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Dietary treatment modulates mast cell phenotype, density, and activity in adult eosinophilic oesophagitis
Author(s) -
Arias Á.,
Lucendo A. J.,
MartínezFernández P.,
GonzálezCastro A. M.,
Fortea M.,
GonzálezCervera J.,
YagüeCompadre J. L.,
MotaHuertas T.,
Vicario M.
Publication year - 2016
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/cea.12504
Subject(s) - eosinophilic esophagitis , eosinophil , pathophysiology , medicine , proteases , gastroenterology , phenotype , mast cell , gene expression , major basic protein , eosinophilia , immunology , pathology , disease , gene , biology , asthma , biochemistry , enzyme
Summary Background Mast cells ( MC s) are abundant in the inflammatory infiltrate in eosinophilic oesophagitis (EoE), but decrease with disease remission. However, their phenotype, role in the pathophysiology of the disease, and modulation after effective dietary therapy are still unclear. Objective To define the phenotype of oesophageal MC s, their modulation through dietary therapy, and their association with clinical manifestations of EoE. Methods Oesophageal mucosal samples from 10 adult patients with EoE obtained before and after effective six‐food elimination diet ( SFED ) therapy, as well as from 10 control subjects were analysed. Eosinophil and MC density were quantified. Gene expression of chemoattractants for eosinophils ( CCL 11, CCL 24, and CCL 26), MC s ( SCF ), and their receptors ( CCR 3 and SCFR , respectively) were assessed by means of qPCR . Gene and protein expression of specific MC proteases ( CPA 3, CMA , and TPSB 2) were evaluated with qPCR and immunofluorescence. Clinical manifestations and atopic background were recorded. Results MC density was significantly increased in EoE compared with controls, decreasing after dietary treatment (18.6 to 1.44 cells/hpf, respectively; P < 0.001). The MC TC subtype predominated in the oesophageal mucosa (90%) in both patients with EoE and controls. Gene expression of MC ‐related proteases, eotaxins, and SCF were up‐regulated in patients with EoE, but significantly decreased after therapy, regardless of atopic background. Epithelial peaks of MC s and eosinophils were significantly associated (ρ = 0.80) in EoE and correlated with the symptom score (ρ = 0.78). Gene expression of MC proteases and eotaxins also correlated with the symptom score ( P < 0.05). Conclusions and Clinical Relevance MC and its proteases seem to play a relevant role in the pathophysiology and symptoms of EoE, which can be reversed after effective dietary treatment.