International Session（Workshop）2(JSGE・JGES・JSGCS)
Fri. November 3rd   9:30 - 12:00   Room 9: Portopia Hotel Main Building Kairaku 3
IS-W2-8_G
 Esophageal mucosal permeability and regulatory T cells reflect disease activity in eosinophilic esophagitis
Junji Chen1, Tadayuki Oshima1, Hiroto Miwa1
1Department of Gastroenterology and Hepatology, Hyogo Medical University
Background and aim: The incidence of eosinophilic esophagitis (EoE) is increasing. The role of esophageal mucosal permeability and regulatory T cells (Tregs) in EoE remain unclear. We aimed to clarify the role of them in EoE patients.
Methods: Biopsies from controls and EoE patients before and after treatment were analyzed. Eosinophil infiltration were assessed by HE staining. Esophageal mucosal permeability was assessed using surface biotinylation. Infiltration of Tregs, mast cell and IgG4 deposits were assessed by immunohistochemical staining. Gene expression was evaluated by RT-qPCR.
Results: Esophageal mucosal permeability, infiltration of Tregs, mast cells and IgG4 deposits were significantly increased in EoE patients. IL-13, calpain-14 and eotaxin-3 mRNAs were significantly upregulated, while filaggrin, SPINK7 and involucrin mRNAs were significantly downregulated in EoE patients. Infiltration of Tregs was significantly decreased in EoE patients after treatment achieving histologic remission (<15 eosinophil count/HPF). Eotaxin-3 mRNA was significantly downregulated and filaggrin and SPINK7 were significantly upregulated in EoE patients after treatment. In patients achieving histologic remission, a subset of EoE patients showed unchanged increased permeability with increased mast cell infiltration and IgG4 deposits.
Conclusions: Esophageal mucosal permeability and Tregs were increased in EoE patients. Increased permeability of the esophagus in EoE patients without eosinophil infiltration after treatment was associated with mast cell infiltration and IgG4 deposits.
Index Term 1: Eosinophilic esophagitis
Index Term 2: mucosal permeability
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