食管肥大细胞可能与嗜酸性食管炎患者的症状感知有关。
Esophageal mast cells may be associated with the perception of symptoms in patients with eosinophilic esophagitis.
作者信息
Kanamori Atsushi, Tanaka Fumio, Takashima Shingo, Sawada Akinari, Ominami Masaki, Nadatani Yuji, Fukunaga Shusei, Otani Koji, Hosomi Shuhei, Kamata Noriko, Nagami Yasuaki, Taira Koichi, Watanabe Toshio, Fujiwara Yasuhiro
机构信息
Department of Gastroenterology, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.
Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka, Japan.
出版信息
Esophagus. 2023 Apr;20(2):333-341. doi: 10.1007/s10388-022-00967-w. Epub 2022 Nov 7.
BACKGROUND
Eosinophilic esophagitis (EoE) is a type 2 helper T-cell (Th2)-mediated allergic disease that involves mast cells. This study aimed to clarify the relationship between perception of symptoms and mast cell levels in patients with EoE.
METHODS
We enrolled patients with asymptomatic esophageal eosinophilia (aEE) and those with symptomatic EoE. Immunofluorescence staining was performed on esophageal biopsy specimens to quantify mast cell-related molecules, such as tryptase, proteinase-activated receptor (PAR)-2, and vasoactive intestinal peptide receptor (VPAC)-1.
RESULTS
We evaluated 28 and 58 patients with aEE and EoE, respectively. There were no significant differences in clinical and endoscopic features and peak eosinophil counts between both groups. Mast cell tryptase-positive areas were significantly higher in EoE than in aEE (4.9 [3.5-6.2] vs. 2.0 [1.2-3.4] %, p < 0.01). The number of PAR-2-positive cells was significantly higher in EoE than in aEE (14 [8.8-20.0] vs. 4 [2.8-8.0] cells/high-power field [HPF], p < 0.01). The number of VPAC-1-positive cells was significantly higher in the EoE group than in the aEE group (13 [8.8-16.0] vs. 6 [3.0-9.3] cells/HPF, p < 0.01). A positive correlation was observed between the numbers of PAR-2-positive cells and VPAC-1-positive cells (r = 0.851, p < 0.01). Moreover, mast cell tryptase-positive areas positively correlated with the number of PAR-2- and VPAC-1-positive cells (r = 0.352, p < 0.01; r = 0.355, p < 0.01, respectively).
CONCLUSIONS
Esophageal mast cells and their receptors, PAR-2 and VPAC-1, may contribute to the perception of symptoms in patients with EoE.
背景
嗜酸性粒细胞性食管炎（EoE）是一种由2型辅助性T细胞（Th2）介导的涉及肥大细胞的过敏性疾病。本研究旨在阐明EoE患者症状感知与肥大细胞水平之间的关系。
方法
我们纳入了无症状食管嗜酸性粒细胞增多症（aEE）患者和有症状的EoE患者。对食管活检标本进行免疫荧光染色，以量化肥大细胞相关分子，如类胰蛋白酶、蛋白酶激活受体（PAR）-2和血管活性肠肽受体（VPAC）-1。
结果
我们分别评估了28例aEE患者和58例EoE患者。两组患者的临床和内镜特征以及嗜酸性粒细胞峰值计数无显著差异。EoE患者的肥大细胞类胰蛋白酶阳性区域显著高于aEE患者（4.9[3.5-6.2]%对2.0[1.2-3.4]%，p<0.01）。EoE患者的PAR-2阳性细胞数量显著高于aEE患者（14[8.8-20.0]对4[2.8-8.0]个细胞/高倍视野[HPF]，p<0.01）。EoE组的VPAC-1阳性细胞数量显著高于aEE组（13[8.8-16.0]对6[3.0-9.3]个细胞/HPF，p<0.01）。观察到PAR-2阳性细胞数量与VPAC-1阳性细胞数量之间呈正相关（r=0.851，p<0.01）。此外，肥大细胞类胰蛋白酶阳性区域与PAR-2和VPAC-1阳性细胞数量呈正相关（分别为r=0.352，p<0.01；r=0.355，p<0.01）。
结论
食管肥大细胞及其受体PAR-2和VPAC-1可能有助于EoE患者的症状感知。
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