PMID- 23943655
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20130814
LR  - 20211021
IS  - 1177-2719 (Print)
IS  - 1177-2719 (Electronic)
IS  - 1177-2719 (Linking)
VI  - 8
DP  - 2013
TI  - Markers that can Reflect Asthmatic Activity before and after Reduction of Inhaled 
      Corticosteroids: A Pilot Study.
PG  - 97-105
LID - 10.4137/BMI.S12537 [doi]
AB  - Evaluation of airway inflammation is important in achieving adequate dosing of 
      inhaled corticosteroids (ICS) for treating bronchial asthma. However, there is no 
      evaluation tool that can be used in clinical settings. We examined biomarkers 
      that can precisely reflect airway inflammation when ICS are decreased in stable 
      asthmatic patients. This was a 12-week, single-arm, open-label clinical study 
      performed at a single university hospital. Twenty-five patients (6 male and 19 
      female) with stable asthma were included in this study. We investigated whether 
      the levels of nitrite and nitrate in exhaled breath condensate (EBC) increase 
      after ICS reduction. We also investigated whether blood eosinophils, serum 
      immunoglobulin E (IgE), high-sensitivity C reactive protein (hs-CRP), interleukin 
      (IL)-13, IL-17, and periostin are different before and after ICS reduction. Peak 
      expiratory flow (PEF), pulmonary function tests, asthma control test (ACT), and 
      asthma quality of life questionnaire (AQLQ) were also examined. We considered an 
      unscheduled hospital visit due to asthmatic symptoms and decline in average PEF 
      over one week by more than 10% to indicate disease instability, and compared 
      patients with stable and unstable disease for analysis. Unstable status was 
      detected in 5 patients. Age, sex, asthma duration, ACT and AQLQ scores, and the 
      level of serum IgE did not differ between stable and unstable groups. In the 
      unstable group, the total concentration of nitrite and nitrate at the last visit 
      was 9.84 (6.65-11.24) muM. Surprisingly, this was similar to the concentration at 
      the first visit (5.58 (2.94-17.29) muM). Serum periostin before ICS reduction 
      (141.9 [107.7-147.7] pg/mL) was higher in the unstable group than in the stable 
      group (91.5 [78.75-103.5] pg/mL). The unstable group had a higher peripheral 
      blood eosinophil count and wider diurnal variation of PEF at the first visit 
      compared to the stable group. Higher eosinophils in peripheral blood and wider 
      diurnal variation of PEF were predictive markers for unstable disease after ICS 
      reduction. Serum periostin is another candidate for the predictive marker.
FAU - Kato, Go
AU  - Kato G
AD  - Division of Hematology, Respiratory Medicine and Oncology, Department of Internal 
      Medicine, Saga University Medical School, Saga, Japan.
FAU - Takahashi, Koichiro
AU  - Takahashi K
FAU - Izuhara, Kenji
AU  - Izuhara K
FAU - Komiya, Kazutoshi
AU  - Komiya K
FAU - Kimura, Shinya
AU  - Kimura S
FAU - Hayashi, Shinichiro
AU  - Hayashi S
LA  - eng
PT  - Journal Article
DEP - 20130804
PL  - United States
TA  - Biomark Insights
JT  - Biomarker insights
JID - 101288638
PMC - PMC3738382
OTO - NOTNLM
OT  - bronchial asthma
OT  - exhaled breath condensate
OT  - inhaled corticosteroid
OT  - nitric oxides
OT  - periostin
EDAT- 2013/08/15 06:00
MHDA- 2013/08/15 06:01
PMCR- 2013/08/04
CRDT- 2013/08/15 06:00
PHST- 2013/08/15 06:00 [entrez]
PHST- 2013/08/15 06:00 [pubmed]
PHST- 2013/08/15 06:01 [medline]
PHST- 2013/08/04 00:00 [pmc-release]
AID - bmi-8-2013-097 [pii]
AID - 10.4137/BMI.S12537 [doi]
PST - epublish
SO  - Biomark Insights. 2013 Aug 4;8:97-105. doi: 10.4137/BMI.S12537. eCollection 2013.