Cross-talk between human mast cells and epithelial cells by IgE-mediated periostin production in eosinophilic nasal polyps

Serum periostin, as a biomarker, is elevated in severe eosinophilic asthma and aspirin-exacerbated respiratory disease1 and levels can predict the development of airflow limitation in patients with asthma on an inhaled corticosteroid2 as well as responsiveness to omalizumab or lebrikizumab in uncontrolled severe allergic asthma.3,4 However, despite its clinical significance, the mechanism by which periostin regulates inflammation remains poorly understood in the pathogenesis of airway inflammatory diseases. Periostin expression is also associated with CRS tissue eosinophil and disease severity.5,6 However, it is still unclear how periostin contributes to the pathophysiology of CRS with NPs (CRSwNP). [...]the expression, cellular origin, and function of periostin in NP tissues were investigated according to various subtypes of CRSwNP. Periostin mRNA and protein levels were significantly increased in CRSwNP-NP compared with control-UP, CRSsNP-UP, and CRSwNP-UP. [...]subjects with E-NP had greater periostin mRNA expression and higher protein levels than did those with noneosinophilic NP (NE-NP) (see Fig E1, A and B, in this article's Online Repository at www.jacionline.org). TSLP expression positively correlated with integrin αV expression and periostin levels (Fig 1, H and I; r = 0.854; P = .0008; r = 0.742; P = .018, respectively). [...]it was hypothesized that the periostin/integrin αV pathway induces TSLP in the epithelium of E-NPs. Characteristics Control-UP (N = 22) CRSsNP-UP (N = 62) CRSwNP-UP (N = 68) NE-NP (N = 34) E-NP (N = 38) Demographic data Sex: male/female 14/8 37/25 53/15 27/7 30/8 Age (y), mean ± SD 44.3 ± 19.8 47.7 ± 14.0 50.0 ± 14.3...