Cysteinyl leukotriene levels in esophageal mucosal biopsies of children with eosinophilic inflammation: are they all the same?
OBJECTIVE
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/microg 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.
Gupta
Sandeep K
SK
Division of Pediatric Gastroenterology, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis 46202, USA.
Peters-Golden
Marc
M
Fitzgerald
Joseph F
JF
Croffie
Joseph M
JM
Pfefferkorn
Marian D
MD
Molleston
Jean P
JP
Corkins
Mark R
MR
Lim
Joel R
JR
D000293:Adolescent; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D004382:Duodenitis / Q000378:metabolism; D004802:Eosinophilia / Q000378:metabolism; D004941:Esophagitis / Q000378:metabolism*; D004947:Esophagus / Q000737:chemistry* / Q000473:pathology; D005260:Female; D005756:Gastritis / Q000378:metabolism; D006801:Humans; D007223:Infant; D015289:Leukotrienes / Q000032:analysis*; D008297:Male; D009092:Mucous Membrane / Q000737:chemistry / Q000473:pathology
D015289:Leukotrienes