EoE ToT Module 4 References-Ravi etal Gastroenterology 2019 Penetration of the esophageal epithelium by dust mite Ag in pts with EoE

Ravi etal Gastroenterology 2019 Penetration of the esophageal epithelium by dust mite Ag in pts with EoE

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This brief communication explores the presence of dust mite antigens in the esophageal epithelium of patients with Eosinophilic Esophagitis (EoE), an allergic condition predominantly driven by food antigens but possibly influenced by environmental allergens. The research team comprised members from the Departments of Pediatrics and Gastroenterology and Hepatology at the Mayo Clinic.<br /><br />The study involved three groups of patients: those with active EoE (characterized by esophageal eosinophilia ≥15 per high power field and dysphagia), those with inactive EoE, and control patients undergoing clinically indicated endoscopy without esophageal disease or symptoms. The presence of esophageal dust mite antigen was detected using immunohistochemical staining techniques.<br /><br />Results revealed that patients with active EoE showed significantly higher levels of dust mite antigen staining in their esophageal epithelium compared to those with inactive EoE and the control group. Specifically, the active EoE group had more extensive staining measured both by field percentage and number of discrete antigen sites. In contrast, control patients showed no dust mite antigen staining.<br /><br />These findings suggest that aeroallergens like dust mites can penetrate the esophageal epithelium and potentially activate EoE similarly to food antigens. This is supported by evidence of epithelial barrier dysfunction in active EoE, which allows antigen penetration and may trigger an immune response.<br /><br />The study challenges the existing notion that EoE triggered by aeroallergens occurs solely via systemic pathways, suggesting a direct epithelial route could also play a role. Further research is necessary to elucidate how epithelial dust mite antigens contribute to EoE pathogenesis and whether antigen presence correlates with disease causality or represents incidental passage through compromised epithelial barriers.<br /><br />The study was funded by various sources, and some authors disclosed potential conflicts of interest related to advisory roles and financial interests in pharmaceutical companies.

Keywords

Eosinophilic Esophagitis

dust mite antigens

esophageal epithelium

immunohistochemical staining

aeroallergens

epithelial barrier dysfunction

food antigens

Mayo Clinic

esophageal eosinophilia

immune response