Esophageal epithelial immunoglobulin G is an important marker for the diagnosis and management of pediatric eosinophilic esophagitis
Abstract Background and Aim Our primary aim was to describe the prevalence of immunoglobulin G (IgG) and its subclass IgG4 in immunohistochemistry staining in esophageal biopsy specimens of children with eosinophilic esophagitis (EoE) compared with that of specimens from children with gastroesophage...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-06-01
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| Series: | JGH Open |
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| Online Access: | https://doi.org/10.1002/jgh3.12752 |
| _version_ | 1811335200682016768 |
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| author | Syed Ahsan Rizvi Chukwuemeka Oriala Laura E Irastorza Jeffrey Bornstein Shuan Li Yamen Smadi |
| author_facet | Syed Ahsan Rizvi Chukwuemeka Oriala Laura E Irastorza Jeffrey Bornstein Shuan Li Yamen Smadi |
| author_sort | Syed Ahsan Rizvi |
| collection | DOAJ |
| description | Abstract Background and Aim Our primary aim was to describe the prevalence of immunoglobulin G (IgG) and its subclass IgG4 in immunohistochemistry staining in esophageal biopsy specimens of children with eosinophilic esophagitis (EoE) compared with that of specimens from children with gastroesophageal reflux disease (GERD). Methods Esophageal biopsy specimens from children with EoE or GERD were stained prospectively for IgG and IgG4 antibodies. Subjects with EoE were divided into cohorts with either active EoE or EoE in remission. Active EoE cases were further divided into proton pump inhibitor responsive (PPI‐r) and PPI‐nonresponsive (PPI‐nr) subgroups. Demographic, clinical, and histologic data were compared among groups, including quantified IgG and IgG4 staining, peak eosinophil count, eosinophil‐derived neurotoxin levels, and EoE endoscopic reference score. Results Seventy‐nine children (aged 10.6 ± 5.6 years; 68% male) were enrolled. IgG‐positive cell counts were significantly elevated in those with active EoE (n = 29, 3 [interquartile range, IQR: 2–6]/high‐powered field [HPF]), compared with those having EoE remission (n = 25, 1 [IQR: 0–2]/HPF; P = 0.002) and those with GERD (n = 25, 0 [IQR: 0–0.25]/HPF, P = <0.0001). IgG‐positive cell counts were significantly higher in the PPI‐r (n = 15, 5 [IQR: 2.5–11]/HPF) subgroup, compared with the PPI‐nr subgroup (n = 11, 3 [IQR: 1.5–3.5]/HPF; P = 0.041) at baseline endoscopy. Conclusion Initial esophageal tissue biopsy specimens from pediatric subjects with active EoE showed a significant increase in IgG‐positive staining compared with tissue from subjects in EoE remission or with GERD. There was higher positivity of IgG‐stained cells in the PPI‐r subgroup compared with the PPI‐nr subgroup. |
| first_indexed | 2024-04-13T17:20:36Z |
| format | Article |
| id | doaj.art-97c9887381cf40809c9317f2650f9036 |
| institution | Directory Open Access Journal |
| issn | 2397-9070 |
| language | English |
| last_indexed | 2024-04-13T17:20:36Z |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj.art-97c9887381cf40809c9317f2650f90362022-12-22T02:38:00ZengWileyJGH Open2397-90702022-06-016640240710.1002/jgh3.12752Esophageal epithelial immunoglobulin G is an important marker for the diagnosis and management of pediatric eosinophilic esophagitisSyed Ahsan Rizvi0Chukwuemeka Oriala1Laura E Irastorza2Jeffrey Bornstein3Shuan Li4Yamen Smadi5Center for Digestive Health and Nutrition Arnold Palmer Hospital for Children Orlando Florida USADepartment of Pathology Orlando Health Orlando Florida USACenter for Digestive Health and Nutrition Arnold Palmer Hospital for Children Orlando Florida USACenter for Digestive Health and Nutrition Arnold Palmer Hospital for Children Orlando Florida USADepartment of Pathology Orlando Health Orlando Florida USACenter for Digestive Health and Nutrition Arnold Palmer Hospital for Children Orlando Florida USAAbstract Background and Aim Our primary aim was to describe the prevalence of immunoglobulin G (IgG) and its subclass IgG4 in immunohistochemistry staining in esophageal biopsy specimens of children with eosinophilic esophagitis (EoE) compared with that of specimens from children with gastroesophageal reflux disease (GERD). Methods Esophageal biopsy specimens from children with EoE or GERD were stained prospectively for IgG and IgG4 antibodies. Subjects with EoE were divided into cohorts with either active EoE or EoE in remission. Active EoE cases were further divided into proton pump inhibitor responsive (PPI‐r) and PPI‐nonresponsive (PPI‐nr) subgroups. Demographic, clinical, and histologic data were compared among groups, including quantified IgG and IgG4 staining, peak eosinophil count, eosinophil‐derived neurotoxin levels, and EoE endoscopic reference score. Results Seventy‐nine children (aged 10.6 ± 5.6 years; 68% male) were enrolled. IgG‐positive cell counts were significantly elevated in those with active EoE (n = 29, 3 [interquartile range, IQR: 2–6]/high‐powered field [HPF]), compared with those having EoE remission (n = 25, 1 [IQR: 0–2]/HPF; P = 0.002) and those with GERD (n = 25, 0 [IQR: 0–0.25]/HPF, P = <0.0001). IgG‐positive cell counts were significantly higher in the PPI‐r (n = 15, 5 [IQR: 2.5–11]/HPF) subgroup, compared with the PPI‐nr subgroup (n = 11, 3 [IQR: 1.5–3.5]/HPF; P = 0.041) at baseline endoscopy. Conclusion Initial esophageal tissue biopsy specimens from pediatric subjects with active EoE showed a significant increase in IgG‐positive staining compared with tissue from subjects in EoE remission or with GERD. There was higher positivity of IgG‐stained cells in the PPI‐r subgroup compared with the PPI‐nr subgroup.https://doi.org/10.1002/jgh3.12752eosinophil‐derived neurotoxineosinophilic esophagitisgastroesophageal reflux diseaseimmunoglobulin Gimmunoglobulin G4immunohistochemistry |
| spellingShingle | Syed Ahsan Rizvi Chukwuemeka Oriala Laura E Irastorza Jeffrey Bornstein Shuan Li Yamen Smadi Esophageal epithelial immunoglobulin G is an important marker for the diagnosis and management of pediatric eosinophilic esophagitis JGH Open eosinophil‐derived neurotoxin eosinophilic esophagitis gastroesophageal reflux disease immunoglobulin G immunoglobulin G4 immunohistochemistry |
| title | Esophageal epithelial immunoglobulin G is an important marker for the diagnosis and management of pediatric eosinophilic esophagitis |
| title_full | Esophageal epithelial immunoglobulin G is an important marker for the diagnosis and management of pediatric eosinophilic esophagitis |
| title_fullStr | Esophageal epithelial immunoglobulin G is an important marker for the diagnosis and management of pediatric eosinophilic esophagitis |
| title_full_unstemmed | Esophageal epithelial immunoglobulin G is an important marker for the diagnosis and management of pediatric eosinophilic esophagitis |
| title_short | Esophageal epithelial immunoglobulin G is an important marker for the diagnosis and management of pediatric eosinophilic esophagitis |
| title_sort | esophageal epithelial immunoglobulin g is an important marker for the diagnosis and management of pediatric eosinophilic esophagitis |
| topic | eosinophil‐derived neurotoxin eosinophilic esophagitis gastroesophageal reflux disease immunoglobulin G immunoglobulin G4 immunohistochemistry |
| url | https://doi.org/10.1002/jgh3.12752 |
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