4-3OAS Serum Periostin Level Is Higher in Respiratory Type of NSAID Hypersensitivity Than Cutaneous Type

Thursday, 15 October 2015: 11:30 - 11:45
Room R2 ABC (Floor 3) (Coex Convention Center)

Mi-Ae Kim, MD , Allergy and Clinical Immunology, Bundang Medical Center, CHA University, Seongnam, South Korea

Moon Gyeong Yoon, M.S , Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea

Young-Soo Lee, MD , Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea

Ji Hye Kim, MD , Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea

Ga Young Ban, MD , Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea

Hye-Soo Yoo, M.D , Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea

Yoo Seob Shin, MD, PhD , Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea

Young Min Ye, MD, PhD , Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea

Dong-Ho Nahm, MD, PhD , Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea

Hae-Sim Park, MD, PhD , Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea

Background

Nonsteroidal antiinflammatory drugs (NSAIDs) hypersensitivity is a commonly found drug allergy, in which two major phenotypes, respiratory (aspirin-exacerbated respiratory disease <AERD>) and cutaneous (aspirin-exacerbated cutaneous disease <AECD> or aspirin-intolerant acute urticaria <AIAU>) types were noted in this country. Periostin is an extracellular matrix protein and structurally homologous with fasciclin I, an insect adhesion molecule. Previous study demonstrated that serum periostin level was significantly higher in AERD than in aspirin tolerant asthma. To evaluate serum periostin level as a biomarker for differentiating the phenotypes of NSAIDs hypersensitivity, we compared serum periostin levels between respiratory and cutaneous types of NSAID hypersensitivity.

Methods

Serum periostin levels were measured by human periostin ELISA in sera from 326 adult patients with NSAID hypersensitivity and 87 healthy normal controls (NC). The phenotype of NSAID hypersensitivity was defined according to previous histories of adverse drug reaction and/or aspirin provocation test.

Results

There were 45.7% of respiratory type of NSAID hypersensitivity (n=149) and 54.3% of cutaneous type (n=177). Mean serum periostin level was significantly higher in respiratory type (82.6 ± 38.8 ng/mL) than in cutaneous type (39.7 ± 31.1 ng/ML) and NC group (46.2 ± 29.0 ng/mL). However, there were no significant differences of serum periostin levels between AECD and AIAU groups (P = 0.708), between AECD and NC groups (P = 0.195), and between AIAU and NC groups (P = 0.110). The ROC analysis revealed that serum periostin level could differentiate AERD from cutaneous type of NSAIDs hypersensitivity (AUC = 0.826, P < 0.001) and cut-off level was 42.5 ng/mL with 93.3% of sensitivity and 61.0% of specificity.

Conclusion

These findings suggest that serum periostin level can be a useful biomarker for predicting the phenotype of AERD among NSAID hypersensitivity patients.