The Clinical Characteristics and Treatment Outcomes of Concomitant Eosinophilic Esophagitis and Inflammatory Bowel Disease

Urquhart, Siri A.; Quinn, Kevin P.; Ravi, Karthik; Loftus, Edward V.

doi:10.1093/crocol/otab018

Cited by 4 publications

(3 citation statements)

References 34 publications

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“…Patients with two concomitant diseases (i.e. EoE and CD) may affect the same area but exhibit different histology and symptoms and require different treatments (9). The pediatric population with IBD are particularly vulnerable to growth failure (10, 11) and interruptions in social-emotional development (12) and will require decades of healthcare for their condition, thus non-invasive diagnostics and targeted therapies are particularly valuable to this subset of patients.…”

Section: Introductionmentioning

confidence: 99%

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Genomic Insights into Pediatric Intestinal Inflammatory and Eosinophilic Disorders using Single-sell RNA-sequencing

Keever-Keigher,

Harvey,

Williams

et al. 2023

Preprint

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Chronic inflammation of the gastrointestinal (GI) tissues underlies GI inflammatory disorders, leading to tissue damage and a constellation of painful and debilitating symptoms. These GI disorders include inflammatory bowel diseases (Crohn’s disease (CD) and ulcerative colitis (UC)), and eosinophilic disorders (eosinophilic esophagitis (EoE) and eosinophilic duodenitis (EoD)). GI inflammatory disorders can often present with overlapping symptoms necessitating the use of invasive procedures to give a proper diagnosis. This study aims to use peripheral blood mononuclear cells (PBMCs) from individuals with CD, UC, EoE, and EoD to better understand the alterations to the transcriptome of individuals with these diseases and identify potential markers of active inflammation within the peripheral blood of patients that may be useful in diagnosis. Single-cell RNA-sequencing (scRNA-seq) was performed on PBMCs isolated from the blood samples of pediatric patients diagnosed with a GI disorder, including CD, UC, EoE, EoD, and controls with histologically healthy gastrointestinal tracts. We identified 1,185 (FDR < 0.05) differentially expressed genes (DEGs) between individuals with GI disorders and controls across six distinct immune cell populations. Few patterns of gene dysregulation were common among all GI disorders, including the downregulation ofESR2in CD4+T cells compared to controls. Many DEGs showed distinct patterns of dysregulation among individuals with CD, UC, EoE, and EoD compared to controls, such as dysregulation of genes associated with oxidative stress in monocytes of individuals CD and the upregulation ofSCGB3A1in CD4+T cells in individuals with EoD. These findings indicate both overlapping and distinct alterations to the transcriptome of individuals with CD, UC, EoD, and EoE compared to controls, which provide insight as to which genes may be useful as markers for disease in the peripheral blood of patients.

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Section: Introductionmentioning

confidence: 99%

“…Patients with two concomitant diseases (i.e. EoE and CD) may affect the same area but exhibit different histology and symptoms and require different treatments (10). Additionally, early knowledge of whether mucosal eosinophilia is burgeoning IBD can allow early and appropriate intervention.…”

Section: Introductionmentioning

confidence: 99%

Genomic Insights into Pediatric Intestinal Inflammatory and Eosinophilic Disorders using Single-sell RNA-sequencing

Keever-Keigher,

Harvey,

Williams

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Patients with both diseases appeared to have more IBD‐related complications compared to patients only diagnosed with IBD. Only few prospective cohort studies described the clinical characteristics and treatment outcomes of concomitant EoE and IBD 7 . The relatively low incidence of the two concomitantly diagnoses makes it difficult to draw conclusions about the bidirectional impact of the two diseases.…”

mentioning

confidence: 99%

Inflammatory bowel diseases and eosinophilic oesophagitis: Two overlapping disorders?

Grellier,

Kirchgesner

2023

UEG Journal

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Inflammatory bowel diseases and eosinophilic oesophagitis: Two overlapping disorders?Inflammatory bowel diseases (IBD) and eosinophilic oesophagitis (EoE) are immune-mediated disorders of the gastrointestinal (GI) tract with an increasing incidence worldwide. 1,2 Both diseases are characterised by a loss of tolerance towards luminal antigens favoured by microbiota disruption suggesting that they may share similar pathophysiology. 3,4 Associations between the two diseases have been suggested in previous studies, especially the risk of developing EoE in individuals with IBD. 5 However, data regarding the risk of developing IBD in individuals with EoE are scarce.In the current issue of the United European Gastroenterology Journal, Uchida et al. assessed the risk of developing IBD in individuals with histopathologic-proven diagnosis of EoE. 6 Between 1990 and 2017, using a Swedish nationwide histopathologic database, the authors identified 1587 individuals with EoE. Each of them was matched to five general population reference individuals according to age, sex, and year of diagnosis of EoE, with a total of 7808 individuals. Individuals with EoE were excluded if they had a prior diagnosis of IBD and the follow-up ended in December 2019. Of note, individuals with EoE underwent more endoscopies during follow-up than the reference individuals. Overall, 16 EoE individuals(0.01%) and 21 reference individuals (0.003%), were diagnosed with IBD during follow-up. The risk of developing IBD was 3.5-fold higher in the EoE group compared to matched individuals from the general population. In subgroup analyses, individuals with EoE were at higher risk of developing later Crohn's disease (CD), but not ulcerative colitis (UC). These results suggest that only CD could be associated with EoE. Additionally, the risk of being diagnosed with EoE was 15 times higher in patients with IBD compared to the general population, suggesting a bidirectional association. Some limitations need to be acknowledged. First, surveillance bias could occur as individuals with EoE were more likely to have upper GI endoscopies during follow-up that could identify lesions related to CD. Patients with EoE are more prone to being followed by GI doctors and so undergo subsequent GI endoscopies. Second, important confounding factors are not collected in the Swedish administrative healthcare databases, notably smoking or medications such as proton pump inhibitors, and residual confounding cannot be excluded.

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Genomic insights into pediatric intestinal inflammatory and eosinophilic disorders using single-cell RNA-sequencing

Keever-Keigher,

Harvey,

Williams

et al. 2024

Front. Immunol.

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IntroductionChronic inflammation of the gastrointestinal tissues underlies gastrointestinal inflammatory disorders, leading to tissue damage and a constellation of painful and debilitating symptoms. These disorders include inflammatory bowel diseases (Crohn’s disease and ulcerative colitis), and eosinophilic disorders (eosinophilic esophagitis and eosinophilic duodenitis). Gastrointestinal inflammatory disorders can often present with overlapping symptoms necessitating the use of invasive procedures to give an accurate diagnosis.MethodsThis study used peripheral blood mononuclear cells from individuals with Crohn’s disease, ulcerative colitis, eosinophilic esophagitis, and eosinophilic duodenitis to better understand the alterations to the transcriptome of individuals with these diseases and identify potential markers of active inflammation within the peripheral blood of patients that may be useful in diagnosis. Single-cell RNA-sequencing was performed on peripheral blood mononuclear cells isolated from the blood samples of pediatric patients diagnosed with gastrointestinal disorders, including Crohn’s disease, ulcerative colitis, eosinophilic esophagitis, eosinophilic duodenitis, and controls with histologically healthy gastrointestinal tracts.ResultsWe identified 730 (FDR < 0.05) differentially expressed genes between individuals with gastrointestinal disorders and controls across eight immune cell types.DiscussionThere were common patterns among GI disorders, such as the widespread upregulation of MTRNR2L8 across cell types, and many differentially expressed genes showed distinct patterns of dysregulation among the different gastrointestinal diseases compared to controls, including upregulation of XIST across cell types among individuals with ulcerative colitis and upregulation of Th2-associated genes in eosinophilic disorders. These findings indicate both overlapping and distinct alterations to the transcriptome of individuals with gastrointestinal disorders compared to controls, which provide insight as to which genes may be useful as markers for disease in the peripheral blood of patients.

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The Clinical Characteristics and Treatment Outcomes of Concomitant Eosinophilic Esophagitis and Inflammatory Bowel Disease

Cited by 4 publications

References 34 publications

Genomic Insights into Pediatric Intestinal Inflammatory and Eosinophilic Disorders using Single-sell RNA-sequencing

Genomic Insights into Pediatric Intestinal Inflammatory and Eosinophilic Disorders using Single-sell RNA-sequencing

Inflammatory bowel diseases and eosinophilic oesophagitis: Two overlapping disorders?

Genomic insights into pediatric intestinal inflammatory and eosinophilic disorders using single-cell RNA-sequencing

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