Allergy Asthma Immunol Res.  2019 May;11(3):394-405. 10.4168/aair.2019.11.3.394.

Serum Levels of Eosinophil-Derived Neurotoxin: A Biomarker for Asthma Severity in Adult Asthmatics

• Lee Y
• Lee JH
• Yang EM
• Kwon E
• Jung CG
• Kim SC
• Choi Y
• Cho YS
• Kim CK
• Park HS

• KMID: 2442050
• DOI: http://doi.org/10.4168/aair.2019.11.3.394

Abstract

PURPOSE
Eosinophilic inflammation is a key component of severe asthma (SA). However, there has been no reliable serum biomarker for the eosinophilic inflammation of SA. We hypothesized that serum eosinophil-derived neurotoxin (EDN) could predict the eosinophilic inflammation of SA in adult asthmatics.
METHODS
Severe asthmatics (n = 235), nonsevere asthmatics (n = 898), and healthy controls (n = 125) were enrolled from Ajou University Hospital, South Korea. The serum levels of EDN and periostin were measured by enzyme-linked immunosorbent assay and compared between severe and nonsevere asthmatics. Their associations with total eosinophil count (TEC) and clinical parameters were evaluated; clinical validation of the K-EDN kit for the measurement of serum EDN was evaluated.
RESULTS
Severe asthmatics were older and had longer disease duration with significantly lower levels of forced expiratory volume in 1 second and methacholine PC20 than nonsevere asthmatics. Significant differences were found in TEC or sputum eosinophil count (%) between the groups. The serum levels of EDN and periostin were significantly higher in severe asthmatics than in nonsevere asthmatics and in healthy controls (all P < 0.05). Although significant correlations were found between serum EDN levels measured by the 2 kits (ρ = 0.545, P < 0.0001), higher correlation coefficients between serum EDN levels measured by the K-EDN kit and TEC were higher (ρ = 0.358, P < 0.0001) than those between serum EDN levels measured by the MBL kit and TEC (ρ = 0.319, P < 0.0001) or serum periostin level (ρ = 0.222, P < 0.0001). Multivariate regression analysis demonstrated that serum EDN levels measured by the K-EDN kit predicted the phenotype of SA (P = 0.003), while 2 other biomarkers did not.
CONCLUSIONS
The serum EDN level may be a useful biomarker for assessing asthma severity in adult asthmatics.

Keyword

Eosinophil-derived neurotoxin; asthma; biomarkers

MeSH Terms

Adult*
Asthma*
Biomarkers
Enzyme-Linked Immunosorbent Assay
Eosinophil-Derived Neurotoxin*
Eosinophils
Forced Expiratory Volume
Humans
Inflammation
Korea
Methacholine Chloride
Phenotype
Sputum
Biomarkers
Eosinophil-Derived Neurotoxin
Methacholine Chloride

Figure

• 

  Fig. 1 (A) Comparison of serum EDN levels measured by the K-EDN kit among severe asthmatics, nonsevere asthmatics, and NCs. (B) Comparison of serum EDN levels measured by the MBL kit between severe asthmatics, nonsevere asthmatics, and NCs.EDN, eosinophil-derived neurotoxin; NC, normal control.

• 

  Fig. 2 Correlation between the eosinophilic biomarkers in total asthmatics. (A) TEC and serum EDN levels measured by the K-EDN kit. (B). TEC and serum EDN levels measured by the MBL kit. (C) TEC and serum periostin levels.EDN, eosinophil-derived neurotoxin; TEC, total eosinophil count.

• 

  Fig. 3 (A) ROC curves for the serum EDN levels measured by the K-EDN kit in the prediction of severe asthma in the total asthmatics. (B) ROC curves for the serum EDN levels measured by the MBL kit in the prediction of severe asthma in the total asthmatics.ROC, receiver operating characteristic; EDN, eosinophil-derived neurotoxin; AUC, area under the curve; CI, confidence interval.

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