Allergen-Specific In Vitro Cytokine Production in Adult Patients with Eosinophilic Esophagitis

Abstract

Although the pathogenesis of eosinophilic esophagitis (EE) likely involves hypersensitivity reactions against exogenous allergens, allergen-specific cellular immune responses have not been studied. We investigated allergen-induced cytokine production by peripheral blood mononuclear cells (PBMCs) in adult patients with EE (n=15) and healthy controls (HC; n=9). PBMCs were incubated with nine common food and environmental allergens or a nonspecific mitogen, and the levels of interleukin (IL)-5, IL-10, IL-13, and interferon-gamma in the cell-free supernatants were determined. Spontaneous and mitogen-stimulated cytokine production did not differ between EE and HC. House dust mite, ragweed, Aspergillus, milk, and soy induced significantly higher IL-5 production in EE (P < 0.05). House dust mite also augmented IL-13 production in EE (P < 0.05). Furthermore, PBMCs from three EE patients without allergen-specific IgE vigorously produced IL-5 and IL-13 on allergen stimulation. Thus, immune responses in EE are characterized by enhanced production of Th2-like cytokines against both food and environmental allergens.

Negative Feedback Regulation of IFN-γ Pathway by IFN Regulatory Factor 2 in Esophageal Cancers

“…Accumulated evidence from clinical analysis has disclosed that inflammation is a key risk factor for ESCCs (2), and IFN-g is implicated in esophageal inflammation (38)(39)(40)(41). In light of our observation that low concentration of IFN-g could induce IRF-2 expression, we speculated that the IFN-g produced during esophageal inflammation might, at least in part, be responsible for the transformation from esophagitis to ESCCs by stimulating the expression of IRF-2.…”

Eosinophilic esophagitis is characterized by a non-IgE-mediated food hypersensitivity

“…Although widely used, the APT has limited value in the diagnosis of food allergy in EoE (16) perhaps owing to the fact that here the skin and not the esophagus is tested. Upon food allergen, but not nonspecific stimulation, peripheral blood mononuclear cells from EoE patients with or without allergen-specific IgE produce significant amounts of IL-5 (48). In peanut-allergic children, skin-and gut-homing T cells expressing Th2 and Th9 genes as well as IL-9 and IL-5 production by distinct T helper cell populations have been reported (49).…”

Gastrointestinal Food Allergy in Children

“…Предполагается, что имеет значение заглатывание пыльцы в сезон цвете-ния [30,32,33]. Существуют данные, что мононуклеары больных ЭоЭ имеют значимо более высокий уровень интерлейкинов (Interleukin, IL) 5 и 13 под воздействием ингаляционных аллергенов в сравнении со здоровыми даже при отсутствии IgE-сенсибилизации к этим аллер-генам [34].…”

“…Так, наличие как минимум 15 эозино-филов в поле зрения микроскопа высокого разрешения (ϫ400) как минимум в одном биоптате слизистой оболоч-ки пищевода является гистологическим диагностическим критерием эозинофильной патологии желудочно-кишеч-ного тракта [34][35][36].…”

“…Аминокислотная формула показа-на младенцам со множественной пищевой аллергией , задержкой физического развития, а также пациентам с тяжелым течением заболевания, детям более старшего возраста, которым не удается организовать элиминаци-онную диету (или она неэффективна). Длительное при-менение элементной диеты ограничено высокой стои-мостью аминокислотных смесей [34,52,53].…”