RT Journal Article SR Electronic T1 Activin -A and follistatin in sputum supernatant and BAL in patients with asthma JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP P832 VO 42 IS Suppl 57 A1 Anastasia Papaporfyriou A1 Petros Bakakos A1 Konstantinos Kostikas A1 Georgios Papatheodorou A1 Georgios Hillas A1 Elissavet Konstantelou A1 Nikolaos Koulouris A1 Spyridon Papiris A1 Stelios Loukides YR 2013 UL http://erj.ersjournals.com/content/42/Suppl_57/P832.abstract AB Introduction: In human asthma, activin A levels are increased and in vitro studies suggest that activin A might be implicated in airway remodeling. Follistatin antagonizes the biological effects of activin-A in several disease models.Objective: We aimed to determine the levels of activin-A and follistatin in sputum supernatants and BAL of patients with asthma and to investigate possible associations with mediators and cells involved in both the inflammatory and the remodeling process. Furthermore, to elucidate whether the underlying asthma severity might influence the observed levels.Methods: Sixty three patients with asthma (33 with Severe Refractory [SRA]) optimally treated and 10 healthy subjects were studied. All subjects underwent lung function tests and sputum induction; 23 patients with asthma underwent bronchoscopy and BAL was performed. In both sputum and BAL activin-A, follistatin, cell counts, IL-8, TGF-β1, ECP and IL-13, were assessed.Results: Activin-A (pg/ml) and follistatin were significantly elevated in patients with asthma compared to healthy subjects As for activin, the above elevated levels were related to the underlying severity [sputum: SRA 76(33-185), mild to moderate 45(18-84), BAL: SRA 193 (87-264), mild to moderate 35(22-93),p<0.001 for both]. Regression analysis in one model showed a significant positive association between activin-A in both sputum and BAL with eosinophils, IL-13 and TGF-β1.Conclusion: Our results indicate that Activin-a is up-regulated in both sputum and BAL of patients with asthma. Its levels are mainly associated with mediators involved in airway remodeling pointing towards a contribution of activin-a in the asthmatic remodeling process.