Ağır Astımda Serum Periostin ve IL-13 Düzeylerinin Kan Eozinofilisini Belirlemedeki Etkinlikleri

Giriş: Kan eozinofil düzeyi sıklıkla değişkenlik göstermektedir ve düzeyleri pek çok farklı faktörden etkilenebilmektedir. Bu çalışmada eozinofili ile giden ağır astım fenotiplerinin belirlenmesinde kullanılabilecek iki potansiyel biyobelirteçin eozinofili varlığı ve düzeyini belirlemedeki etkinliklerinin araştırılması amaçlanmıştır. Yöntemler: Bu çalışma NCT03563521 clinical trial kayıt numaralı çalışma bulgularının alt veri analizi yapılarak gerçekleştirilmiştir. Hepsi ağır astım tanılı hasta kohortundan bu çalışma için hastaların demografik bilgileri, stabil dönem ve atak dönemlerine ait kan eozinofil, IL-13 ve periostin düzeylerine ait bilgiler elde edilmiştir. Stabil dönem ve atak dönemlerine ait kan eozinofil düzeyleri ile serum IL-13 ve periostin düzeyleri ortalama (IQR) olarak gösterilmiş ve aralarındaki korelasyon araştırılmıştır. Bulgular: Ortalama yaşı 45.6 ± 11.1 ve 67’si (%87) kadın olan toplam 76 hasta çalışmaya dahil edilmiştir. Hastaların 36’sında (%47) en az bir perennial alerji duyarlığı mevcuttu ve 19’u (%25) uzun süreli sistemik steroid (USSS) tedavisi altındaydı. Stabil döneme ait kan eozinofil, serum IL-13 ve periostin düzeyleri sırası ile 316 (130-420) hücre/mL, 13.1 (0-26.1) pg/mL ve 7194 (5520-9385) pg/mL olarak bulundu. Hem stabil dönem hem de atak dönemlerinde kan eozinofil sayı ve yüzdesi ile periostin değerleri arasında anlamlı bir korelasyon izlendi (sırası ile p=0.003, r=0.364; p=0.002, r=0.368). Atopisi olmayan veya USSS tedavisi almayan hastalarda bu korelasyonun daha güçlü olduğu, atopi varlığı veya USSS varlığında ise korelasyonun kaybolduğu izlendi. IL-13 ile stabil ve atak dönemleri kan eozinofil düzeyleri arasında herhangi bir ilişki tespit edilmedi. Sonuç: Ağır astım tanılı hastalarda serum periostin düzeyi kan eozinofili düzeyini göstermede kullanılabilecek bir biyobelirteçtir. Atopisi olan ve/veya uzun süreli sistemik steroid tedavisi alan hastalarda bu amaçla kullanımında dikkatli olunmalıdır.

Anahtar Kelimeler:

Ağır astım, eozinofili, periostin, interlökin-13

Effectiveness of Serum Periostin and IL-13 Levels in Determining Blood Eosinophilia in Severe Asthma

Introduction: Blood eosinophil levels show daily fluctuations and can be effected by various stimuli. This study aims to investigate two potential biomarkers that can be used to determine severe asthma phenotypes with eosinophilia, were investigated. Methods: This study was carried out by data analysis of the study findings with clinical trial registration number NCT03563521. For this study, the demographic information of the patients, the blood eosinophil, IL-13, and periostin levels were obtained from the cohort of patients with severe asthma. The blood eosinophil levels of the stable and attack periods and serum IL-13 and periostin levels were shown as the mean (IQR) and the correlation between them was investigated. Results: A total of 76 patients with a mean age of 45.9 ± 11.05 and of which 67 (87%) were women, included in the study. Thirty-six (47%) of the patients had at least one perennial allergen sensitivity and 19 (25%) were under long-term systemic steroid (LTSS) treatment. Stable period blood eosinophil, serum IL-13 and periostin levels were found as 316 (130-420) cells/mL, 13.1 (0-26.1) pg/mL and 7194 (5520-9385) pg/mL, respectively. A significant correlation was observed between the blood eosinophil number and percentage and periostin levels in both stable and attack periods (p=0.003, r=0.364; p=0.002, r=0.368, respectively). It was observed that this correlation was stronger in patients without atopy or who did not receive LTSS, and the correlation was lost in the presence of atopy or LTSS. No relationship was found between IL-13 and stable and attack periods blood eosinophil levels. Conclusion: Serum periostin is a biomarker that can be used to show the blood eosinophilia level in patients with severe asthma. Care should be taken for this purpose in patients with atopy and/or under long-term systemic steroid therapy.

Keywords:

Severe asthma, eosinophilia, periostin, interleukin-13,

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