EoE Module 10 References-Cheng et al Gut 2013 Omeprazole blocks eotaxin-3 expression by oesophageal squamous cells from patients with eosinophilic oesophagitis and GORD

Cheng et al Gut 2013 Omeprazole blocks eotaxin-3 expression by oesophageal squamous cells from patients with eosinophilic oesophagitis and GORD

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The study explores the expression of eotaxin-3, a protein involved in attracting eosinophils, in esophageal squamous cells from patients with eosinophilic esophagitis (EoE) and gastroesophageal reflux disease (GORD). EoE and GORD can present similar clinical features, making differentiation challenging. The research examines the impacts of Th2 cytokines (IL-4 and IL-13) on eotaxin-3 expression in these cells and investigates how omeprazole, a proton pump inhibitor (PPI), affects this expression.<br /><br />The research involved both primary cultures and telomerase-immortalized cell lines from patients with EoE and GORD. It was found that Th2 cytokines increase eotaxin-3 mRNA and protein expression in both EoE and GORD cell lines. Interestingly, omeprazole effectively blocked this cytokine-stimulated expression of eotaxin-3 in both types of cells.<br /><br />The findings suggest that eotaxin-3 production is not inherently different between EoE and GORD cells, implying that the elevated levels seen in EoE patients are likely due to external stimulation, possibly related to allergy mechanisms. Furthermore, the ability of PPIs to inhibit eotaxin-3 expression independent of their effects on gastric acid suggests that PPIs may have eosinophil-reducing effects unrelated to acid suppression.<br /><br />Clinically, this implies that a response to PPI therapy does not definitively distinguish EoE from GORD, as previously thought, since PPIs may reduce eosinophil levels in both conditions. This challenges the notion that EoE is solely distinct from GORD by its response to PPIs and suggests the potential for PPIs as part of EoE management irrespective of the presence of GORD. This study broadens the understanding of eosinophil-related mechanisms in esophageal diseases and invites reconsideration of treatment strategies.

Keywords

eotaxin-3

eosinophilic esophagitis

gastroesophageal reflux disease

Th2 cytokines

IL-4

IL-13

omeprazole

proton pump inhibitor

eosinophils

esophageal diseases