Kenichi Akashi

Periostin as a biomarker for the diagnosis of pediatric asthma

There are some biomarkers for asthma diagnosis but they are often difficult in clinical use, particularly in pediatric cases. Periostin is an extracellular matrix protein, upregulated in response to IL‐4 or IL‐13. Serum periostin is expected to be used as a non‐invasive biomarker for asthma diagnosis and management.

Up-regulation of serum periostin and squamous cell carcinoma antigen levels in infants with acute bronchitis due to respiratory syncytial virus

BACKGROUND Periostin and squamous cell carcinoma antigen (SCCA) are involved in the pathogenesis of asthma. Acute bronchitis due to respiratory syncytial virus (RSV) infection during infancy exhibits an asthma-like pathogenesis, suggesting that it may be associated with the subsequent development of asthma. However, the mechanism by which RSV infection leads to development of asthma has not yet been fully elucidated. METHODS Infants younger than 36 months were enrolled and classified into three groups. Group I included patients hospitalized with RSV-induced bronchitis. These patients were further stratified into two sub-groups according to whether the criteria for the modified Asthma Predictive Index (mAPI) had been met: Group I consisted of mAPI (+) and mAPI (-) patients; Group II included patients with food allergy as a positive control group; and Group III included children with no allergy as a negative control group. Serum periostin and SCCA levels were measured in the groups. This study was registered as a clinical trial (UMIN000012339). RESULTS We enrolled 14 subjects in Group I mAPI (+), 22 in Group I mAPI (-), 18 in Group II, and 18 in Group III. In Group I, the serum periostin and SCCA levels were significantly higher during the acute phase compared with the recovery phase. However, no significant differences were found between Group I mAPI (+) and mAPI (-). CONCLUSIONS The serum periostin and SCCA levels increased during acute RSV bronchitis. Both periostin and SCCA may play a role in the pathogenesis of acute bronchitis due to RSV.

Sinobronchial syndrome treated as intractable asthma

cose uptake on FDG-PET. Akman et al. confirmed that hypometabolism was present in the thalamus on FDG-PET in GLUT 1 DS, but that GLUT 1 DS patients without epilepsy did not have any thalamic abnormality. They speculated that the dysfunction of the thalamocortical network plays a key epileptogenic role. When there is a lack of glucose, a major cerebral energy substrate, then non-glucose substrates such as pyruvate, glycogen, ketone bodies, Glu, Gln, and aspartate are metabolized to maintain neuron function. In an animal study of insulin-induced acute neuroglycopenia in the developing brain, a decrease was noted in lactate concentration, which was soon followed by Glu and Gln becoming major energy substrates. Increased Glx in the thalami may be useful not only for GLUT1 DS diagnosis, but also as an indication of the severity of this syndrome. This study was limited by the small number of patients, and it is not clear whether this MRS finding is caused by GLUT1 DS or by other genetic factors in this family. Further studies involving larger sample sizes and using smaller voxels with 3 T scanners may improve metabolite concentrationmeasuring accuracy and allow clear discrimination. Acknowledgments