Cysteinyl Leukotriene Levels in Esophageal Mucosal Biopsies of Children with Eosinophilic Inflammation: Are They All the Same?

Authors: Gupta, Sandeep K.1; Peters-Golden, Marc2; Fitzgerald, Joseph F.1; Croffie, Joseph M.1; Pfefferkorn, Marian D.1; Molleston, Jean P.1; Corkins, Mark R.1; Lim, Joel R.1

Source: The American Journal of Gastroenterology, Volume 101, Number 5, May 2006 , pp. 1125-1128(4)

Publisher: Blackwell Publishing

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Abstract:

OBJECTIVES: Allergic eosinophilic esophagitis (AEE) is characterized by intense eosinophilic inflammation of the esophageal mucosa. Cysteinyl leukotrienes (CysLT) are eosinophil chemoattractants. We studied CysLT levels in esophageal mucosa of children with AEE and controls.

METHODS: CysLT levels (pg CysLT/μg protein) were quantified by Enzyme-linked Immunosorbent Assay (ELISA) on endoscopically obtained esophageal mucosal biopsies.

RESULTS: Twelve children with AEE (eight boys, mean age 6.6 yr, range 1.0–14.5 yr) and 10 controls (six boys, mean age 9.56 yr, range 1.08–15.08 yr) were enrolled. None were on anti-LT or corticosteroid therapy. All controls had histologically normal mucosal biopsies of the esophagus, stomach, and duodenum. Patients with AEE had intense eosinophilic inflammation of the esophageal mucosa (mean 39 eosinophils/hpf, range 15–70 eosinophils/hpf) and a normal 24-h pH probe study. CysLT levels were similar between the two groups: mean levels were 12.44 (median 10.87, range 2.54–28.29) in AEE patients and 9.52 (median 9.26, range 1.71–21.64) in controls. CysLT levels did not correlate with the degree of esophageal eosinophilic inflammation. Incidentally, five patients with eosinophilic gastroduodenitis, in addition to esophagitis, were enrolled; their CysLT levels were statistically higher than those of controls.

CONCLUSIONS: This is the first study to examine CysLT levels in esophageal mucosal biopsies of children with AEE and normal children. CysLT levels in AEE patients are similar to those in controls, and independent of the severity of inflammation. While this would argue against the use of CysLT antagonists in the treatment of AEE, further studies into the expression of the CysLT receptor itself are needed.

(Am J Gastroenterol 2006;101:1125–1128)

Document Type: Research article

DOI: 10.1111/j.1572-0241.2006.00557.x

Affiliations: 1: Division of Pediatric Gastroenterology, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana 2: Division of Pulmonary and Critical Care Medicine, University of Michigan Health System, Ann Arbor, Michigan

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