EoE Module 10 References-Wen et al J Allergy Clin Immunol 2015 Transcriptome analysis of PPI responsive EoE_

Wen et al J Allergy Clin Immunol 2015 Transcriptome analysis of PPI responsive EoE__inflammation

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This study explores the relationship between proton pump inhibitor-responsive esophageal eosinophilia (PPI-REE) and eosinophilic esophagitis (EoE), diseases characterized by similar clinical presentations but different responses to treatment. EoE is a known antigen-driven, Th2-associated allergic disorder, while PPI-REE's etiology is less understood. Researchers conducted transcriptome analyses using an esophageal diagnostic panel (EDP), encompassing 94 transcripts, across multiple medical institutions. The study aimed to see if PPI therapy could reverse transcriptional abnormalities in PPI-REE and identify molecular overlaps with EoE.<br /><br />The researchers found that untreated PPI-REE shares a molecular signature with EoE, indicating significant overlap in their underlying allergic inflammation mechanisms. This similarity is demonstrated by shared expression of genes associated with eosinophil chemotaxis, tissue remodeling, and mast cell presence. PPI therapy effectively reversed the transcriptional profile of PPI-REE, reducing signs of Th2-driven inflammation, unlike in EoE, where PPI treatment did not alter the signature. These findings suggest that PPI-REE may be a sub-phenotype within the EoE spectrum.<br /><br />Furthermore, the study highlights the potential to differentiate PPI-REE from EoE prior to intervention by identifying specific gene expression profiles. Particularly, the KCNJ2 gene, which affects ion channel activities, could potentially serve as a marker to distinguish between the disorders before treatment.<br /><br />The study concludes that recognizing the molecular similarities between PPI-REE and EoE could refine diagnosis and treatment strategies, allowing more targeted management of esophageal eosinophilic inflammation. This new understanding emphasizes the need to view PPI-REE and EoE as potentially related inflammatory disorders, with implications for improving therapeutic approaches based on their shared pathogenesis.

Keywords

PPI-REE

EoE

esophageal eosinophilia

transcriptome analysis

Th2 inflammation

gene expression

KCNJ2

PPI therapy

allergic disorder

molecular signature