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Author Spotlight: Investigating the Pathophysiology of Eosinophilic Esophagitis
Published on: May 10, 2024
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Persistent esophageal changes after histologic remission in eosinophilic esophagitis
Melanie A Ruffner1, Tetsuo Shoda2, Megha Lal3
1Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pa; Division of Allergy & Immunology, Children's Hospital of Philadelphia, Philadelphia, Pa.
The Journal of Allergy and Clinical Immunology
|December 28, 2023
Summary
Eosinophilic esophagitis (EoE) patients in remission show persistent esophageal gene expression changes. These findings suggest epigenetic mechanisms may drive EoE relapse, even when symptoms are absent.
Area of Science:
- Gastroenterology
- Immunology
- Molecular Biology
Background:
- Eosinophilic esophagitis (EoE) involves persistent allergic inflammation.
- Understanding EoE relapse mechanisms is crucial to prevent long-term complications.
Purpose of the Study:
- To determine if esophageal gene expression remains dysregulated in EoE patients achieving histologic remission.
Main Methods:
- Molecular profiling of esophageal biopsies from pediatric and adult EoE patients in remission using the EoE diagnostic panel (94 transcripts).
- Comparison with control subjects.
Main Results:
- Significant differential gene expression was observed in both pediatric (51 genes) and adult (32 genes) EoE patients in remission (<15 eos/hpf).
- Even with stringent remission (0 eos/hpf), 25 pediatric and 18 adult genes remained differentially expressed.
- CDH26 was upregulated in EoE patients in remission, and POSTN expression correlated with endoscopic scores in adults.
Conclusions:
- Persistent EoE-associated gene expression occurs in patients with deep remission.
- Inflammation-induced epigenetic changes may influence gene expression during EoE remission.
- These findings offer insights into potential mechanisms underlying EoE relapse.
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