Prospective assessment of serum periostin as a biomarker for diagnosis and monitoring of eosinophilic oesophagitis

Aliment Pharmacol Ther. 2016 Jul;44(2):189-97. doi: 10.1111/apt.13672. Epub 2016 May 18.

Abstract

Background: Periostin is highly expressed in eosinophilic oesophagitis (EoE), but has not been extensively studied as a non-invasive biomarker.

Aim: To assess whether serum periostin distinguished EoE from controls at baseline, had utility for monitoring treatment response, or was associated with IL-13 levels.

Methods: This was a sub-analysis of a prospective cohort study of adults undergoing out-patient upper endoscopy. Incident cases of EoE were diagnosed per consensus guidelines. Controls were subjects with either GERD or dysphagia without EoE. EoE patients were treated with swallowed/topical steroids and had repeat endoscopy/biopsy. Serum periostin levels for cases and controls were compared at baseline, and pre/post-treatment levels were compared for cases. Serum IL-13 and tissue expression of periostin were also assessed.

Results: A total of 61 incident EoE cases and 87 controls were analysed. Despite a marked increase in tissue periostin expression in cases, the median baseline serum periostin level was only slightly higher in cases than controls (22.1 ng/mL vs. 20.7; P = 0.04); there was no change in post-treatment levels. There was also no difference in serum periostin for cases by histologic response or atopic status. There was a strong trend towards higher serum IL-13 levels in cases in the highest periostin quartile (57.1 pg/mL vs. 2.6; P = 0.07).

Conclusions: Serum periostin levels were similar in cases and controls, and there were no changes post-treatment. Given elevated IL-13 levels in the EoE patients with the highest periostin levels, future studies could explore periostin as a biomarker in EoE, perhaps in the setting of anti-IL-13 therapy.

MeSH terms

  • Adult
  • Biomarkers / blood
  • Biopsy
  • Cell Adhesion Molecules / blood*
  • Deglutition Disorders / diagnosis
  • Endoscopy / methods
  • Eosinophilic Esophagitis / diagnosis*
  • Female
  • Humans
  • Interleukin-13 / blood*
  • Male
  • Middle Aged
  • Outpatients
  • Prospective Studies

Substances

  • Biomarkers
  • Cell Adhesion Molecules
  • Interleukin-13
  • POSTN protein, human