Document Detail

Increased expression of eotaxin-3 distinguishes between eosinophilic esophagitis and gastroesophageal reflux disease.
MedLine Citation:
PMID:  17900656     Owner:  NLM     Status:  MEDLINE    
Differentiating eosinophilic esophagitis from gastroesophageal reflux disease is important given their pathogenetic differences and responses to therapy. Eotaxins are a family of chemokines important for activation and recruitment of eosinophils mediated by their receptor, chemokine receptor-3 (CCR-3). Interleukin 5 (IL-5) is a key cytokine involved in many steps of eosinophil production and recruitment. The aim of this study was to compare the messenger RNA expression of the eotaxins, CCR-3, and IL-5 between well-characterized groups of patients with eosinophilic esophagitis, patients with gastroesophageal reflux disease, and healthy individuals. This was a retrospective study using esophageal biopsies from 33 patients with eosinophilic esophagitis, 20 patients with gastroesophageal reflux disease, and 17 healthy controls. Parameters studied included demographic features, presenting symptoms, endoscopic findings, histopathologic features, and messenger RNA levels of eotaxins 1, 2, and 3, CCR-3, and IL-5 by quantitative real-time polymerase chain reaction using formalin-fixed, paraffin-embedded tissue. Patients with eosinophilic esophagitis were predominantly males (M/F=3:1), with a mean age of 15.9 years and a mean eosinophil count of 55 per x400 high-power field. Patients with gastroesophageal reflux disease had a mean age of 31.5 years and a mean eosinophil count of 5.8 per high-power field. Total intraepithelial eosinophil and lymphocyte counts, the presence of superficial eosinophil clusters, microabscesses, and basal cell hyperplasia were all significantly associated with eosinophilic esophagitis as opposed to gastroesophageal reflux disease (P<.0001). The mean expression levels of eotaxin-3 were markedly elevated in patients with eosinophilic esophagitis as compared with the gastroesophageal reflux disease and healthy control groups (731+/-276, 31+/-12, and 1.5+/-0.4 pg/ng beta-actin, respectively; P<.001). Mean expression levels of eotaxins 1 and 2, IL-5, and CCR-3 were also significantly increased in the patients with eosinophilic esophagitis, albeit at lower levels than eotaxin-3. In conclusion, our results highlight the important contribution of eotaxin-3 in the pathogenesis of eosinophilic esophagitis. Determination of eotaxin-3 levels by real-time polymerase chain reaction on paraffinized, formalin-fixed tissue may be a useful test in the differentiation of eosinophilic esophagitis from gastroesophageal reflux disease.
Baishali Bhattacharya; James Carlsten; Edmond Sabo; Sripathi Kethu; Patricia Meitner; Rosemarie Tavares; Shriram Jakate; Shamlal Mangray; Bassam Aswad; Murray B Resnick
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2007-09-27
Journal Detail:
Title:  Human pathology     Volume:  38     ISSN:  0046-8177     ISO Abbreviation:  Hum. Pathol.     Publication Date:  2007 Dec 
Date Detail:
Created Date:  2007-12-06     Completed Date:  2008-01-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421547     Medline TA:  Hum Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1744-53     Citation Subset:  IM    
Department of Pathology, Rhode Island Hospital, Brown Medical School, Lifespan Academic Center, Providence, RI 02903, USA.
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MeSH Terms
Aged, 80 and over
Biological Markers / analysis*
Chemokines, CC / biosynthesis*
Child, Preschool
Diagnosis, Differential
Eosinophilia / diagnosis*,  metabolism
Esophagitis / diagnosis*,  metabolism
Gastroesophageal Reflux / diagnosis*,  metabolism
Gene Expression
Interleukin-5 / biosynthesis
Middle Aged
RNA, Messenger / analysis
Receptors, CCR3 / biosynthesis
Retrospective Studies
Reverse Transcriptase Polymerase Chain Reaction
Grant Support
5 P20 RR017695-02/RR/NCRR NIH HHS
Reg. No./Substance:
0/Biological Markers; 0/CCL26 protein, human; 0/CCR3 protein, human; 0/Chemokines, CC; 0/Interleukin-5; 0/RNA, Messenger; 0/Receptors, CCR3

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