TY - JOUR T1 - Combined assessment of serum eosinophil-derived neurotoxin and YKL-40 may identify asthma-COPD overlap JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2020.5040 VL - 56 IS - suppl 64 SP - 5040 AU - Toshihiro Shirai AU - Keita Hirai AU - Yasuhiro Gon AU - Shuichiro Maruoka AU - Kenji Mizumura AU - Mari Hikichi AU - Kunihiko Itoh AU - Shu Hashimoto Y1 - 2020/09/07 UR - http://erj.ersjournals.com/content/56/suppl_64/5040.abstract N2 - Background: We previously showed that the proportion of patients with both high serum periostin and YKL-40 levels was significantly higher in asthma-COPD overlap (ACO) than in asthma or COPD (Odds ratio, 2.59: JACI Pract 2019). In this study, we hypothesised that using serum eosinophil-derived neurotoxin (EDN) instead of periostin would be useful to identify ACO.Aims: To assess the usefulness of combined assessment of serum EDN and YKL-40 in identifying ACO.Methods: Subjects included Japanese patients with asthma (n = 177), ACO (n = 115), or COPD (n = 61). Serum EDN, YKL-40, and total IgE, blood eosinophils, and FeNO were measured and compared among the patients.Results: Serum EDN was higher in ACO than in asthma or COPD, whereas serum YKL-40 was higher in both COPD and ACO than in asthma (Figure 1A). Serum EDN levels weakly correlated with serum YKL-40 levels in COPD, but not in asthma and ACO. Multivariate linear regression analysis revealed that higher eosinophil counts and higher YKL-40 levels were significantly associated with higher EDN levels. Based on cutoff values derived by ROC analysis (EDN: 23.0 ng/mL; YKL-40: 61.3 ng/mL), patients were classified into high or low groups. The proportion of patients with both high serum EDN and YKL-40 levels was significantly higher in ACO than in asthma or COPD (odds ratio, 3.85 (95% CI, 2.35-6.36); p < .001; sensitivity, 45.2%; specificity, 82.4%: Figure 1B).Conclusions: Combined assessment of serum EDN, rather than periostin, and YKL-40 may identify ACO.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 5040.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -