Cianferoni A, Ruffner MA, Guzek R, Guan S, Brown-Whitehorn T, Muir A, Spergel JM. Elevated expression of activated T
H2 cells and milk-specific T
H2 cells in milk-induced eosinophilic esophagitis.
Ann Allergy Asthma Immunol 2017;
120:177-183.e2. [PMID:
29289462 DOI:
10.1016/j.anai.2017.11.006]
[Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/07/2017] [Accepted: 11/07/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND
Eosinophilic esophagitis (EoE) is an allergic inflammatory disease that is triggered by food allergens and characterized by progressive esophageal dysfunction. Esophageal biopsy specimens are characterized by eosinophilia and expression of TH2 cytokines.
OBJECTIVE
To ascertain whether TH2 cells can exist in the peripheral blood in patients with milk-induced EoE.
METHODS
Peripheral blood mononuclear cells from 20 children with milk-induced EoE were collected during active EoE (EoE-A) while consuming milk and inactive EoE (EoE-I) while not consuming milk, and 8 healthy patients without EoE were used as controls. The samples were analyzed for T-cell phenotype, including intracellular cytokines before and after incubation with milk antigens and assessed by flow cytometry.
RESULTS
We found a significant increase in CD4+ TH2 cells in the peripheral blood of patients with EoE-A compared with the controls. Furthermore, we observed a significant mean (SD) increase in the activation marker of CD154+ T cells (0.17% [0.047%]) in patients with EoE-A compared with control patients (0.034% [0.007%]) and EoE-I (0.025% [0.008]). These CD4+ T cells expressed significantly increase levels of TH2 cytokines (interleukins 4, 5, and 13) compared with the EoE-I and control groups. CD3+CD4+CD154+IL-5+ cells were significantly increased by milk antigens in both milk-induced EoE-A (0.050% [0.008%] to 0.079% [0.017%]) and EoE-I (0.0045% [0.002%] to 0.014% [0.008%]) compared with the controls (0.008% [0.003%] to 0.003% [0.001%]).
CONCLUSION
Our findings indicate that in EoE peripheral T cells have specific activation to milk allergens.
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