title: Th17 cells reflect colon submucosal pathologic changes in active eosinophilic granulomatosis with polyangiitis.
abstract: BACKGROUND
  Chronic eosinophilic pneumonia (CEP) or eosinophilic gastroenteritis (EG), or both, with asthma precede the onset of eosinophilic granulomatosis with polyangiitis (EGPA) in half of all EGPA patients. It is not known what determines whether patients with CEP or with EG following asthma will develop EGPA.
  
  
  METHODS
  We studied 17 EGPA patients and 12 patients with CEP but without EGPA. We assayed serum ICAM-1, VCAM-1, and VEGF, and the percentage of peripheral blood CD4(+) T cells producing IL-17 (Th17 cells), at both onset and remission. We also examined the numbers of submucosal eosinophils and the basement membrane-to-crypt and crypt-to-crypt distance to evaluate edema in the colon submucosa at onset and remission in EGPA and at onset in CEP.
  
  
  RESULTS
  Nine of 12 (75.0%) CEP patients had symptoms or endoscopic findings. Colonic submucosal eosinophil counts and edema in EGPA at onset were greater than at remission or in CEP at onset. Th17 cells (%) and serum ICAM-1 levels at onset were greater in EGPA than in CEP. In EGPA, peripheral blood Th17 cells (%) were significantly correlated with serum ICAM-1 level, colonic submucosal eosinophil count, and degree of edematous change; inversely correlated with serum VEGF level; but not correlated with VCAM-1 level.
  
  
  CONCLUSIONS
  Eosinophilia and colonic submucosal edematous change were greater in EGPA than in CEP. The mechanism of vasculitis in EGPA appears related to increases in serum Th17 cell numbers and ICAM-1 levels and decreases in VEGF levels.
authors.affiliation: Departments of Allergy and Respirology, Sagamihara, Kanagawa, Japan. n-tsurikisawa@sagamihara-hosp.gr.jp.
authors.forename: Naomi
authors.initials: N
authors.lastname: Tsurikisawa
authors.affiliation: Departments of Allergy and Respirology, Sagamihara, Kanagawa, Japan. c-oshikata@sagamihara-hosp.gr.jp.
authors.forename: Chiyako
authors.initials: C
authors.lastname: Oshikata
authors.affiliation: Departments of Allergy and Respirology, Sagamihara, Kanagawa, Japan. t-tuburai@sagamihara-hosp.gr.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tsuburai
authors.affiliation: Department of Medical Gastroenterology, Sagamihara, Kanagawa, Japan. s-sugano@sagamihara-hosp.gr.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sugano
authors.affiliation: Department of Medical Gastroenterology, Sagamihara, Kanagawa, Japan. y-nakamura@sagamihara-hosp.gr.jp.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Department of Medical Gastroenterology, Sagamihara, Kanagawa, Japan. t-shimoda@sagamihara-hosp.gr.jp.
authors.forename: Takuya
authors.initials: T
authors.lastname: Shimoda
authors.affiliation: Department of Medical Gastroenterology, Sagamihara, Kanagawa, Japan. s-tamama@sagamihara-hosp.gr.jp.
authors.forename: Shunpei
authors.initials: S
authors.lastname: Tamama
authors.affiliation: Department of Medical Gastroenterology, Sagamihara, Kanagawa, Japan. k-adachi@sagamihara-hosp.gr.jp.
authors.forename: Ken
authors.initials: K
authors.lastname: Adachi
authors.affiliation: Department of Diagnostic Pathology, Sagamihara, Kanagawa, Japan. a-horita@sagamihara-hosp.gr.jp.
authors.forename: Ayako
authors.initials: A
authors.lastname: Horita
authors.affiliation: Department of Diagnostic Pathology, Sagamihara, Kanagawa, Japan. i-saito@sagamihara-hosp.gr.jp.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Saito
authors.affiliation: Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara, Kanagawa, 252-0392, Japan. h-saito@sagamihara-hosp.gr.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Saito
mesh_terms: D000328:Adult; D015415:Biomarkers; D003106:Colon / Q000276:immunology* / Q000378:metabolism / Q000473:pathology*; D015897:Comorbidity; D016099:Endoscopy, Gastrointestinal; D004751:Enteritis / Q000150:complications / Q000175:diagnosis / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D004802:Eosinophilia / Q000150:complications / Q000175:diagnosis / Q000276:immunology* / Q000378:metabolism / Q000473:pathology*; D005260:Female; D005756:Gastritis / Q000150:complications / Q000175:diagnosis / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D014890:Granulomatosis with Polyangiitis / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D007413:Intestinal Mucosa / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011657:Pulmonary Eosinophilia / Q000150:complications / Q000175:diagnosis / Q000276:immunology / Q000378:metabolism / Q000473:pathology; D058504:Th17 Cells / Q000276:immunology* / Q000378:metabolism; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
chemical_list: D015415:Biomarkers; D019010:Vascular Cell Adhesion Molecule-1; D042461:Vascular Endothelial Growth Factor A; D018799:Intercellular Adhesion Molecule-1