Periostin Dynamics in Eosinophilic Airway Inflammation

Periostin is a secreted matricellular protein that becomes elevated in the subepithelial matrix of inflamed airways under the influence of type 2 cytokines such as interleukin-4 and interleukin-13. In eosinophilic airway inflammation, periostin contributes to the recruitment and activation of eosinophils, amplifies extracellular matrix remodelling and augments airway fibrosis. Its expression is dynamic, rising in acute exacerbations and chronic nasal polyp formation and declining in response to corticosteroid therapy. As a mediator of epithelial–mesenchymal crosstalk, periostin integrates signals from transforming growth factor-β and integrin receptors, thereby influencing tissue repair, mucus production and airway hyperresponsiveness. Clinically, circulating and local periostin measurements have emerged as biomarkers for identifying patients with a Th2-high phenotype, guiding anti-IL-13 and anti-IgE biologic therapies, and predicting surgical outcomes in chronic rhinosinusitis with nasal polyps. Ongoing research seeks to delineate isoform-specific functions and to develop periostin-targeted inhibitors that may attenuate remodelling without compromising mucosal defence.

Research from Nature Portfolio

Recent studies have elucidated periostin’s role in chronic rhinosinusitis with nasal polyps, demonstrating that tissues from patients with eosinophilic polyposis exhibit markedly increased periostin alongside elevated vascular endothelial growth factor, eotaxin-2 and RANTES. In vitro modulation of periostin in fibroblasts derived from polyp tissue altered VEGF and chemokine expression, indicating a feed-forward loop that sustains eosinophilic inflammation and angiogenesis. Another investigation mapped periostin deposition patterns in nasal mucosa, correlating diffuse periostin staining with higher rates of postoperative recurrence. Together, these insights identify periostin both as a driver of mucosal hyperplasia and as a candidate therapeutic target to prevent polyp regrowth and attenuate eosinophil-driven disease progression.

Periostin Dynamics in Eosinophilic Airway Inflammation publication trend

The graph below shows the total number of articles in periostin dynamics in eosinophilic airway inflammation across all publications each year (not limited to Nature Index journals).

Technical terms

Periostin: A matricellular protein secreted by epithelial and fibroblast cells that modulates extracellular matrix remodelling and inflammatory cell recruitment.

Eosinophils: Granulocytic leukocytes that mediate type 2 inflammation and release cytotoxic proteins contributing to airway damage.

Th2 inflammation: An immune response characterised by interleukin-4, interleukin-5 and interleukin-13 production, driving eosinophil activation and IgE synthesis.

Airway remodelling: Structural changes in the bronchial wall including subepithelial fibrosis, smooth muscle hypertrophy and mucus gland enlargement.

CRSwNP: Chronic rhinosinusitis with nasal polyps, a phenotype of upper-airway disease marked by eosinophilic inflammation and tissue hyperplasia.

References

1. Nasal TSLP and periostin in infants with severe bronchiolitis and risk of asthma at 4 years of age. Respiratory Research (2023).
2. The role of periostin in tissue remodeling across health and disease. Cellular and Molecular Life Sciences (2013).
3. Periostin as a novel biomarker for postoperative recurrence of chronic rhinosinitis with nasal polyps. Scientific Reports (2018).
4. Periostin: its role in asthma and its potential as a diagnostic or therapeutic target. Respiratory Research (2015).
5. A protective role for periostin and TGF‐β in IgE‐mediated allergy and airway hyperresponsiveness. Clinical & Experimental Allergy (2011).
6. Periostin in Allergy and Inflammation. Frontiers in Immunology (2021).
7. The Role of Periostin in the Occurrence and Progression of Eosinophilic Chronic Sinusitis with Nasal Polyps. Scientific Reports (2017).
8. A novel pathophysiologic link between upper and lower airways in patients with chronic rhinosinusitis: Association of sputum periostin levels with upper airway inflammation and olfactory function. World Allergy Organization Journal (2020).