Serum periostin among infants with severe bronchiolitis and risk of developing asthma: A prospective multicenter cohort study

Authors

Makiko Nanishi, Department of Emergency Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA.
Michimasa Fujiogi, Department of Emergency Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA.
Robert J. Freishtat, Department of Genomics and Precision Medicine, George Washington University, Washington, District of Columbia, USA.
Claire E. Hoptay, Children's Research Institute, Children's National Hospital, Washington, District of Columbia, USA.
Cindy S. Bauer, Division of Allergy and Immunology, Phoenix Children's Hospital, Phoenix, Arizona, USA.
Michelle D. Stevenson, Department of Pediatrics, Emergency Medicine, Norton Children's Hospital, University of Louisville School of Medicine, Louisville, Kentucky, USA.
Carlos A. Camargo, Department of Emergency Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA.
Kohei Hasegawa, Department of Emergency Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA.

Document Type

Journal Article

Publication Date

1-9-2022

Journal

Allergy

DOI

10.1111/all.15216

Keywords

allergic predisposition; asthma; bronchiolitis; children; periostin

Abstract

BACKGROUND: Infants hospitalized for bronchiolitis (severe bronchiolitis) are at high risk for developing childhood asthma. However, the pathobiological link between these conditions remains unclear. We examined the longitudinal relationship of periostin (an extracellular matrix protein upregulated in response to type 2 inflammation) during bronchiolitis with the subsequent development of asthma. METHODS: In a 17-center prospective cohort study of infants (aged <1 year) with severe bronchiolitis, we measured the serum periostin level at hospitalization and grouped infants into 3 groups: low, intermediate, and high levels. We examined their association with asthma development by age 6 years and investigated effect modification by allergic predisposition (eg, infant's IgE sensitization). RESULTS: The analytic cohort consists of 847 infants with severe bronchiolitis (median age, 3 months). Overall, 28% developed asthma by age 6 years. In the multivariable model adjusting for nine patient-level factors, compared to the low periostin group, the asthma risk was significantly higher among infants in the intermediate group (23% vs. 32%, OR 1.68, 95%CI 1.12-2.51, p = .01) and non-significantly higher in the high-level group (28%, OR 1.29, 95%CI 0.86-1.95, p = .22). In the stratified analysis, infants with IgE sensitization had a significantly higher risk for developing asthma (intermediate group, OR 4.76, 95%CI 1.70-13.3, p = .002; high group, OR 3.19, 95%CI 1.08-9.36, p = .04). By contrast, infants without IgE sensitization did not have a significantly higher risk (p > .15). CONCLUSIONS: In infants with severe bronchiolitis, serum periostin level at bronchiolitis hospitalization was associated with asthma risk by age 6 years, particularly among infants with an allergic predisposition.

APA Citation

Nanishi, Makiko; Fujiogi, Michimasa; Freishtat, Robert J.; Hoptay, Claire E.; Bauer, Cindy S.; Stevenson, Michelle D.; Camargo, Carlos A.; and Hasegawa, Kohei, "Serum periostin among infants with severe bronchiolitis and risk of developing asthma: A prospective multicenter cohort study" (2022). GW Authored Works. Paper 272.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/272

Department

Genomics and Precision Medicine