Serum Periostin Level in Asthmatic Children with Exercise Induced Bronchospasm

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Reem M. Soliman
Mohamed B. Hamza
Rasha M. El-Shafiey
Hesham A. Elserogy
Nabil M El-Esawy


Background: There are few biomarkers that can be easily accessed in clinical settings and may reflect refractory Th2-eosinophlic inflammation and remodeling of the asthmatic airways. Serum periostin may be one such biomarker to aid our understanding of the patho-bio-physiology of asthma and exercise induced asthma. The aim of the study is to explore the relationship between serum periostin level and exercise induced bronchoconstriction in asthmatic children.

Materials and Methods: This cross-sectional study was carried out on (90) children both sexes aged from 6 to 15 years including, (60) children with bronchial asthma and (30) children were enrolled as control group in the period from January 2018 to January 2019. Patients were randomly classified into two groups: I) Patient group: divided into 2 groups according to standardized treadmill exercise challenge test: Group A: (30) asthmatic children with positive test. Group B: (30) asthmatic children with negative test. II-Control group: (30) children apparently healthy with no personal or family history of asthma. All children were subjected to the following Investigations: Chest x-ray, pulmonary functions tests (FEV1 & PEFR) except controls, Laboratory investigations as CBC and Serum periostin level.

Results: The mean values of both the percentage of PEFR and FEV1 after exercise in group A were significantly lower than those in group B and the percentage of PEFR and FEV1 after exercise in each group were significantly lower than the percentage before exercise in the same group. The mean value of eosinophilic count in group A was significantly higher than (group B and control group) and the mean value of eosinophilic count in group B was significantly higher than control group. The mean value of serum level of periostin in group A was significantly higher than (group B and control group), however, there was no significant difference between group B and control group as regard to serum level of periostin.

Chest tightness, cough and wheezes after exercise and eosinophilic count in patients with high serum periostin level were significantly higher than patients with low serum periostin level, and both PEFR and FEV1 after exercise in patients with high serum periostin level were significantly lower than patients with low serum periostin level. Also the normal serum periostin levels vary among different age groups.

Conclusion: Serum periostin level can be considered as a useful biomarker for diagnosis of Exercise induced bronchospasm (EIB) in asthmatic children especially when lung function test cannot be done However, cautious is required in evaluating serum periostin levels in children because it varies with age.

Serum periostin, asthmatic children, exercise, bronchospasm.

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How to Cite
Soliman, R. M., Hamza, M. B., El-Shafiey, R. M., Elserogy, H. A., & El-Esawy, N. M. (2020). Serum Periostin Level in Asthmatic Children with Exercise Induced Bronchospasm. Journal of Advances in Medicine and Medical Research, 32(17), 53-67.
Original Research Article


Kippelen P, Fitch KD, Anderson SD, Bougault V, Boulet LP, Rundell KW, et al. Respiratory health of elite athletes - preventing airway injury: a critical review. British journal of sports medicine. 2012;46:471-6.

Rundell KW, Anderson SD, Sue-Chu M, Bougault V, Boulet LP. Air quality and temperature effects on exercise-induced bronchoconstriction. Comprehensive Physiology. 2015;5:579-610.

Szefler SJ, Wenzel S, Brown R, Erzurum SC, Fahy JV, Hamilton RG, et al. Asthma outcomes: biomarkers. The Journal of allergy and clinical immunology. 2012;129:9-23.

Sidhu SS, Yuan S, Innes AL, Kerr S, Woodruff PG, Hou L, et al. Roles of epithelial cell-derived periostin in TGF-beta activation, collagen production, and collagen gel elasticity in asthma. Proceedings of the National Academy of Sciences of the United States of America. 2010;107:14170-5.

Lopez-Guisa JM, Powers C, File D, Cochrane E, Jimenez N, Debley JS. Airway epithelial cells from asthmatic children differentially express proremodeling factors. Journal of Allergy Clinical Immunology. 2012;129:990-7.

Parsons JP, Hallstrand TS, Mastronarde JG, Kaminsky DA, Rundell KW, Hull JH, et al. An official American Thoracic Society clinical practice guideline: exercise-induced bronchoconstriction. American journal of respiratory and critical care medicine. 2013;187:1016-27.

Izuhara K, Conway SJ, Moore BB, Matsumoto H, Holweg CT, Matthews JG, et al. Roles of Periostin in Respiratory Disorders. American journal of respiratory and critical care medicine. 2016;193:949-56.

Cho JH, Kim K, Yoon JW, Choi SH, Sheen YH, Han M, et al. Serum levels of periostin and exercise-induced bronchoconstriction in asthmatic children. World Allergy Organ J. 2019;12(1):100-4.

Song JS, You JS, Jeong SI, Yang S, Hwang IT, Im YG, et al. Serum periostin levels correlate with airway hyper-responsiveness to methacholine and mannitol in children with asthma. Allergy. 2015;70:674-81.

Inoue T, Akashi K, Watanabe M, Ikeda Y, Ashizuka S, Motoki T, et al. Periostin as a biomarker for the diagnosis of pediatric asthma. Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. 2016;27:521-6.

Johansson MW, Evans MD, Crisafi GM, Holweg CT, Matthews JG, Jarjour NN. Serum periostin is associated with type 2 immunity in severe asthma. Journal of Allergy Clinical Immunology. 2016;137:1904-7.

Kimura H, Konno S, Makita H, Taniguchi N, Kimura H, Goudarzi H, et al. Serum periostin is associated with body mass index and allergic rhinitis in healthy and asthmatic subjects. Allergology international : official journal of the Japanese Society of Allergology. 2018;67:357-63.

Hoshino M, Ohtawa J, Akitsu K. Effect of treatment with inhaled corticosteroid on serum periostin levels in asthma. Respirology (Carlton, Vic). 2018;21:297-303.

Park HK, Jung JW, Cho SH, Min KU, Kang HR. What makes a difference in exercise-induced bronchoconstriction: an 8 year retrospective analysis. PloS one. 2014;9:871-5.

Koh YI, Choi S. Blood eosinophil counts for the prediction of the severity of exercise-induced bronchospasm in asthma. Respiratory medicine. 2002;96:120-5.

Lin LL, Huang SJ, Ou LS, Yao TC, Tsao KC, Yeh KW, et al. Exercise-induced bronchoconstriction in children with asthma: an observational cohort study. Journal of Microbiology, Immunology Infection. 2019;52:471-9.

Inoue Y, Izuhara K, Ohta S, Ono J, Shimojo N. No increase in the serum periostin level is detected in elementary school-age children with allergic diseases. Allergology International. 2015;64:289-90.

Elhady M. Serum Periostin Level in Children with Bronchial Asthma: A Comparative Study. Journal of Medical Science And clinical Research. 2017;05:15536-42.

Nagasaki T, Matsumoto H, Kanemitsu Y, Izuhara K, Tohda Y, Kita H, et al. Integrating longitudinal information on pulmonary function and inflammation using asthma phenotypes. The Journal of allergy and clinical immunology. 2014;133:1474-7, 7.e1-2.