Work

Serum CCL23 as a Potential Biomarker for Asthma in Pregnancy: A Prospective Case-Control Study

Year: 2026

Type: article

Abstract: Purpose: 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. Methods: 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. Results: 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). Conclusion: 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. Keywords: asthma in pregnancy, CCL23, eosinophils, biomarkers

Source: Journal of Asthma and Allergy

DOI: 10.2147/jaa.s644651

Authors: Jing Xie, Xiaopei Yan, Ye Song, Hui Wang, Guopeng Xu, Li Xu

Institutions: Suzhou Municipal Hospital, Nanjing Medical University

Language: English

Topic: Asthma and respiratory diseases

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,836