Mucosal cytokine profiles in paediatric eosinophilic oesophagitis: a case-control study.
BACKGROUND
Eosinophilic oesophagitis is an inflammatory condition characterized by a dense eosinophilic infiltrate. The migration of eosinophils into the oesophagus is influenced by cytokines such as IL-5, IL-13 and eotaxin-3. The aim of this study was to evaluate changes in the cytokine expression profiles (IL-5, IL-13 and eotaxin-3/CCL26) in children after topical steroid treatment.


METHODS
a prospective case-control study was performed in 23 paediatric patients (age 5-16 years) with a histological diagnosis of eosinophilic oesophagitis. Histological evaluation and cytokine levels assay (IL-5, IL-13 and eotaxin-3/CCL26) in the proximal and distal oesophagus were performed before, and after 8 weeks of topical budesonide. Data were compared with a matched healthy control group.


RESULTS
quantitative expression levels of IL-5, IL-13 and eotaxin-3 were significantly higher in the eosinophilic oesophagitis group both compared to healthy subjects (p<0.0001). A significant reduction of the eosinophil infiltrate as well as of IL-5, IL-13 and eotaxin-3 mucosal profiles was observed after steroid treatment both at the proximal and distal oesophagus (p<0.0001).


CONCLUSIONS
IL-5, IL-13 and eotaxin-3/CCL26 are significantly over-expressed in the oesophageal epithelium of children with eosinophilic oesophagitis. Topical steroid treatment (inhaled and swallowed budesonide) can induce clinical response with partial mucosal remission.
Department of Pediatrics, Paediatric Endoscopy Unit, University of Messina, Italy.
Claudio
C
Romano
Department of Pediatrics, Paediatric Endoscopy Unit, University of Messina, Italy.
Andrea
A
Chiaro
Department of Pediatrics, Paediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Italy.
Sandra
S
Lucarelli
Department of Pediatrics, Paediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Italy.
Cinzia
C
Santarelli
Department of Pediatrics, Paediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Italy.
Salvatore
S
Cucchiara
Paediatric Gastroenterology Unit, Maggiore Hospital, Crema, Italy.
Tiziana
T
Guadagnini
Department of Pediatrics, University Federico II, Naples, Italy.
Erasmo
E
Miele
Department of Pediatrics, Paediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Italy. Electronic address: giovanni.dinardo@uniroma1.it.
Giovanni
G
Di Nardo
D000287:Administration, Topical; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D019819:Budesonide / Q000008:administration & dosage; D016022:Case-Control Studies; D000075906:Chemokine CCL26; D019742:Chemokines, CC / Q000378:metabolism; D002648:Child; D016207:Cytokines / Q000378:metabolism*; D057765:Eosinophilic Esophagitis / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology*; D004947:Esophagus / Q000378:metabolism*; D005260:Female; D006801:Humans; D018793:Interleukin-13 / Q000378:metabolism; D015848:Interleukin-5 / Q000378:metabolism; D008297:Male; D009092:Mucous Membrane / Q000378:metabolism; D011446:Prospective Studies
D000893:Anti-Inflammatory Agents; C120429:CCL26 protein, human; D000075906:Chemokine CCL26; D019742:Chemokines, CC; D016207:Cytokines; D018793:Interleukin-13; D015848:Interleukin-5; D019819:Budesonide
Cytokines; Eosinophilic oesophagitis; Eotaxin-3; IL-13; IL-5; Steroid treatment