Hironimus Theresa, Degen Sabrina, Rappl Anja, Allabauer Ida, Woelfle Joachim, Hartmann Arndt, Bruns Volker, Kletzander Rosalie, Geppert Carol, Hoerning André
Department of Pediatrics, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Institute of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
J Pediatr Gastroenterol Nutr. 2025 Sep;81(3):618-625. doi: 10.1002/jpn3.70137. Epub 2025 Jul 2.
Eosinophilic esophagitis (EoE) is a type 2 inflammatory chronic allergic disease with several additional immune cell subsets being involved. The aim of this study was to assess the identification and quantification of mast cells (MC) infiltrates using an objective and examiner independent analysis via digital image analysis of digitized histochemically stained biopsies.
Biopsies were taken from the esophagus of 24 children and adolescents diagnosed with EoE and stained for MC and eosinophilic granulocytes using anti-CD117 and Congo red, respectively. Samples were digitized, eosinophilic granulocytes and MCs were quantified using the MIKAIA® image analysis software.
At diagnosis MC infiltrations were regularly observed in active disease. MC numbers were 160 (cells/mm) before therapy initiation and 33 (cells/mm) in histological remission (<15 Eos/HPF). The number of mucosal MCs at the time of remission decreased less than that of eosinophilic granulocytes, regardless of the initiated therapy. Therefore, patients in histological remission with eosinophilic granulocytes showing on average 2,4 cells/mm still exhibited MC infiltrations (average 33 cells/mm). Furthermore, male patients displayed higher numbers of eosinophilic granulocytes at time of diagnosis. With regard to the site of biopsy sampling, an accumulation of the MC count in the distal direction can be observed.
Mast cells are involved in EoE and persist after achieving histological remission. Both CD117 + MC and eosinophilic granulocytes can be quantified using MIKAIA® as a tool for objectifying the histological diagnosis of EoE.
Identification number: DRKS-ID 00014688; https://drks.de/search/de/trial/DRKS00014688.
嗜酸性粒细胞性食管炎（EoE）是一种2型炎症性慢性过敏性疾病，涉及多个其他免疫细胞亚群。本研究的目的是通过对数字化组织化学染色活检进行数字图像分析，使用客观且独立于检查者的分析方法来评估肥大细胞（MC）浸润的识别和定量。
从24名诊断为EoE的儿童和青少年的食管中获取活检组织，分别使用抗CD117和刚果红对MC和嗜酸性粒细胞进行染色。样本数字化后，使用MIKAIA®图像分析软件对嗜酸性粒细胞和MC进行定量。
在诊断时，活动性疾病中经常观察到MC浸润。治疗开始前MC数量为160（细胞/mm），组织学缓解时（<15个嗜酸性粒细胞/高倍视野）为33（细胞/mm）。无论开始何种治疗，缓解时黏膜MC数量的减少少于嗜酸性粒细胞。因此，组织学缓解的患者中，嗜酸性粒细胞平均为2.4个细胞/mm时仍表现出MC浸润（平均33个细胞/mm）。此外，男性患者在诊断时嗜酸性粒细胞数量较多。关于活检取样部位，可观察到MC计数在远端方向上的积累。
肥大细胞参与EoE，并且在实现组织学缓解后仍然存在。CD117 + MC和嗜酸性粒细胞均可使用MIKAIA®进行定量，作为客观化EoE组织学诊断的工具。
识别号：DRKS-ID 00014688；https://drks.de/search/de/trial/DRKS00014688 。
