Background: Airway epithelium contributes to the natural history of bronchial asthma through the production of various cytokines and chemokines. The purpose of this study was to assess nasal epithelial cell genes (TMEM178, FKBP5, CLCA1, SERPINB2 and periostin) in childhood asthma and their utility in predicting asthma severity, and atopic status. Seventy asthmatic children were included and further subdivided into mild, moderate and severe persistent asthma together with 30 apparently healthy children as a control group. All children were subjected to medical history taking, clinical examination. Nasal epithelial samples were collected for detection of epithelial cell genes (TMEM178, FKBP5, CLCA1, SERPINB2 and periostin) by real-time PCR. Results: TMEM178 showed signifcant down-regulation in asthmatic children and its expression levels decreased signifcantly with the progression of asthma severity. CLCA1, SERPINB2 and periostin showed statistically signifcant up-regulation in asthmatic children, whereas FKBP5 was increased in asthmatic children but with non-signifcant upregulation when compared with the control group. Regarding atopic status, relative gene expression levels of CLCA1, SERPINB2 and periostin were signifcantly up-regulated in atopic asthma. Conclusion: Our fndings suggest the role of nasal airways epithelial cells in predicting asthma severity and atopic status, as TMEM178 expression gained attention as a predictor of asthma severity. CLCA1, SERPINB2 and periostin expression were up-regulated not only in asthmatic children, but also in atopic asthma. Highlights • CLCA1, SERPINB2 and periostin expression were up-regulated not only in airway epithelial cells of asthmatic children but also in atopic asthma. • TMEM178 expression gained attention as a predictor of asthma severity. • Identifcation of nasal epithelial cell genes of childhood asthma may represent a step forward toward tailored management and therapy.