Eosinophil granule major basic protein 1 deposition in eosinophilic esophagitis correlates with symptoms independent of eosinophil counts.
In patients with eosinophilic esophagitis (EoE), symptoms often do not correlate with peak eosinophil counts (PEC) determined on histopathological examination of biopsy specimens. This may be because eosinophils degranulate during active disease and lose their morphological identity as intact cells and, therefore, are not enumerated on microscopic examination. Eosinophil granule proteins that are released into tissues with degranulation, including major basic protein 1 (eMBP1), likely contribute to disease pathogenesis and, therefore, may correlate with symptoms better than PEC. We sought to determine whether symptoms in patients with EoE more closely relate to eosinophil granule protein deposition than to eosinophil enumeration, especially in patients with fewer than 15 eosinophils per high power field (HPF). Esophageal biopsy specimens from 34 patients diagnosed with EoE were obtained for histopathological examination and for evaluation of eMBP1 staining by indirect immunofluorescence. PEC by histopathology were compared to extracellular eMBP1 grades by immunostaining. PEC and eMBP1 grades also were analyzed for their relationship to symptoms and clinical course. Biopsy specimens from 19 of the 34 patients had fewer than 15 PEC on histopathological examination, and the other 15 patients had 15 or greater PEC. Positive eMBP1 immunostaining was found in all symptomatic patients. EoE symptoms were related to eMBP1 immunostaining grades (p = 0.0001), but not PEC (P = 0.14). Eosinophil granule protein deposition, specifically eMBP1, is increased in esophageal biopsy specimens from symptomatic patients with EoE and may be a marker of disease activity, including patients with EoE who have 'resolved' disease.
['Peterson|K A|KA|', 'Gleich|G J|GJ|', 'Limaye|N S|NS|', 'Crispin|H|H|', 'Robson|J|J|', 'Fang|J|J|', 'Saffari|H|H|', 'Clayton|F|F|', 'Leiferman|K M|KM|']
D000328:Adult D000368:Aged D058070:Asymptomatic Diseases D015415:Biomarkers D001706:Biopsy D047093:Eosinophil Major Basic Protein D057765:Eosinophilic Esophagitis D004804:Eosinophils D000071041:Esophageal Mucosa D005260:Female D006801:Humans D007958:Leukocyte Count D008297:Male D008875:Middle Aged D011509:Proteoglycans D063189:Symptom Assessment D055815:Young Adult
eosinophilic esophagitis allergy eosinophilic oesophagitis