Disrupted mucosal vascular barrier in eosinophilic esophagitis

Area of Science:

• Gastroenterology
• Immunology
• Vascular Biology

Background:

• Esophageal barrier research has historically focused on the epithelial layer.
• Gut vascular barrier dysfunction is increasingly linked to immune-mediated gastrointestinal disorders.

Purpose of the Study:

• To characterize the esophageal vascular barrier (EVB) in eosinophilic esophagitis (EoE).
• To investigate the role of plasmalemma vesicle-1 (PV-1) as a marker for EVB disruption in EoE.

Main Methods:

• Probe-based confocal laser endomicroscopy (pCLE) was used to assess EVB integrity.
• Immunohistochemistry and qPCR were performed on esophageal biopsies from EoE, reflux esophagitis (RE), and healthy controls (HC) to measure PV-1 levels.

Main Results:

• pCLE demonstrated EVB leakage in EoE patients, but not in RE patients.
• PV-1 protein and transcript levels were significantly elevated in EoE compared to RE and HC.
• EVB leakage in one EoE patient was restored after dupilumab treatment.

Conclusions:

• The esophageal vascular barrier is disrupted in active eosinophilic esophagitis.
• Elevated PV-1 levels indicate vascular leakage and support EVB disruption in EoE.
• Further research is needed to explore the diagnostic and pathogenic significance of EVB disruption in EoE.