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Serum periostin shows potential for identifying patients with type 2–dominant ulcerative colitis and predicting treatment efficacy.

“Several biomarkers … are now available for the management of UC [ulcerative colitis] patients,” researchers wrote in Inflammatory Bowel Diseases. “These biomarkers are useful for monitoring intestinal inflammation; however, there is no biomarker clinically available for endotyping of UC.”

Prior investigations by this research team and other groups identified periostin as a biomarker for type 2 inflammation, but its usefulness as a biomarker in patients with UC was unknown.

In the current study, the same group analyzed periostin expression in the colons of patients with UC, as well as serum periostin and its correlation with eosinophilic infiltration in the colon. They also examined whether serum periostin was able to predict the efficacy of oral prednisolone and periostin’s role in UC pathogenesis.

Serum Periostin Can Stratify Type 2–Dominant UC

In comparing patients with UC and healthy control participants, the study team found that periostin expression in the colon and serum periostin were significantly greater in patients with UC. Periostin expression levels in patients were diverse, however, which researchers said reflected the heterogeneity of the underlying mechanisms of UC.

When the team looked at correlations with eosinophilic infiltration in the colons of patients with UC, they found significant associations with serum periostin and tissue periostin expression. Blood eosinophils, on the other hand, were not linked with eosinophil infiltration.

Using Serum Periostin in Treatment Planning

“Although peripheral blood eosinophils might be a candidate biomarker reflecting type 2 inflammation in UC, it has been reported that tissue eosinophil counts are not correlated with peripheral blood eosinophil counts in UC patients, in agreement with our present study,” researchers wrote. “Therefore, our present finding that serum periostin has a high potency to stratify type 2-dominant UC highlights the significance of serum periostin as a biomarker for treating UC patients.”

Patients whose serum periostin identified them as having type 2–dominant UC had significantly higher rates of clinical remission after treatment with oral prednisolone. This finding shows potential for serum periostin in guiding treatment decisions.

Finally, genetic deficiency of periostin improved inflammation, especially eosinophil recruitment, in a model using dextran sulfate sodium treatment.

“Periostin can be a useful biomarker to stratify type 2-dominant UC patients, thereby predicting the efficacy of oral prednisolone,” researchers wrote. “Moreover, periostin plays an important role in the setting of type 2-dominant UC.”