Evidence for an abnormal profile of interleukin-4 (IL-4), IL-5, and ?-interferon (?-IFN) in peripheral blood T cells from patients with allergic eosinophilic gastroenteritis

Abstract

Allergic eosinophilic gastroenteritis is characterized by elevated total IgE, specific IgE to food antigens, and eosinophilia of tissue and blood. Because the lymphokines IL-4, IL-5, and gamma-interferon, regulate IgE synthesis, and eosinophilopoiesis in vitro, we examined whether there is an imbalance in their production in allergic eosinophilic gastroenteritis. To explore this hypothesis, three adult patients with allergic eosinophilic gastroenteritis were studied. Flow cytometric studies of peripheral blood mononuclear cells from these patients did not reveal evidence of T cell activation or disturbance of T cell numbers or subsets. T cells were capable of normal mitogenic activation in vitro. IL-4 and IL-5 production were markedly elevated with mitogenic stimulation. Most IL-4 and IL-5 production was by CD4+ T cells. Synthesis of IL-5 by CD4+ T lymphocytes in three patients and CD8+ T lymphocytes in two patients occurred in the absence of mitogen. Mitogen-stimulated GM-CSF and gamma-interferon synthesis by CD4+ T cells was normal. Lymphokine mRNA in total cellular RNA derived from endoscopic biopsies was examined by reverse transcription/polymerase chain reaction. Mucosal biopsies from control subjects and most biopsies from allergic eosinophilic gastroenteritis patients contained less than 10(-8) micrograms IL-5 mRNA/1 microgram total cellular mRNA. gamma-Interferon mRNA was not detected by reverse transcription/polymerase chain reaction in biopsies from patients with allergic eosinophilic gastroenteritis but was present in controls. These lymphokine abnormalities are consistent with the elevated IgE and eosinophilia seen in allergic eosinophilic gastroenteritis and suggest that strategies targeting T lymphocytes may be efficacious in treatment of this disease.

Eosinophilic gastroenteritis: a review

“…41 In clinical studies, increased secretion of IL-4 and IL-5 by peripheral blood T cells has been reported in patients with EG. 54 Furthermore, T cells derived from the lamina propria of the duodenum of patients with EG preferentially secrete Th-2 cytokines (especially IL-13) when stimulated with milk proteins. 55…”

Eosinophil function in eosinophil-associated gastrointestinal disorders

“…As such, the diagnosis of eosinophilic gastritis (EG), enteritis, and gastroenteritis is even more complex than EE. Although these diseases are idiopathic, an allergic mechanism has been suggested in at least a subset of patients [26]. Indeed, elevated total IgE and food-specific IgE have been detected in most patients.…”

Food allergy: a practical update from the gastroenterological viewpoint

“…Todavia, embora a absorção de macromoléculas seja elevada em prematuros, isso não está necessariamente associado a maior incidência da AA 2,16 . 19,20 . Contudo, essas informações vêm sendo pouco usadas para desenvolver abordagens clínicas mais específi-cas ou sensíveis para o diagnóstico e manejo da AA.…”