Serum CCL23 as a Potential Biomarker for Asthma in Pregnancy: A Prospective Case-Control Study.
- 1Department of Respiratory and Critical Care Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, People's Republic of China.
- 2Department of Obstetrics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, People's Republic of China.
Abstract
Early identification of asthma in pregnancy is challenging due to limited feasibility of pulmonary function testing. We aimed to characterize serum CCL23 expression in pregnant women with asthma and to assess its potential as an auxiliary clinical marker. Transcriptomic sequencing first identified differentially expressed genes (DEGs) in peripheral blood between pregnant women with asthma and healthy pregnant controls. A validation cohort of 37 pregnant women with asthma and 36 healthy pregnant controls was then enrolled. Clinical data (EOS, pregnancy outcomes) were collected, and serum CCL23, IL-4, and IL-5 levels were measured. The expression characteristics and potential adjunctive identification value of CCL23 were evaluated using the Mann-Whitney U-test, Spearman correlation analysis, and binary logistic regression. Transcriptomic sequencing revealed CCL23 upregulation in asthma (P < 0.01). ELISA showed higher serum CCL23 in pregnant women with asthma than in healthy pregnant controls (adjusted means 775.0 ± 91.42 vs 512.92 ± 92.95 pg/mL; adjusted P = 0.07). CCL23 correlated positively with EOS (ρ=0.74, P<0.01) and FeNO (ρ=0.35, P = 0.03) in the asthma group. Elevated CCL23 was independently associated with an increased risk of asthma in pregnancy (overall P < 0.01). ROC analysis showed an AUC of 0.74 (95% CI 0.63-0.86) for CCL23, 0.88 (0.80-0.95) for EOS, 0.87 (0.79-0.95) for CCL23 + EOS; combined model sensitivity 94.60% and specificity 66.70% at optimal cut-off. The combination did not improve discrimination over EOS alone (DeLong P = 0.13). Serum CCL23 is elevated in pregnant women with asthma and positively correlates with peripheral blood EOS and FeNO, implicating a role in systemic type 2 inflammation. CCL23 was independently associated with asthma after adjustment for gestational age and maternal age, but adding it to EOS did not improve discrimination over EOS alone. These exploratory findings require validation in large-scale, multicenter cohorts before any clinical use.
Related
- Reduced serum Dickkopf-1 levels as a potential supportive biomarker for the development and severity of retinopathy of prematurity: a prospective observational clinical study
- Serum Prokineticin-2 and Calprotectin as Potential Biomarkers of Disease Stage and Focal Organ Involvement in Human Brucellosis: A Prospective Case–Control Study
- Maternal serum retinol, vitamin K, and ferritin profiles during pregnancy, gestational diabetes mellitus, and offspring neurodevelopment: a prospective case-control study
- Anaemia in pregnancy in Bangladesh by the WHO 2024 haemoglobin cut-offs: a national biomarker survey and comparison with 2011
- Daycare attendance, breastfeeding, and risk of asthma in the prospective MoBa and DIPP birth cohorts
BibTeX
@article{xie2026serum,
title = {{Serum CCL23 as a Potential Biomarker for Asthma in Pregnancy: A Prospective Case-Control Study.}},
author = {Jing Xie and Xiaopei Yan and Ye Song and Hui Wang and Guopeng Xu and Li Xu},
journal = {Journal of asthma and allergy},
year = {2026},
month = nov,
doi = {10.2147/jaa.s644651},
url = {https://europepmc.org/article/MED/42999621},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Serum CCL23 as a Potential Biomarker for Asthma in Pregnancy: A Prospective Case-Control Study.
AU - Jing Xie
AU - Xiaopei Yan
AU - Ye Song
AU - Hui Wang
AU - Guopeng Xu
AU - Li Xu
PY - 2026
DA - 2026/11/03
JO - Journal of asthma and allergy
DO - 10.2147/jaa.s644651
UR - https://europepmc.org/article/MED/42999621
AB - Early identification of asthma in pregnancy is challenging due to limited feasibility of pulmonary function testing. We aimed to characterize serum CCL23 expression in pregnant women with asthma and to assess its potential as an auxiliary clinical marker. Transcriptomic sequencing first identified differentially expressed genes (DEGs) in peripheral blood between pregnant women with asthma and healthy pregnant controls. A validation cohort of 37 pregnant women with asthma and 36 healthy pregnant controls was then enrolled. Clinical data (EOS, pregnancy outcomes) were collected, and serum CCL23, IL-4, and IL-5 levels were measured. The expression characteristics and potential adjunctive identification value of CCL23 were evaluated using the Mann-Whitney U-test, Spearman correlation analysis, and binary logistic regression. Transcriptomic sequencing revealed CCL23 upregulation in asthma (P < 0.01). ELISA showed higher serum CCL23 in pregnant women with asthma than in healthy pregnant controls (adjusted means 775.0 ± 91.42 vs 512.92 ± 92.95 pg/mL; adjusted P = 0.07). CCL23 correlated positively with EOS (ρ=0.74, P<0.01) and FeNO (ρ=0.35, P = 0.03) in the asthma group. Elevated CCL23 was independently associated with an increased risk of asthma in pregnancy (overall P < 0.01). ROC analysis showed an AUC of 0.74 (95% CI 0.63-0.86) for CCL23, 0.88 (0.80-0.95) for EOS, 0.87 (0.79-0.95) for CCL23 + EOS; combined model sensitivity 94.60% and specificity 66.70% at optimal cut-off. The combination did not improve discrimination over EOS alone (DeLong P = 0.13). Serum CCL23 is elevated in pregnant women with asthma and positively correlates with peripheral blood EOS and FeNO, implicating a role in systemic type 2 inflammation. CCL23 was independently associated with asthma after adjustment for gestational age and maternal age, but adding it to EOS did not improve discrimination over EOS alone. These exploratory findings require validation in large-scale, multicenter cohorts before any clinical use.
SN - 1178-6965
ER -