Abstract
Rationale: The diagnosis of eosinophilic esophagitis (EE) is based on the number of eosinophils/high power field (HPF) in esophageal biopsies. The goal of this work is to evaluate whether the number of eosinophils seen by H&E stain correlates with eosinophil activation as measured by extracellular (xc) major basic protein (MBP) and EDN deposition in esophageal tissues and to assess the correlation with the levels of EDN in gastric secretions and reported patient dysphagia.Methods: Biopsies from patients with either EE or dysphagia were obtained from mid esophagus. Eosinophil counts/HPF were obtained by examination of H&E stained sections. Immunofluorescence (IF) staining for MBP and EDN was performed to semiquantitatively evaluate the number of eosinophils and the amount of cellular and xcMBP and xcEDN deposition; the slides were scored by two independent observers on a scale from 0 to 3. Gastric aspirates obtained during the same endoscopic procedure were analyzed. Patients completed a dysphagia questionnaire.ResultsA high correlation coefficient (cc) was found between all the parameters tested. Cc between the H&E stain eosinophil count and the IF cellular MBP (cMBP) was 0.82829; eosinophil count and xcMBP, 0.80398; and eosinophil count and gastric EDN (gEDN), 0.76840. xcMBP had a higher cc (0.707566) with gEDN than cMBP did (cc = 0.580222). In patients with EE the dysphagia score correlated with gEDN (cc = .0.72106).ConclusionsEsophageal eosinophil counts correlated with markers of eosinophilic degranulation. Moreover, gEDN was correlated with esophageal eosinophil counts and esophageal markers of degranulation, and patients' dysphagia score. gEDN is a good marker for assessing clinical severity of EE. Rationale: The diagnosis of eosinophilic esophagitis (EE) is based on the number of eosinophils/high power field (HPF) in esophageal biopsies. The goal of this work is to evaluate whether the number of eosinophils seen by H&E stain correlates with eosinophil activation as measured by extracellular (xc) major basic protein (MBP) and EDN deposition in esophageal tissues and to assess the correlation with the levels of EDN in gastric secretions and reported patient dysphagia. : The diagnosis of eosinophilic esophagitis (EE) is based on the number of eosinophils/high power field (HPF) in esophageal biopsies. The goal of this work is to evaluate whether the number of eosinophils seen by H&E stain correlates with eosinophil activation as measured by extracellular (xc) major basic protein (MBP) and EDN deposition in esophageal tissues and to assess the correlation with the levels of EDN in gastric secretions and reported patient dysphagia. Methods: Biopsies from patients with either EE or dysphagia were obtained from mid esophagus. Eosinophil counts/HPF were obtained by examination of H&E stained sections. Immunofluorescence (IF) staining for MBP and EDN was performed to semiquantitatively evaluate the number of eosinophils and the amount of cellular and xcMBP and xcEDN deposition; the slides were scored by two independent observers on a scale from 0 to 3. Gastric aspirates obtained during the same endoscopic procedure were analyzed. Patients completed a dysphagia questionnaire. : Biopsies from patients with either EE or dysphagia were obtained from mid esophagus. Eosinophil counts/HPF were obtained by examination of H&E stained sections. Immunofluorescence (IF) staining for MBP and EDN was performed to semiquantitatively evaluate the number of eosinophils and the amount of cellular and xcMBP and xcEDN deposition; the slides were scored by two independent observers on a scale from 0 to 3. Gastric aspirates obtained during the same endoscopic procedure were analyzed. Patients completed a dysphagia questionnaire. ResultsA high correlation coefficient (cc) was found between all the parameters tested. Cc between the H&E stain eosinophil count and the IF cellular MBP (cMBP) was 0.82829; eosinophil count and xcMBP, 0.80398; and eosinophil count and gastric EDN (gEDN), 0.76840. xcMBP had a higher cc (0.707566) with gEDN than cMBP did (cc = 0.580222). In patients with EE the dysphagia score correlated with gEDN (cc = .0.72106). A high correlation coefficient (cc) was found between all the parameters tested. Cc between the H&E stain eosinophil count and the IF cellular MBP (cMBP) was 0.82829; eosinophil count and xcMBP, 0.80398; and eosinophil count and gastric EDN (gEDN), 0.76840. xcMBP had a higher cc (0.707566) with gEDN than cMBP did (cc = 0.580222). In patients with EE the dysphagia score correlated with gEDN (cc = .0.72106). ConclusionsEsophageal eosinophil counts correlated with markers of eosinophilic degranulation. Moreover, gEDN was correlated with esophageal eosinophil counts and esophageal markers of degranulation, and patients' dysphagia score. gEDN is a good marker for assessing clinical severity of EE. Esophageal eosinophil counts correlated with markers of eosinophilic degranulation. Moreover, gEDN was correlated with esophageal eosinophil counts and esophageal markers of degranulation, and patients' dysphagia score. gEDN is a good marker for assessing clinical severity of EE.
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