Changes in mucosal IgG4 + - and IL-10 + -cell frequencies in adults with eosinophilic esophagitis on a two-food elimination diet

• Published in: Clinical immunology (Orlando, Fla.) Fla.), 2023-12, Vol.257, p.109853-109853, Article 109853
• Main Authors: Appanna, Ramapraba, Gargano, Domenico, Caputo, Alessandro, De Bartolomeis, Fabio, Ricciardi, Luca, Santonicola, Antonella, Stefanelli, Berenice, Caiazza, Laura, Guarciariello, Marialuisa, D'Antonio, Antonio, D'Auria, Raffaella, Conti, Valeria, Casolaro, Vincenzo, Iovino, Paola
• Format: Article
• Language: English
• Subjects: Adult; Allergens; Biopsy; Eosinophilic Esophagitis - immunology; Humans; Immunoglobulin G; Interleukin-10
• ISSN: 1521-6616; 1521-7035
• DOI: 10.1016/j.clim.2023.109853

Eosinophilic esophagitis (EoE) is increasingly diagnosed in patients with dysphagia. Type-2 immunity can induce EoE histopathology via non-IgE-dependent mechanisms, possibly involving IgG4 and IL-10. To elucidate the contribution of this response to EoE pathogenesis, we examined its association with clinical and histologic endpoints in adult EoE patients given a two-food elimination diet. IgG4- and IL-10-expressing cells were counted in esophageal biopsies and serum food-specific IgG4 measured at baseline and follow-up. Variables were correlated with histologic measures of disease activity. Patients exhibited significant reduction in esophageal eosinophilia and overall histology. A significant decrease in IL-10 -cell frequencies correlated with histologic changes. In contrast, a decline in serum and esophageal IgG4, while substantial, did not correlate with IL-10 -cell frequencies or histologic parameters. These results suggest a critical role of IL-10 in EoE pathogenesis. Conversely, IgG4 expression, while reflecting exposure to food antigens, is not obviously related to EoE histopathology or IL-10 expression.