Allakos, Inc., Redwood City, California, USA.
Division of Allergy and Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
JCI Insight. 2019 Oct 3;4(19):126219. doi: 10.1172/jci.insight.126219.
Aberrant accumulation and activation of eosinophils and potentially mast cells (MCs) contribute to the pathogenesis of eosinophilic gastrointestinal diseases (EGIDs), including eosinophilic esophagitis (EoE), gastritis (EG), and gastroenteritis (EGE). Current treatment options, such as diet restriction and corticosteroids, have limited efficacy and are often inappropriate for chronic use. One promising new approach is to deplete eosinophils and inhibit MCs with a monoclonal antibody (mAb) against sialic acid-binding immunoglobulin-like lectin 8 (Siglec-8), an inhibitory receptor selectively expressed on MCs and eosinophils. Here, we characterize MCs and eosinophils from human EG and EoE biopsies using flow cytometry and evaluate the effects of an anti-Siglec-8 mAb using a potentially novel Siglec-8-transgenic mouse model in which EG/EGE was induced by ovalbumin sensitization and intragastric challenge. MCs and eosinophils were significantly increased and activated in human EG and EoE biopsies compared with healthy controls. Similar observations were made in EG/EGE mice. In Siglec-8-transgenic mice, anti-Siglec-8 mAb administration significantly reduced eosinophils and MCs in the stomach, small intestine, and mesenteric lymph nodes and decreased levels of inflammatory mediators. In summary, these findings suggest a role for both MCs and eosinophils in EGID pathogenesis and support the evaluation of anti-Siglec-8 as a therapeutic approach that targets both eosinophils and MCs.
嗜酸性粒细胞和潜在的肥大细胞(MCs)的异常积累和激活导致嗜酸性粒细胞性胃肠道疾病(EGIDs)的发病机制,包括嗜酸性食管炎(EoE)、胃炎(EG)和肠胃炎(EGE)。目前的治疗选择,如饮食限制和皮质类固醇,疗效有限,且往往不适合长期使用。一种有前途的新方法是用针对唾液酸结合免疫球蛋白样凝集素 8(Siglec-8)的单克隆抗体(mAb)耗尽嗜酸性粒细胞并抑制 MCs,Siglec-8 是一种选择性表达在 MCs 和嗜酸性粒细胞上的抑制性受体。在这里,我们使用流式细胞术对来自人类 EG 和 EoE 活检的 MCs 和嗜酸性粒细胞进行了表征,并使用一种潜在的新型 Siglec-8 转基因小鼠模型评估了抗 Siglec-8 mAb 的作用,该模型通过卵清蛋白致敏和胃内挑战诱导 EG/EGE。与健康对照组相比,人类 EG 和 EoE 活检中的 MCs 和嗜酸性粒细胞明显增加和激活。在 EG/EGE 小鼠中也观察到了类似的观察结果。在 Siglec-8 转基因小鼠中,抗 Siglec-8 mAb 给药可显著减少胃、小肠和肠系膜淋巴结中的嗜酸性粒细胞和 MCs,并降低炎症介质的水平。总之,这些发现表明 MCs 和嗜酸性粒细胞在 EGID 发病机制中都起作用,并支持评估抗 Siglec-8 作为一种靶向嗜酸性粒细胞和 MCs 的治疗方法。