of the study were to estimate the percentage of cases of uncontrolled severe asthma (UcSA) in children with poorly controlled asthma and to evaluate the role of periostin as a biomarker. MATERIAL AND METHODS: We performed an observational study in children aged 5 to 14 years with poorly controlled asthma. Demographic and clinical data were collected in addition to the results of the lung function test, the fraction of exhaled nitric oxide, the skin prick test, total IgE, specific IgE, blood eosinophil count, serum periostin, treatment, asthma control, and quality of life. Variables were compared between the group with UcSA and the other children. RESULTS: 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 and had visited the emergency department. In addition, 38% were hospitalized. Quality of life was poor. Only 42% of the children received appropriate treatment. The UcSA group was more likely to have a total IgE >500 kUA/mL (52.6% vs 19%, P=.02) and less likely to have serum periostin >1000 ng/mL (31.2% vs 63%, P=.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.

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

Background: 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. Objectives: The aims of the study were to estimate the percentage of cases of uncontrolled severe asthma (UcSA) in children with poorly controlled asthma and to evaluate the role of periostin as a biomarker. Materials and Methods: We performed an observational study in children aged 5 to 14 years with poorly controlled asthma. Demographic and clinical data were collected in addition to the results of the lung function test, the fraction of exhaled nitric oxide, the skin prick test, total IgE, specific IgE, blood eosinophil count, serum periostin, treatment, asthma control, and quality of life. Variables were compared between the group with UcSA and the other children. Results: 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 and had visited the emergency department. In addition, 38% were hospitalized. Quality of life was poor. Only 42% of the children received appropriate treatment. The UcSA group was more likely to have a total IgE >500 kUA/mL (52.6% vs 19%, P=.02) and less likely to have serum periostin >1000 ng/mL (31.2% vs 63%, P=.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 (AU)

Introducción: El asma es la enfermedad crónica más frecuente en niños. El asma grave (AG) está infradiagnosticada. La periostina es un biomarcador de asma grave en adultos, pero su papel en niños es pobremente conocido. El objetivo de este estudio ha sido estimar el porcentaje de casos de asma grave no controlada (AGNC) en niños con asma mal controlada y evaluar el papel de la periostina como biomarcador. Material y métodos: Estudio observacional en niños de 5 a 14 años de edad con asma mal controlada. Se recogieron datos demográficos y clínicos, pruebas de función pulmonar y fracción de óxido nítrico exhalado (FENO), prick test, IgE total, IgE específica, eosinófilos en sangre, periostina en suero, tratamiento, control del asma y calidad de vida. Se compararon las variables entre el grupo con AGNC y el resto de niños. Resultados: Se incluyeron a 50 niños con asma mal controlada (72% varones). Diecinueve niños (38%) presentaban AGNC. La mayoría de los niños tenían limitaciones en las actividades de la vida diaria, visitas a urgencias y el 38% habían necesitado ingreso hospitalario. La media de calidad de vida fue baja. Solo el 42% de los niños tenían un tratamiento adecuado. El grupo AGNC (19 niños, 38%) tenían más probabilidad de tener una IgE >500 kU/ml (52,6% frente a 19%, p=0,002) y menos probabilidad de tener periostina en suero >1000 ng/ml (31,2% frente a 63%, p = 0,04). Conclusiones: En nuestra serie, el 38% de niños con asma no controlada tenían AGNC, que está asociado con altos niveles de IgE total y menores niveles de periostina en suero (AU)