IL-13 involvement in eosinophilic esophagitis: transcriptome analysis and reversibility with glucocorticoids.
BACKGROUND
Eosinophilic esophagitis (EE) is an emerging worldwide disease that mimics gastroesophageal reflux disease. Early studies have established that esophageal eosinophilia occurs in association with T(H)2 allergic responses, and we recently identified an EE-specific esophageal transcriptome that included eotaxin-3.


OBJECTIVE
We sought to determine the mechanism by which this T(H)2 response leads to EE.


METHODS
Real-time PCR and microarray analysis were performed on RNA extracted from esophageal biopsy specimens and primary esophageal epithelial cell cultures stimulated with IL-13 (0-100 ng/mL). Transient transfections in esophageal cell lines were performed with plasmids containing the luciferase gene driven by eotaxin-3 promoter fragments and modified forms of signal transducer and activator of transcription 6.


RESULTS
The IL-13 mRNA level was markedly increased (16-fold) in esophageal biopsy specimens from patients with EE compared with those from healthy individuals. Furthermore, IL-13 treatment of primary esophageal epithelial cells was sufficient to induce a global-expression transcript profile that remarkably overlapped with the EE-specific esophageal transcriptome. In addition, esophageal epithelial cells markedly produce eotaxin-3 after IL-13 stimulation through a transcriptional mechanism dependent on signal transducer and activator of transcription 6. Lastly, increased IL-13 mRNA levels and the EE transcriptome were largely reversible with glucocorticoid treatment in vivo.


CONCLUSIONS
Taken together, we propose that the pathogenesis of EE is mediated by an IL-13-stimulated keratinocyte-derived transcriptome that is largely reversible with corticosteroid treatment. Furthermore, we identify an in vivo IL-13-induced transcriptome that has potential utility for target assessment after anti-IL-13 therapeutics.


CONCLUSIONS
IL-13-induced pathways and genes are fundamental processes in the cause and manifestations of EE; as such, therapeutic agents that interfere with IL-13 might be particularly useful for disease treatment.
Blanchard
Carine
C
Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
Mingler
Melissa K
MK
Vicario
Maria
M
Abonia
J Pablo
JP
Wu
Yi Ying
YY
Lu
Thomas X
TX
Collins
Margaret H
MH
Putnam
Philip E
PE
Wells
Susanne I
SI
Rothenberg
Marc E
ME
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D045744:Cell Line, Tumor; D004802:Eosinophilia / Q000188:drug therapy* / Q000235:genetics / Q000276:immunology*; D004941:Esophagitis / Q000188:drug therapy* / Q000235:genetics / Q000276:immunology*; D020869:Gene Expression Profiling; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D018793:Interleukin-13 / Q000096:biosynthesis / Q000235:genetics / Q000502:physiology*; D015603:Keratinocytes / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D012333:RNA, Messenger / Q000096:biosynthesis / Q000235:genetics; D015398:Signal Transduction / Q000187:drug effects / Q000235:genetics / Q000276:immunology
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D018793:Interleukin-13; D012333:RNA, Messenger