Τομέας Υγείας - Μητέρας - Παιδιού
Library of the School of Health Sciences

2017-06-23

2017

Angelakopoulou -Polizois Aspassia

Ρώμα Ελευθερία Ομότιμη Καθηγήτρια ,Ιατρική, ΕΚΠΑ
Κανακά Χριστίνα Καθηγήτρια ,Ιατρική, ΕΚΠΑ
Μίχος Αθανάσιος Επίκουρος Καθηγητής ,Ιατρική, ΕΚΠΑ
Συριοπούλου Βασιλική Ομότιμη Καθηγήτρια ,Ιατρική, ΕΚΠΑ
Παπαγρηγορίου -Θεοδωρίδου Μαρία Ομότιμη Καθηγήτρια ,Ιατρική, ΕΚΠΑ
Πολίτη Αικατερίνη Αναπληρώτρια Καθηγήτρια ,Ιατρική, ΕΚΠΑ
Καραμανώλης Γεώργιος Επίκουρος Καθηγητής ,Ιατρική, ΕΚΠΑ

Μελέτη της ηωσινοφιλικής οισοφαγίτιδας στα παιδιά

Greek

Eosinophilic esophagitis in children

Εosinophilic esophagitis in children
Background: ΕοΕ is a disease with increasing incidence during the last decades, mainly affecting atopic individuals. Despite the current knowledge that it is an immune reaction to food or aeroallergens, still there are controversies regarding its pathogenicity. Limited previous data suggest that the expression of filaggrin (FLG) and periostin (POSTN) proteins may be dysregulated in the mucosa of patients with eosinophilic esophagitis (EoE), but the exact role of these candidate biomarkers remains poorly investigated.
The aim was to study of clinical, endoscopic and histological findings in children with EoE and in those with gastroesophageal reflux (GER), as well as the expression of filaggrin and periostin on oesophageal tissue and their comparison between those two groups and controls (with normal oesophageal biopsy).
Methods: A total of 61 prospectively collected cases, including 40 children with EoE and 21 children with gastroesophageal reflux disease (GERD), as well as a control group of 14 sex and age-matched healthy children, were enrolled. Patients with EoE were treated with skin testing-driven elimination diet and/or corticosteroids. The immunohisto¬chemical expression of FLG and POSTN was evaluated in esophageal biopsies obtained from patients and controls. The immunohistochemistry results were correlated with EoE-related clinicopathological parameters, including severity of symptoms, maximum number of eosinophils (EOS) / high power microscopic field (HPF) and treatment data.
Results: Clinical and endoscopic findings were more severe in EoE patients, as well as the number of eosinophils significantly increased. EoE patients were sensitized to food allergens in 90% of the cases, compared to 38.1% of those with GER. Sensitization to cow’s milk was more common in both groups, while in a high percentage were sensitized to 3 or more food allergens. Positive FLG and negative POSTN staining were observed in all esophageal biopsies from normal controls. In contrast, FLG and POSTN stained negative and positive, respectively, in all pretreatment biopsies obtained from patients with EoE, while FLG and POSTN stained positive in 57.1% and 95.2% of GER cases, respectively (p<0.001). A statistically significant decrease of the proportion of cases with negative FLG and positive POSTN staining was observed from the first (pre-treatment) to the second (post-treatment) biopsy in the subgroup of patients with EoE (p<0.001 in both correlations).
Conclusions: Clinical and endoscopic findings were more severe in EoE patients compared to those of GER, as well as the number of eosinophils significantly increased. EoE patients were highly sensitized to food allergens. FLG and POSTN expression may be downregulated and upregulated, respectively, in the esophageal mucosa of patients with active EoE, and these changes may be restored with treatment in a significant percentage of patients. Confirmation of these findings in future prospective immunohistochemical and molecular studies is nevertheless warranted.

Health Sciences

Eosinophilic esophagitis, Gastroesophageal reflux, Filagrin, Periostin, Elimination diet

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Yes

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https://pergamos.lib.uoa.gr/uoa/dl/object/1678970