The functional role and the clinical application of periostin in chronic rhinosinusitis

ABSTRACT

Introduction

Chronic rhinosinusitis (CRS) comprises several heterogenous groups, now classified based on endotype more often than on phenotype. A number of studies aimed at finding a useful biomarker for type 2 CRS suggest that periostin is a promising surrogate.

Areas covered

A comprehensive overview of the clinical significance of tissue periostin expression and serum periostin in CRS patients is provided. The effects of comorbid asthma on serum periostin and samples other than serum in which periostin can be detected in CRS patients are also discussed. Moreover, the functional roles of periostin in CRS pathogenesis are summarized.

Expert opinion

The position of periostin as a signature biomarker of type 2 CRS has been well established, enabling us to classify CRS patients by endotyping. Serum periostin is useful not only for endotyping CRS patients, but also for estimating disease severity, comorbidity, prognosis, and response to treatment, and in particular, predicting recurrence after surgery. However, it remains to be addressed how we apply serum periostin to using biologics for CRS patients. Further studies aimed at showing periostin to be a therapeutic target for CRS are awaited.

KEYWORDS:

• Biologic
• biomarker
• chronic rhinosinusitis
• comorbid asthma
• endotype
• periostin
• recurrence
• therapeutic target
• type 2 CRS

Article highlights

• The basis for classifying CRS has shifted from phenotype to endotype.

• The position of periostin as a signature biomarker of type 2 CRS has been well established, which enables us to classify CRS patients by endotyping.

• Serum periostin is useful not only for endotyping also for treating CRS patients, in particular the prediction of recurrence after surgery.

• It remains to be addressed how we apply serum periostin to using biologics for CRS patients.

• Periostin is a promising therapeutic target for CRS.

Acknowledgments

We thank Dr. Dovie R. Wylie for the critical review of this manuscript.

Declaration of interest

Kenji Izuhara has received honoraria and grants from Shino-test Corporation. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.