PMID- 25112708
OWN - NLM
STAT- MEDLINE
DCOM- 20141209
LR  - 20220317
IS  - 1365-2036 (Electronic)
IS  - 0269-2813 (Linking)
VI  - 40
IP  - 8
DP  - 2014 Oct
TI  - Proton pump inhibitor-responsive oesophageal eosinophilia correlates with 
      downregulation of eotaxin-3 and Th2 cytokines overexpression.
PG  - 955-65
LID - 10.1111/apt.12914 [doi]
AB  - BACKGROUND: The molecular basis and effects of proton pump inhibitor (PPI) 
      therapy on PPI-responsive oesophageal eosinophilia (PPI-REE) and eosinophilic 
      oesophagitis (EoE) remain unknown. AIM: To compare symptom-histological and 
      cytokine gene expression in PPI-REE and EoE patients, at baseline and after 
      specific treatment. METHODS: In consecutive adult patients with an EoE phenotype 
      (dysphagia/food impaction, typical endoscopic findings and > 15 eos/HPF), gene 
      expression of eotaxin-3, IL-13, and IL-5 were determined in distal and proximal 
      oesophagus, at baseline and after omeprazole 40 mg b.d. for 8 weeks. PPI-REE was 
      defined by clinicohistological response. PPI nonresponders (EoE) were offered 
      treatment with topical steroids. RESULTS: Fifty three patients were re-evaluated 
      on PPI therapy. 23 patients (43%) had PPI-REE and 30 patients (57%) had EoE. At 
      baseline, eotaxin-3/IL-13/IL-5 gene expression was indistinguishable between EoE 
      and PPI-REE, excepting increased IL-5 expression in proximal oesophagus (12.54 
      vs. 57, P = 0.029). PPI therapy significantly decreased eotaxin-3/IL-13 in 
      PPI-REE, at both oesophageal sites (P </= 0.008), and IL-5 in distal (P = 0.016), 
      but not in proximal oesophagus. Patients with steroid-responsive EoE also showed 
      a significant decrease in eotaxin-3/IL-5 expression at both oesophageal sites. In 
      EoE patients, initial PPI trial significantly decreased distal oesophageal 
      eosinophilia (63.78 to 41.79 eos/HPF, P = 0.025) and led to symptom remission in 
      16%, but did not influence Th2 markers. CONCLUSIONS: Baseline cytokine gene 
      expression in PPI-REE was nearly indistinguishable from EoE. PPI therapy 
      significantly downregulated oesophageal eotaxin-3/Th2-cytokine gene expression in 
      PPI-REE, similarly to that seen in steroid-responsive EoE. A subset of EoE 
      patients showed clinicohistological improvement on PPI therapy.
CI  - (c) 2014 John Wiley & Sons Ltd.
FAU - Molina-Infante, J
AU  - Molina-Infante J
AD  - Department of Gastroenterology, Hospital San Pedro de Alcantara, Caceres, Spain.
FAU - Rivas, M D
AU  - Rivas MD
FAU - Hernandez-Alonso, M
AU  - Hernandez-Alonso M
FAU - Vinagre-Rodriguez, G
AU  - Vinagre-Rodriguez G
FAU - Mateos-Rodriguez, J M
AU  - Mateos-Rodriguez JM
FAU - Duenas-Sadornil, C
AU  - Duenas-Sadornil C
FAU - Perez-Gallardo, B
AU  - Perez-Gallardo B
FAU - Ferrando-Lamana, L
AU  - Ferrando-Lamana L
FAU - Fernandez-Gonzalez, N
AU  - Fernandez-Gonzalez N
FAU - Banares, R
AU  - Banares R
FAU - Zamorano, J
AU  - Zamorano J
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20140811
PL  - England
TA  - Aliment Pharmacol Ther
JT  - Alimentary pharmacology & therapeutics
JID - 8707234
RN  - 0 (CCL26 protein, human)
RN  - 0 (Chemokine CCL26)
RN  - 0 (Chemokines, CC)
RN  - 0 (IL13 protein, human)
RN  - 0 (IL5 protein, human)
RN  - 0 (Interleukin-13)
RN  - 0 (Interleukin-5)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Chemokine CCL26
MH  - Chemokines, CC/genetics
MH  - Down-Regulation
MH  - Eosinophilia/drug therapy/*genetics
MH  - Eosinophilic Esophagitis/drug therapy/*genetics/immunology
MH  - Female
MH  - Gene Expression Regulation/*drug effects
MH  - Humans
MH  - Interleukin-13/genetics
MH  - Interleukin-5/genetics
MH  - Male
MH  - Middle Aged
MH  - Proton Pump Inhibitors/*pharmacology/therapeutic use
MH  - Th2 Cells/immunology
MH  - Young Adult
EDAT- 2014/08/13 06:00
MHDA- 2014/12/15 06:00
CRDT- 2014/08/13 06:00
PHST- 2014/06/20 00:00 [received]
PHST- 2014/07/09 00:00 [revised]
PHST- 2014/07/22 00:00 [revised]
PHST- 2014/07/22 00:00 [accepted]
PHST- 2014/08/13 06:00 [entrez]
PHST- 2014/08/13 06:00 [pubmed]
PHST- 2014/12/15 06:00 [medline]
AID - 10.1111/apt.12914 [doi]
PST - ppublish
SO  - Aliment Pharmacol Ther. 2014 Oct;40(8):955-65. doi: 10.1111/apt.12914. Epub 2014 
      Aug 11.