title: Barrett's oesophagus is characterized by a predominantly humoral inflammatory response.
abstract: Barrett's oesophagus (BO) is thought to be an intermediate step in the progression from reflux oesophagitis (RO) to oesophageal adenocarcinoma. Premalignant conditions that develop in the presence of chronic inflammation are often associated with the development of a more pronounced humoral immune response during progression of the disease. The aim of this study was to determine whether BO is also associated with a more pronounced humoral immune response when compared to RO. Immunohistochemical studies were performed to quantify the mean numbers of Th2 effector cells (plasma cells and mast cells) and Th1 effector cells (macrophages and CD8(+) T cells) to detect the antibody classes produced by plasma cells (IgA, IgG, IgM or IgE) and to determine the presence of isolated lymph follicles [segregated B and T cell areas, follicular dendritic cells (CD23) and expression of CXCL13] in 124 oesophageal biopsies from 20 patients with BO and 20 patients with RO. The proportion of Th2 effector cells was higher in BO than in RO, mainly due to higher numbers of plasma cells and mast cells in BO (p < 0.001). Most plasma cells in BO and RO expressed IgG, but several IgE(+) plasma cells were detected in BO: these were rare in RO. In line with this, isolated lymph follicles were observed in 4/20 (20%) patients with BO, but not in RO. We therefore conclude that the inflammatory response is skewed towards a more pronounced humoral immune response when RO progresses to BO. It may be that this shift, which is similar to that found in other chronic inflammatory conditions, contributes to an increased cancer risk in BO.
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.
authors.forename: Leon M G
authors.initials: LM
authors.lastname: Moons
authors.forename: Johannes G
authors.initials: JG
authors.lastname: Kusters
authors.forename: Evelien
authors.initials: E
authors.lastname: Bultman
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Kuipers
authors.forename: Herman
authors.initials: H
authors.lastname: van Dekken
authors.forename: Wendy M W
authors.initials: WM
authors.lastname: Tra
authors.forename: Alex
authors.initials: A
authors.lastname: Kleinjan
authors.forename: Jaap
authors.initials: J
authors.lastname: Kwekkeboom
authors.forename: Arnoud H M
authors.initials: AH
authors.lastname: van Vliet
authors.forename: Peter D
authors.initials: PD
authors.lastname: Siersema
mesh_terms: D000368:Aged; D000917:Antibody Formation / Q000276:immunology*; D001471:Barrett Esophagus / Q000276:immunology*; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D054382:Chemokine CXCL13; D019743:Chemokines, CXC / Q000276:immunology; D020566:Dendritic Cells, Follicular / Q000276:immunology; D004848:Epithelium / Q000276:immunology; D004941:Esophagitis / Q000276:immunology; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D007073:Immunoglobulin E / Q000276:immunology; D007074:Immunoglobulin G / Q000276:immunology; D007075:Immunoglobulin M / Q000276:immunology; D007150:Immunohistochemistry / Q000379:methods; D018655:Lymphocyte Count / Q000379:methods; D008264:Macrophages / Q000276:immunology; D008297:Male; D008407:Mast Cells / Q000276:immunology; D008875:Middle Aged; D009092:Mucous Membrane / Q000276:immunology; D010950:Plasma Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology
chemical_list: C110663:CXCL13 protein, human; D054382:Chemokine CXCL13; D019743:Chemokines, CXC; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007073:Immunoglobulin E