Correlation between Periostin, IL-33, and chronic cough after thoracoscopic lobectomy in patients with CABG combined with lung cancer_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

QI Yujuan ¹ , BAI Yaobang ¹ , JIAO Yan ¹ , ZHU Xiaolong ² , FU Bo ² ,  WU Zhenhua ¹

1. Department of Intensive Care Medicine, Tianjin Chest Hospital, Tianjin, 300222, P. R. China;
2. Department of Cardiac Surgery, Tianjin Chest Hospital, Tianjin, 300222, P. R. China;

Corresponding author：

WU Zhenhua, Email: wzh8306@aliyun.com

Keywords：

Periostin; interleukin-33; coronary artery bypass grafting; thoracoscopic lobectomy; chronic cough

DOI：

10.7507/1007-4848.202408056

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Objective To study the correlation between Periostin, interleukin-33 (IL-33), and chronic cough after thoracoscopic lobectomy in patients with coronary artery bypass grafting (CABG) combined with lung cancer. Methods A total of 102 lung cancer patients at Tianjin Chest Hospital from January 2022 to January 2024 were prospectively enrolled, and they were divided into a chronic cough group and a non chronic cough group based on whether chronic cough occurred after surgery. Serum levels of Periostin and IL-33 were measured on the 1st, 7th, and 14th days post-lobectomy. The Pearson method was employed to analyze the correlation between Periostin and IL-33 levels and the severity of cough. Univariate and multivariate logistic regression analyses were conducted to identify factors influencing the occurrence of chronic cough. Additionally, ROC curve analysis was utilized to assess the potential value of serum Periostin and IL-33 levels in predicting postoperative chronic cough. Results In patients with chronic cough, the peripheral blood Periostin and IL-33 levels measured on days 7 and 14 were significantly higher than those in patients with non-chronic cough, and the interactions between the two groups and at different time points were significant (P<0.001). The degree of cough was positively correlated with the levels of Periostin and IL-33 on days 7 and 14 (P<0.05), but had no significant correlation with the levels on day 1 (P>0.05). In patients with lung cancer, after thoracoscopic lobectomy, Periostin [OR=1.619, 95%CI (1.295, 2.025)] and IL-33 [OR=1.831, 95%CI (1.216, 2.758)] on day 7 and Periostin on day 14 [OR=1.952, 95%CI (1.306, 2.918)] and IL-33 [OR=1.742, 95%CI (1.166, 2.603)] were identified as risk factors for chronic cough. ROC curve analysis showed that the sensitivity of Periostin on day 7 was 69.05%, the specificity was 71.67%, and the AUC was 0.756 [95%CI (0.616, 0.893)]. The sensitivity of Periostin on day 14 increased to 71.43% and the specificity was 76.67%, AUC was 0.762 [95%CI (0.633, 0.898)]. At the same time, the critical value of IL-33 on day 7 was 45.03 pg/mL, the sensitivity and specificity were both 83.33%, the AUC was 0.884 [95%CI (0.789, 0.980)], and the critical value of IL-33 on day 14 was 56.01 pg/mL, the sensitivity was 85.71%, the specificity was 80.00%, and the AUC was 0.899 [95%CI (0.799, 0.999)]. Further regression analysis showed that the sensitivity was 95.24%, the specificity was 95.00%, and the AUC reached 0.993 [95%CI (0.979, 1.000)]. Conclusion Periostin and IL-33 levels, measured at various time points, are abnormally elevated following thoracoscopic lobectomy in patients with combined CABG and lung cancer. These levels significantly correlate with cough severity. Given their predictive potential for chronic cough, these markers are deemed valuable biomarkers.

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11.	Hirons B, Rhatigan K, Kesavan H, et al. Cough in chronic lung disease: A state of the art review. J Thorac Dis, 2023, 15(10): 5823-5843.
12.	Turner RD, Hirons B, Cortese A, et al. Chronic cough as a genetic neurological disorder? Insights from cerebellar ataxia with neuropathy and vestibular areflexia syndrome (CANVAS). Lung, 2023, 201(6): 511-519.
13.	Drake MG, McGarvey LP, Morice AH. From bench to bedside: The role of cough hypersensitivity in chronic cough. Clin Transl Med, 2023, 13(8): e1343.
14.	Brister D, Wahab M, Rashad M, et al. Emerging drugs in the treatment of chronic cough. Expert Opin Emerg Drugs, 2023, 28(2): 67-77.
15.	Lai K, Satia I, Song WJ, et al. Cough and cough hypersensitivity as treatable traits of asthma. Lancet Respir Med, 2023, 11(7): 650-662.
16.	Hanibuchi M, Mitsuhashi A, Kajimoto T, et al. Clinical significance of fractional exhaled nitric oxide and periostin as potential markers to assess therapeutic efficacy in patients with cough variant asthma. Respir Investig, 2023, 61(1): 16-22.
17.	Qiu Z, Zhu Z, Liu X, et al. A dysregulated sebum-microbial metabolite-IL-33 axis initiates skin inflammation in atopic dermatitis. J Exp Med, 2022, 219(10): e20212397.
18.	Kono Y, To M, Tsuzuki R, et al. Elevated serum periostin level in patients with chronic cough and airway hyperresponsiveness. Respir Investig, 2019, 57(2): 122-125.
19.	Pivniouk V, Gimenes-Junior JA, Ezeh P, et al. Airway administration of OM-85, a bacterial lysate, blocks experimental asthma by targeting dendritic cells and the epithelium/IL-33/ILC2 axis. J Allergy Clin Immunol, 2022, 149(3): 943-956.

1. Shin J, Bush NJ. Integration of behavioral cough suppression therapy into lung cancer care: Nonpharmacologic interventions for chronic cough. Clin J Oncol Nurs, 2022, 26(1): 40-47.
2. Sun X, Lan Z, Li S, et al. Trajectories and risk factors of persistent cough after pulmonary resection: A prospective two-center study. Thorac Cancer, 2023, 14(36): 3503-3510.
3. Morice A, Dicpinigaitis P, McGarvey L, et al. Chronic cough: New insights and future prospects. Eur Respir Rev, 2021, 30(162): 210127.
4. Peng Y, Zhang T, Yuan L, et al. Management of non-pharmacologic therapy for chronic refractory cough: Mechanism, composition, applicable population, and assessment. Heliyon, 2023, 9(10): e20351.
5. Morice AH, Millqvist E, Bieksiene K, et al. ERS guidelines on the diagnosis and treatment of chronic cough in adults and children. Eur Respir J, 2020, 55(1): 1901136.
6. Chang AB, Oppenheimer JJ, Irwin RS, et al. Managing chronic cough as a symptom in children and management algorithms: CHEST guideline and expert panel report. Chest, 2020, 158(1): 303-329.
7. Khan A, Frazer-Green L, Amin R, et al. Respiratory management of patients with neuromuscular weakness: An American College of Chest Physicians clinical practice guideline and expert panel report. Chest, 2023, 164(2): 394-413.
8. Null JL, Kim DJ, McCann JV, et al. Periostin+stromal cells guide lymphovascular invasion by cancer cells. Cancer Res, 2023, 83(13): 2105-2122.
9. Wang Y, He C, Xin S, et al. A deep view of the biological property of interleukin-33 and its dysfunction in the gut. Int J Mol Sci, 2023, 24(17): 13504.
10. 中华医学会呼吸病学分会哮喘学组. 咳嗽的诊断与治疗指南(2015). 中华结核和呼吸杂志, 2016, 39(5): 323-354.Asthma Group, Chinese Medical Association Respiratory Diseases Branch. Guidelines for the diagnosis and treatment of cough (2015). Chin J Tuberc Respir Dis, 2016, 39(5): 323-354.
11. Hirons B, Rhatigan K, Kesavan H, et al. Cough in chronic lung disease: A state of the art review. J Thorac Dis, 2023, 15(10): 5823-5843.
12. Turner RD, Hirons B, Cortese A, et al. Chronic cough as a genetic neurological disorder? Insights from cerebellar ataxia with neuropathy and vestibular areflexia syndrome (CANVAS). Lung, 2023, 201(6): 511-519.
13. Drake MG, McGarvey LP, Morice AH. From bench to bedside: The role of cough hypersensitivity in chronic cough. Clin Transl Med, 2023, 13(8): e1343.
14. Brister D, Wahab M, Rashad M, et al. Emerging drugs in the treatment of chronic cough. Expert Opin Emerg Drugs, 2023, 28(2): 67-77.
15. Lai K, Satia I, Song WJ, et al. Cough and cough hypersensitivity as treatable traits of asthma. Lancet Respir Med, 2023, 11(7): 650-662.
16. Hanibuchi M, Mitsuhashi A, Kajimoto T, et al. Clinical significance of fractional exhaled nitric oxide and periostin as potential markers to assess therapeutic efficacy in patients with cough variant asthma. Respir Investig, 2023, 61(1): 16-22.
17. Qiu Z, Zhu Z, Liu X, et al. A dysregulated sebum-microbial metabolite-IL-33 axis initiates skin inflammation in atopic dermatitis. J Exp Med, 2022, 219(10): e20212397.
18. Kono Y, To M, Tsuzuki R, et al. Elevated serum periostin level in patients with chronic cough and airway hyperresponsiveness. Respir Investig, 2019, 57(2): 122-125.
19. Pivniouk V, Gimenes-Junior JA, Ezeh P, et al. Airway administration of OM-85, a bacterial lysate, blocks experimental asthma by targeting dendritic cells and the epithelium/IL-33/ILC2 axis. J Allergy Clin Immunol, 2022, 149(3): 943-956.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

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