Increased HLA‐DR Expression on Tissue Eosinophils in Eosinophilic Esophagitis

Patel, Ankit R.; Fuentebella, Judy; Gernez, Yaël; Nguyễn, Andy; Bass, Dorsey; Berquist, William E.; Cox, Kenneth L.; Sibley, Eric; Kerner, John A.; Nadeau, Kari

doi:10.1097/mpg.0b013e3181e083e7

Cited by 22 publications

(22 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…120 One study suggests that esophageal eosinophils in patients with EoE express HLA-DR, invoking the capacity of eosinophils to act as antigen-presenting cells. 121 Peripheral eosinophil cationic protein levels did not correlate with tissue eosinophil numbers, although there were statistically nonsignificant eosinophilic cationic protein decreases after therapy. 120…”

Section: Laboratory Evaluation Peripheral Eosinophil Counts and Eosinmentioning

confidence: 78%

Eosinophilic esophagitis: Updated consensus recommendations for children and adults

Liacouras¹,

Furuta²,

Hirano³

et al. 2011

Journal of Allergy and Clinical Immunology

1,807

2,373

View full text Add to dashboard Cite

Eosinophilic esophagitis (EoE) is a clinicopathologic condition of increasing recognition and prevalence. In 2007, a consensus recommendation provided clinical and histopathologic guidance for the diagnosis and treatment of EoE; however, only a minority of physicians use the 2007 guidelines, which require fulfillment of both histologic and clinical features. Since 2007, the number of EoE publications has doubled, providing new disease insight. Accordingly, a panel of 33 physicians with expertise in pediatric and adult allergy/immunology, gastroenterology, and pathology conducted a systematic review of the EoE literature (since September 2006) using electronic databases. Based on the literature review and expertise of the panel, information and recommendations were provided in each of the following areas of EoE: diagnostics, genetics, allergy testing, therapeutics, and disease complications. Because accumulating animal and human data have provided evidence that EoE appears to be an antigen-driven immunologic process that involves multiple pathogenic pathways, a new conceptual definition is proposed highlighting that EoE represents a chronic, immune/antigen-mediated disease characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation. The diagnostic guidelines continue to define EoE as an isolated chronic disorder of the esophagus diagnosed by the need of both clinical and pathologic features. Patients commonly have high rates of concurrent allergic diatheses, especially food sensitization, compared with the general population. Proved therapeutic options include chronic dietary elimination, topical corticosteroids, and esophageal dilation. Important additions since 2007 include genetic underpinnings that implicate EoE susceptibility caused by polymorphisms in the thymic stromal lymphopoietin protein gene and the description of a new potential disease phenotype, proton pump inhibitor-responsive esophageal eosinophila. Further advances and controversies regarding diagnostic methods, surrogate disease markers, allergy testing, and treatment approaches are discussed.

show abstract

Section: Laboratory Evaluation Peripheral Eosinophil Counts and Eosinmentioning

confidence: 78%

Eosinophilic esophagitis: Updated consensus recommendations for children and adults

Liacouras¹,

Furuta²,

Hirano³

et al. 2011

Journal of Allergy and Clinical Immunology

1,807

2,373

View full text Add to dashboard Cite

show abstract

“…EoE patients had significantly more ERK, Bcl-2, bFGF, and eotaxin compared to controls [37]. Further studies identified increased numbers of Tregs (FoxP3 expression) and HLA-DR expression in the affected EoE mucosa [36,38]. Together, these studies continue to define the microenvironment associated with EoE.…”

Section: New Treatments: Targeted Treatments Need Refined Endpointsmentioning

confidence: 79%

“…Along these lines, Yen et al [35] found significantly greater FceRI expression on epithelial cells in EoE children compared to those with GERD and normal controls suggesting a role in IgE-mediated activation. In a series of articles from Nadeau et al, the role of other T cells in the squamous mucosa and peripheral mononuclear cells in EoE has been examined [36][37][38]. Realtime analysis of peripheral mononuclear cells from 35 children with EoE was compared to eight with GERD, 10 with IBD, and eight healthy controls.…”

Section: New Treatments: Targeted Treatments Need Refined Endpointsmentioning

confidence: 99%

Eosinophilic esophagitis: update on clinicopathological manifestations and pathophysiology

Furuta¹

2011

Current Opinion in Gastroenterology

View full text Add to dashboard Cite

show abstract

“…52 In asthmatics, eosinophils appear to express the MHC Class II protein, HLA-DR, dependent on stimulation by GM-CSF, as well as co-stimulatory molecules CD40, CD80, and CD86, and can traffic to regional lymph nodes after exposure to antigen bringing them in proximity to T-cells for presentation. 53, 54 Likewise in EoE, tissue eosinophils have been shown to express increased HLA-DR, 55 as well as CD40 and CD80, 56 supporting the potential capacity for antigen presentation. However, the evidence to support the ability of eosinophils to engulf and process protein antigens seems lacking and would limit their ability to function in similar ways to professional antigen presenting cells, such as DCs.…”

Section: Bodymentioning

confidence: 95%

Allergic Mechanisms in Eosinophilic Esophagitis

Wechsler

Bryce

2014

Gastroenterology Clinics of North America

View full text Add to dashboard Cite

Paralleling the overall trend in allergic diseases, Eosinophilic Esophagitis is rapidly increasing in incidence. It is associated with food antigen-triggered, eosinophil-predominant inflammation and the pathogenic mechanisms have many similarities to other chronic atopic diseases, such as eczema and allergic asthma. Studies in animal models and from patients over the last 15 years have suggested that allergic sensitization leads to food-specific IgE and T-helper lymphocyte type 2 cells, both of which appear to contribute to the pathogenesis along with basophils, mast cells, and antigen-presenting cells. This review will outline our current understandings of the allergic mechanisms that drive eosinophilic esophagitis, drawing from clinical and translational studies in humans as well as experimental animal models.

show abstract

Increased HLA‐DR Expression on Tissue Eosinophils in Eosinophilic Esophagitis

Abstract: These data demonstrate that the eosinophils from the esophagus of subjects with EoE have increased HLA-DR expression within this tissue.

Cited by 22 publications

References 23 publications

Eosinophilic esophagitis: Updated consensus recommendations for children and adults

Eosinophilic esophagitis: Updated consensus recommendations for children and adults

Eosinophilic esophagitis: update on clinicopathological manifestations and pathophysiology

Allergic Mechanisms in Eosinophilic Esophagitis

Contact Info

Product

Resources

About