Immunohistochemical expression of filaggrin is decreased in proton pump inhibitor non-responders compared with proton pump inhibitor responders of eosinophilic esophagitis
- 1 April 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Esophagus
- Vol. 18 (2), 362-371
- https://doi.org/10.1007/s10388-020-00781-2
Abstract
Background Eosinophilic esophagitis (EoE) is an allergic gastrointestinal disease that features eosinophilic infiltration of esophageal mucosa, but the role of barrier dysfunction of the epithelium in its pathogenesis remains to be elucidated. Clinically, EoE is divided into proton pump inhibitor-non-responders (PPI-NR) and PPI-responders (PPI-R). Our main aims were to investigate the differences of expression of epidermal differential complex (EDC) proteins and desmoglein that are considered to play important roles in formation of the epidermal skin barrier between these two conditions and to seek the usefulness of the differences in pathological diagnosis. Conventional histopathological findings and allergic background were also compared. Methods Twenty-nine PPI-NR and 44 PPI-R were recruited, and 35 reflux esophagitis patients were also enrolled. After clinical information and histopathological findings were reviewed, immunohistochemical expression of EDC proteins (filaggrin, loricrin, and involucrin) and desmoglein in all three groups were examined and semi-quantitatively scored. Results Regarding allergic conditions, the prevalence of asthma was significantly higher in PPI-NR than in PPI-R. Other allergic conditions showed no differences. Histopathological findings did not exhibit the statistical difference between PPI-NR and PPI-R. However, immunostaining score of filaggrin in PPI-NR was significantly lower than in PPI-R, although the expressions of involucrin, loricrin and desmoglein demonstrated no differences. Conclusions The results suggest a role of reduced filaggrin expression in the difference of effectiveness of PPI treatment between PPI-NR and PPI-R. Moreover, immunohistochemical determination of filaggrin expression in EoE patients could be informative in the clinical decision of how to treat the patients.This publication has 30 references indexed in Scilit:
- Eosinophilic gastrointestinal diseases – Pathogenesis, diagnosis, and treatmentAllergology International, 2019
- Atopic dermatitis and filaggrinCurrent Opinion in Immunology, 2016
- Recent Progress in the Research of Eosinophilic Esophagitis and GastroenteritisDigestion, 2016
- Efficacy of Proton Pump Inhibitor Drugs for Inducing Clinical and Histologic Remission in Patients With Symptomatic Esophageal Eosinophilia: A Systematic Review and Meta-AnalysisClinical Gastroenterology and Hepatology, 2016
- Causes of epidermal filaggrin reduction and their role in the pathogenesis of atopic dermatitisJournal of Allergy and Clinical Immunology, 2014
- Proton pump inhibitor‐responsive oesophageal eosinophilia correlates with downregulation of eotaxin‐3 and Th2 cytokines overexpressionAlimentary Pharmacology & Therapeutics, 2014
- Desmoglein-1 regulates esophageal epithelial barrier function and immune responses in eosinophilic esophagitisMucosal Immunology, 2013
- Review article: proton pump inhibitor therapy for suspected eosinophilic oesophagitisAlimentary Pharmacology & Therapeutics, 2013
- Eosinophilic esophagitis: Updated consensus recommendations for children and adultsJournal of Allergy and Clinical Immunology, 2011
- Coordinate Interaction between IL-13 and Epithelial Differentiation Cluster Genes in Eosinophilic EsophagitisThe Journal of Immunology, 2010