Food-specific IgG 4 is associated with eosinophilic esophagitis

Single-cell RNA sequencing identifies inflammatory tissue T cells in eosinophilic esophagitis

“…These cells unexpectedly expressed modest levels of TGFB1 (Supplemental Figure 8) despite high levels of IL10 (Supplemental Figure 12). Accordingly, T8 expressed IL10RA and IL10RB ( Figure 4D), implying that T7 secretes IL-10 to suppress T8 and to help B cells class switch to IgG4 (23). Indeed, B cell class switching was one of the functional nodes exhibiting closeness with T7 (Supplemental Figure 9A).…”

“…The strong local IgG4 response seen in EoE (41) may be mediated in part by these Treg-like cells via production of IgG4-promoting IL-10. It is notable that EoE also develops in the setting of oral immunotherapy for the treatment of food anaphylaxis (42), as Treg and IgG4 responses are also seen in this setting (23).…”

Novel immunologic mechanisms in eosinophilic esophagitis

“…Interestingly, although EoE is often associated with elevated serum IgE levels [1], experimental EoE is not dependent on IgE [45] and patients do not respond to omalizumab therapy [59], suggesting that the disease may not be exclusively IgE mediated. Interestingly, IgG4 is elevated at both the local and systemic level in EoE, along with increased numbers of IgG4-positive plasma cells in the esophageal lamina propria [60 • ]; furthermore, elevated levels of food-specific IgG4 are detected in esophageal biopsies, and serum IgG4 levels decline upon diet-mediated remission [60 • ,61]. Future studies will likely focus on further understanding the role of these immunoglobulins in EoE pathogenesis and directing effective diet therapy.…”

The main statements of the European society of eosinophilic oesophagitis guidelines

“…Более того, все больше данных свидетельствует о том, что ЭоЭ является IgG4-ассоциированным заболеванием, что еще больше ставит под сомнение целесообразность диет, основанных на кожных тестах [191][192][193][194].…”