The Immunologic Mechanisms of Eosinophilic Esophagitis

Hill, David R.C.; Spergel, Jonathan M.

doi:10.1007/s11882-015-0592-3

Cited by 62 publications

(58 citation statements)

References 187 publications

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“…(13) However, there are several lines of experimental and clinical evidence from both animal and human studies to suggest that while IgE-mediated food allergy and EoE both lie on the atopic spectrum, they have distinct pathophysiology. (14–16) We have shown that eosinophilic inflammation is independent of both B cells and IgE in animal models.…”

Section: Introductionmentioning

confidence: 99%

The Prevalence of Eosinophilic Esophagitis in Pediatric Patients with IgE-Mediated Food Allergy

Hill

Dudley

Spergel

2017

The Journal of Allergy and Clinical Immunology: In Practice

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104

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BACKGROUND Eosinophilic esophagitis (EoE) is an allergic inflammatory disease that is triggered by food allergens and characterized by progressive esophageal dysfunction. Recently, EoE has been identified in patients undergoing oral immunotherapy (OIT) for IgE-mediated food allergy, suggesting an association. OBJECTIVE We sought to ascertain whether significant associations exist between IgE-mediated food allergies and EoE. METHODS Utilizing analysis of EMR data and manual chart review, we examined our sub-specialty care network of 35,528 children and adolescents to identify and characterize patients with IgE-mediated, and EoE food allergy. The most common food allergens were defined, and the prevalence of EoE in patients with IgE-mediated food allergy was determined. Logistic regression was used to measure the extent to which IgE-mediated food allergy to specific foods is associated with EoE. RESULTS The most common causes of EoE were milk, grains, meats, peanut, tree nuts, egg, and soy, an allergen pattern that is distinct from that of IgE-mediated food allergy. The prevalence of EoE in patients with IgE-mediated food allergy was higher than that reported in the general population (4.7% vs 0.04%). The distribution of IgE-mediated food allergens in patients with EoE was similar to that of the general population, and IgE-mediated allergy to egg (2.27; 1.91–2.64), milk (4.19; 3.52–4.97), or shellfish (1.55; 1.24–1.92) was significantly associated with EoE diagnosis. CONCLUSIONS Our findings support a clinical association between these conditions that has implications for the management of children with food allergy, and particular relevance to patients undergoing OIT.

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Section: Introductionmentioning

confidence: 99%

The Prevalence of Eosinophilic Esophagitis in Pediatric Patients with IgE-Mediated Food Allergy

Hill

Dudley

Spergel

2017

The Journal of Allergy and Clinical Immunology: In Practice

Self Cite

104

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“…Hill and Spergel45 postulated that the prevalence of EoE is increasing and has now reached rates similar to those of other chronic gastrointestinal disorders such as Crohn’s disease. In this survey, the finding that LyE was as frequent as EoE appears to be of particular interest.…”

Section: Discussionmentioning

confidence: 99%

Lymphocytic oesophagitis, eosinophilic oesophagitis and compound lymphocytic–eosinophilic oesophagitis I: histological and immunohistochemical findings

2016

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Based on the literature regarding the significance of intraepithelial lymphocytes (IELs) in the initiation of EoE, we submit that the IEL phenotypes in LyE might differ from those found in EoE as they were unable to elicit the same eosinophilic response. Recent studies disclosed that group 2 innate lymphocytes (ILC2s), enriched in EoE, remain undetected in CD3 immunostain as they lack surface markers for T, B, natural killer (NK) or NK T cells. If ILC2s also participate in the lymphocytic infiltration of EoE, then the frequency of cases with Co LyE-EoE here reported might have been much higher. The four oesophagitis phenotypes described are easy to recognise, provided that the dual staining procedure (H&E-CD3) is implemented.

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“…EoE features include abdominal pain, painful swallowing (dysphagia) and sometimes food impaction and is more common in males . Inflammation is primarily eosinophilic and is defined by presence of at least 15 eosinophils/HPF in biopsy sections . The EoE transcriptome has been described, with CCL26 (eotaxin‐3), an eosinophil chemoattractant, and MC carboxypeptidase being among the most highly induced genes .…”

Section: Mast Cells and Eosinophils In Allergic Diseasementioning

confidence: 99%

Human eosinophils and mast cells: Birds of a feather flock together

Robida

Puzzovio

Pahima

et al. 2018

Immunological Reviews

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While the origin of the phrase "birds of a feather flock together" is unclear, it has been in use for centuries and is typically employed to describe the phenomenon that people with similar tastes or interests tend to seek each other out and congregate together. In this review, we have co-opted this phrase to compare innate immune cells of related origin, the eosinophil and mast cell, because they very often accumulate together in tissue sites under both homeostatic and inflammatory conditions. To highlight overlapping yet distinct features, their hematopoietic development, cell surface phenotype, mediator release profiles and roles in diseases have been compared and contrasted. What emerges is a sense that these two cell types often interact with each other and their tissue environment to provide synergistic contributions to a variety of normal and pathologic immune responses.

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The Immunologic Mechanisms of Eosinophilic Esophagitis

Cited by 62 publications

References 187 publications

The Prevalence of Eosinophilic Esophagitis in Pediatric Patients with IgE-Mediated Food Allergy

The Prevalence of Eosinophilic Esophagitis in Pediatric Patients with IgE-Mediated Food Allergy

Lymphocytic oesophagitis, eosinophilic oesophagitis and compound lymphocytic–eosinophilic oesophagitis I: histological and immunohistochemical findings

Human eosinophils and mast cells: Birds of a feather flock together

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