Relative lack of T regulatory cells in adult eosinophilic esophagitis - no normalization after corticosteroid therapy

Stuck, M.; Straumann, Alex; Simon, Hans‐Uwe

doi:10.1111/j.1398-9995.2010.02525.x

Cited by 38 publications

(27 citation statements)

References 6 publications

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“…Tregs are reduced in biopsies of adults with EoE as compared to controls, a finding that is irrespective of steroid therapy [172]. In contrast, Tregs seem to be increased in esophageal tissue of children with EoE [173, 174].…”

Section: Pathologic and Protective Cell Populationsmentioning

confidence: 99%

The Immunologic Mechanisms of Eosinophilic Esophagitis

Hill

Spergel

2016

Curr Allergy Asthma Rep

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Eosinophilic esophagitis (EoE) is a chronic allergic inflammatory disease that is triggered by food and/or environmental allergens and is characterized by a clinical and pathologic phenotype of progressive esophageal dysfunction due to tissue inflammation and fibrosis. EoE is suspected in patients with painful swallowing, among other symptoms, and is diagnosed by the presence of 15 or more eosinophils per high-power field in one or more of at least four esophageal biopsy specimens. 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 recent years, our understanding of the immunologic mechanisms underlying this condition has grown considerably. Thanks to new genetic, molecular, cellular, animal, and translational studies, we can now postulate a detailed pathway by which exposure to allergens results in a complex and coordinated type 2 inflammatory cascade that, if not intervened upon, can result in pain on swallowing, esophageal strictures, and food impaction. Here, we review the most recent research in this field to synthesize and summarize our current understanding of this complex and important disease.

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Section: Pathologic and Protective Cell Populationsmentioning

confidence: 99%

The Immunologic Mechanisms of Eosinophilic Esophagitis

Hill

Spergel

2016

Curr Allergy Asthma Rep

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“…In EoE, an imbalance between effector and regulatory T-cells was shown by Stuck et al ., who found the proportion of Foxp3 + CD3 + T-cells was 50% reduced in EoE compared to healthy controls. 32 Using an intranasal aeroallergen-induced murine model of EoE, Zhu et al . found a similar alteration in the frequency of CD4 + T cell subsets in the esophagus of allergen-challenged mice compared with saline-challenged mice.…”

Section: Bodymentioning

confidence: 99%

Allergic Mechanisms in Eosinophilic Esophagitis

Wechsler

Bryce

2014

Gastroenterology Clinics of North America

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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.

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“…Recent studies point to the possibility that the role of regulatory T cells may differ between pediatric and adult EoE. While increased numbers of regulatory T cells were seen in pediatric cases, adult EoE patients were found to have a relative lack of FoxP3-positive T cells [20]. Taken together, the main allergen-induced immunological mechanisms leading to eosinophilic inflammation and allergen-specific IgE synthesis seem to be very similar to other allergic diseases (fig.…”

Section: Cells and Cytokinesmentioning

confidence: 93%

Immunopathogenesis of Eosinophilic Esophagitis

Simon

Straumann

2014

Dig Dis

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Background: Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the esophagus associated with dysphagia in adults and refractory reflux syndromes in children. Methods: Immunological and genetic approaches have been used to better understand the pathophysiology of the underlying inflammation. Results and Conclusions: Evidence has accumulated that EoE represents a T-helper (Th) 2-type inflammatory disease, in which allergens play a role in triggering the disease. The majority of the patients suffer from concurrent allergic rhinitis, asthma, and eczema, and have a history of atopy. The chronic inflammatory response in EoE is associated with tissue damage and remodeling, both of which lead to esophageal dysfunction and bolus impaction. The new insights into the pathophysiology have resulted in the development of the first pharmacological therapies of EoE.

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Relative lack of T regulatory cells in adult eosinophilic esophagitis - no normalization after corticosteroid therapy

Cited by 38 publications

References 6 publications

The Immunologic Mechanisms of Eosinophilic Esophagitis

The Immunologic Mechanisms of Eosinophilic Esophagitis

Allergic Mechanisms in Eosinophilic Esophagitis

Immunopathogenesis of Eosinophilic Esophagitis

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