Department of Pediatrics, Section of Pediatric Gastroenterology, Hepatology & Nutrition, Gastrointestinal Eosinophilic Diseases Program, and the Digestive Health Institute; Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, CO, USA.
Department of Pathology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA.
Dig Liver Dis. 2023 Jan;55(1):53-60. doi: 10.1016/j.dld.2022.08.020. Epub 2022 Sep 3.
Recent studies have shown that IgG4 is increased in the esophageal tissue of eosinophilic esophagitis patients, including the presence of IgG4+ plasma cells.
Our aim was to determine whether IgG4 is elevated in the gastric or duodenal tissue of pediatric patients with eosinophilic gastritis or duodenitis (EoG or EoD).
This was a retrospective single center study. Pediatric patients were characterized as having active EoG, EoD, or as controls based on clinical symptoms and histologic features. Immunohistochemistry for IgG4 was performed in gastric and duodenal tissue, and peak IgG4+ cells were compared between groups and after treatment.
The frequency of IgG4+ cells was significantly higher in patients with EoG and EoD compared to controls in the stomach [EoG 6.5 cells/hpf (3.6-10.9), control 0 cells/hpf (0-0.7), p<0.0001] and duodenum [EoD 7.5 cells/hpf (2.8-37), control 0.5 cells/hpf (0.3-1.3), p<0.001)] respectively, and positively correlated with eosinophil counts (stomach: r 0.74, p<0.0001; duodenum: r 0.57, p<0.0001). The amount of tissue IgG4 was significantly decreased in patients in remission but not in persistently active disease.
These data suggest local tissue production of IgG4 may be a universal feature of eosinophilic gastrointestinal disease that tracks with disease activity.
最近的研究表明，IgG4 在嗜酸粒细胞性食管炎患者的食管组织中增加，包括 IgG4+浆细胞的存在。
我们的目的是确定 IgG4 是否在嗜酸粒细胞性胃炎或十二指肠炎（EoG 或 EoD）患儿的胃或十二指肠组织中升高。
这是一项回顾性单中心研究。根据临床症状和组织学特征，将儿科患者特征化为患有活动性 EoG、EoD 或作为对照。对胃和十二指肠组织进行 IgG4 免疫组化染色，并比较各组之间以及治疗后的 IgG4+细胞峰值。
与对照组相比，EoG 和 EoD 患者胃[EoG 6.5 个细胞/hpf（3.6-10.9），对照组 0 个细胞/hpf（0-0.7），p<0.0001]和十二指肠[EoD 7.5 个细胞/hpf（2.8-37），对照组 0.5 个细胞/hpf（0.3-1.3），p<0.001]中 IgG4+细胞的频率显著更高，并且与嗜酸性粒细胞计数呈正相关（胃：r0.74，p<0.0001；十二指肠：r0.57，p<0.0001）。在缓解的患者中，组织 IgG4 的量显著减少，但在持续活动的疾病中没有减少。
这些数据表明，局部组织产生 IgG4 可能是嗜酸粒细胞性胃肠道疾病的一个普遍特征，与疾病活动度相关。
