title: Dietary treatment modulates mast cell phenotype, density, and activity in adult eosinophilic oesophagitis.
abstract: BACKGROUND
  Mast cells (MCs) are abundant in the inflammatory infiltrate in eosinophilic oesophagitis (EoE), but decrease with disease remission. However, their phenotype, role in the pathophysiology of the disease, and modulation after effective dietary therapy are still unclear.
  
  
  OBJECTIVE
  To define the phenotype of oesophageal MCs, their modulation through dietary therapy, and their association with clinical manifestations of EoE.
  
  
  METHODS
  Oesophageal mucosal samples from 10 adult patients with EoE obtained before and after effective six-food elimination diet (SFED) therapy, as well as from 10 control subjects were analysed. Eosinophil and MC density were quantified. Gene expression of chemoattractants for eosinophils (CCL11, CCL24, and CCL26), MCs (SCF), and their receptors (CCR3 and SCFR, respectively) were assessed by means of qPCR. Gene and protein expression of specific MC proteases (CPA3, CMA, and TPSB2) were evaluated with qPCR and immunofluorescence. Clinical manifestations and atopic background were recorded.
  
  
  RESULTS
  MC density was significantly increased in EoE compared with controls, decreasing after dietary treatment (18.6 to 1.44 cells/hpf, respectively; P < 0.001). The MCTC subtype predominated in the oesophageal mucosa (90%) in both patients with EoE and controls. Gene expression of MC-related proteases, eotaxins, and SCF were up-regulated in patients with EoE, but significantly decreased after therapy, regardless of atopic background. Epithelial peaks of MCs and eosinophils were significantly associated (ρ = 0.80) in EoE and correlated with the symptom score (ρ = 0.78). Gene expression of MC proteases and eotaxins also correlated with the symptom score (P < 0.05).
  
  
  CONCLUSIONS
  MC and its proteases seem to play a relevant role in the pathophysiology and symptoms of EoE, which can be reversed after effective dietary treatment.
authors: Research Unit, Hospital General La Mancha Centro, Alcázar de San Juan, Spain.
authors: Á
authors: Á
authors: Arias
authors: Department of Gastroenterology, Hospital General de Tomelloso, Tomelloso, Spain.
authors: A J
authors: http://orcid.org/0000-0003-1183-1072
authors: AJ
authors: Lucendo
authors: Idipaz Research Laboratory, Institute of Medical and Molecular Genetics (INGEMM), Hospital Universitario La Paz, Madrid, Spain.|Center for Biomedical Research on Rare Diseases (CIBERER), Instituto Carlos III, Madrid, Spain.
authors: P
authors: P
authors: Martínez-Fernández
authors: Digestive Diseases Research Unit, Laboratory of Neuro-immuno-gastroenterology, Department of Gastroenterology, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d´Hebron, Barcelona, Spain.
authors: A M
authors: AM
authors: González-Castro
authors: Digestive Diseases Research Unit, Laboratory of Neuro-immuno-gastroenterology, Department of Gastroenterology, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d´Hebron, Barcelona, Spain.
authors: M
authors: M
authors: Fortea
authors: Department of Allergy, Hospital General de Tomelloso, Tomelloso, Spain.
authors: J
authors: J
authors: González-Cervera
authors: Department of Pathology, Hospital General La Mancha Centro, Alcázar de San Juan, Spain.
authors: J L
authors: JL
authors: Yagüe-Compadre
authors: Department of Pathology, Hospital General La Mancha Centro, Alcázar de San Juan, Spain.
authors: T
authors: T
authors: Mota-Huertas
authors: Digestive Diseases Research Unit, Laboratory of Neuro-immuno-gastroenterology, Department of Gastroenterology, Vall d'Hebron Institut de Recerca, Hospital Universitari Vall d´Hebron, Barcelona, Spain.|Networked Biomedical Research Center for Hepatic and Digestive Diseases (CIBERehd), Spain.
authors: M
authors: M
authors: Vicario
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers; D001706:Biopsy; D002634:Chemotaxis, Leukocyte; D057765:Eosinophilic Esophagitis / Q000175:diagnosis* / Q000178:diet therapy* / Q000209:etiology; D004804:Eosinophils; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D015870:Gene Expression; D006801:Humans; D016130:Immunophenotyping; D007958:Leukocyte Count; D008297:Male; D008407:Mast Cells / Q000276:immunology* / Q000378:metabolism*; D008875:Middle Aged; D009092:Mucous Membrane / Q000378:metabolism / Q000473:pathology; D010641:Phenotype; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: CCL24; CCL26; CCR3; Eosinophilic oesophagitis; SCF; SCFR; carboxypeptidase A3; chemokines CCL21; chymase; dietary treatment; mast cells; six-food elimination diet; tryptase