Department of Anatomy and Cell Biology, Gastrointestinal Diseases Research Unit, Queen's University, Kingston, Ontario, Canada.
Histopathology. 2012 Nov;61(5):810-22. doi: 10.1111/j.1365-2559.2012.4303.x. Epub 2012 Sep 17.
Eosinophilic oesophagitis (EoE) occurs in atopic individuals and features eosinophils and mast cells, but differences in the inflammatory cell density between the epithelium and lamina propria (LP) are not fully understood. The aim of this study was to determine if numbers of eosinophils, B lymphocytes and immunoglobulin E (IgE)-bearing mast cells are increased in the mucosa of EoE patients with and without concurrent atopy.
Oesophageal biopsies containing ≥ 4 high-power fields (HPF) of epithelium and LP were identified for normal (n = 9), gastroesophageal reflux disease (GERD) (n = 5) and EoE (n = 25) patients. Patients were classified as atopic or not by clinical history. Immunohistochemistry identified mast cells, B lymphocytes and eosinophils. Eosinophil density was increased in the LP in EoE. Intraepithelial eosinophil density correlated with eosinophils/HPF, CD20(+) B lymphocyte density and tryptase(+) IgE(+) mast cell density. Increased intraepithelial IgE(+) cell density in EoE was associated with mast cells and not B lymphocytes. Intraepithelial IgE(+) mast cell densities were significantly higher in biopsies from the subgroup of EoE patients with atopy.
EoE diagnosis using maximal eosinophil count/HPF correlates with average counts/mm(2), and intraepithelial eosinophil densities are higher in children than adults with EoE. In EoE, numbers of eosinophils and mast cells are increased in the LP. IgE-bearing mast cells are increased in atopic EoE patients but not in non-atopic EoE patients.
嗜酸性食管炎（EoE）发生于特应性个体，其特征为嗜酸性粒细胞和肥大细胞浸润，但上皮和固有层（LP）之间炎症细胞密度的差异尚不完全清楚。本研究旨在确定特应性和非特应性 EoE 患者的黏膜中是否存在嗜酸性粒细胞、B 淋巴细胞和 IgE 阳性肥大细胞数量的增加。
鉴定了含有≥4 个高倍视野（HPF）上皮和 LP 的食管活检组织，用于正常（n=9）、胃食管反流病（GERD）（n=5）和 EoE（n=25）患者。根据临床病史对患者进行特应性或非特应性分类。免疫组织化学鉴定了肥大细胞、B 淋巴细胞和嗜酸性粒细胞。EoE 患者 LP 中嗜酸性粒细胞密度增加。上皮内嗜酸性粒细胞密度与嗜酸性粒细胞/HPF、CD20（+）B 淋巴细胞密度和 tryptase（+）IgE（+）肥大细胞密度相关。EoE 患者上皮内 IgE（+）细胞密度的增加与肥大细胞而非 B 淋巴细胞有关。特应性 EoE 患者活检组织中上皮内 IgE（+）肥大细胞密度显著高于非特应性 EoE 患者。
使用最大嗜酸性粒细胞计数/HPF 诊断 EoE 与平均计数/mm（2）相关，且 EoE 儿童患者的上皮内嗜酸性粒细胞密度高于成人。在 EoE 中，LP 中嗜酸性粒细胞和肥大细胞数量增加。特应性 EoE 患者 IgE 阳性肥大细胞增加，但非特应性 EoE 患者则没有。
