Food Allergen Component Sensitization Patterns in Eosinophilic Esophagitis: Insights from a Retrospective Comparative...

Area of Science:

• Immunology
• Allergy
• Gastroenterology

Background:

• Eosinophilic esophagitis (EoE) is a chronic, food-allergic esophageal disease.
• Identifying specific food triggers in EoE is challenging and often empirical.
• Dietary antigens are central to EoE pathogenesis.

Purpose of the Study:

• To characterize molecular IgE sensitization profiles in adult EoE patients.
• To compare these profiles with those in allergic chronic urticaria (CU) patients.
• To explore the role of stable food allergen components in EoE.

Main Methods:

• Retrospective, single-center study.
• Component-resolved diagnostics (CRD) used to analyze IgE sensitization.
• Comparison between EoE (n=22) and CU (n=29) cohorts.

Main Results:

• IgE sensitization was prevalent in both EoE and CU groups, mainly to cross-reactive inhalant allergens (e.g., PR-10 proteins).
• Sensitization to stable food allergen components (lipid transfer proteins, plant storage proteins) was found in 31.8% of EoE patients but not in CU patients (p=0.0015).
• These stable food components are resistant to heat and digestion, suggesting sustained dietary exposure.

Conclusions:

• CRD has limited utility for directly identifying EoE trigger foods.
• Molecular sensitization patterns in EoE may reflect sustained dietary exposure rather than acute reactions.
• Further research is needed to integrate molecular data with clinical and dietary outcomes for EoE management.