Title: Mo1181 G-EOE-RD: EXTENT OF EOSINOPHILIC ESOPHAGITIS PREDICTS RESPONSE TO TREATMENT
Abstract: Background: Immunoglobulin E (IgE)-mediated allergic reaction is considered to be involved in the pathogenesis of eosinophilic esophagitis (EoE).However, the pattern of allergic sensitization in EoE has not been elucidated.A diagnostic panel to evaluate serum multiple allergen-specific IgE is widely used as a screening for allergic diseases.The aim of this study is to analyze the sensitization pattern in patients with esophageal eosinophilia (EE) and its relationship with clinical features.Methods: A total of 67 EE patients including 59 patients with EoE and 8 patients with asymptomatic EE were analyzed retrospectively.They underwent View allergy 39 (Thermo Fisher Scientific, Tokyo, Japan), a diagnostic panel to evaluate 39 kinds of serum allergen-specific IgE in our department from April 2016 to October 2018.Cluster analysis was performed using the k-means method with values of antibody titer as variables.Allergens were classified into aeroallergens (outdoor and indoor allergens) and food allergens (plant and animal allergens).Clinical symptoms, findings of blood test, and endoscopic findings based on endoscopic reference score (EREFS) were evaluated.Results: We could classified patients with EE into 3 distinct clusters based on the expression patterns of multiple allergen-specific IgE.As a feature of sensitization pattern for each cluster, cluster 1 (43 cases) was hyposensitized to most allergens except some pollen such as cedar.Cluster 2 (14 cases) was highly sensitized to outdoor and plant allergens.Cluster 3 (10 cases) was highly sensitized to many types of allergens, especially indoor and animal allergens.The presence of dysphagia (cluster 1, 2, and 3; 34.9%, 71.4%, and 80.0%, respectively, p < 0.01), total titer of serum IgE antibody (120 IU/mL, 350 IU/mL, and 1650 IU/mL, p < 0.01), and total EREFS score (3.5, 7.4, and 9.5, p < 0.01) were significantly different among 3 clusters, which indicated that each cluster had a different clinical feature.Especially, cluster 3 had significantly higher EREFS score of rings (0.3 vs. 1.4,p < 0.01) and dysphagia (34.9% vs. 80.0%, p = 0.041) as compared to cluster 1.Therefore, cluster 3 might have a characteristic of esophageal fibrostenotic remodeling.Conclusion: Three distinct patterns of allergenspecific IgE-mediated sensitization may provide new understanding in the pathophysiology of EE including EoE.
Publication Year: 2020
Publication Date: 2020-05-01
Language: en
Type: article
Indexed In: ['crossref']
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