Epidermal allergen sensitization primes for aeroallergen induced eosinophilic esophagitis (EE)

Abstract

Rationale Aeroallergen induced experimental asthma is accompanied by esophageal eosinophilia, which mimics the pathophysiological changes observed in individuals with eosinophilic esophagitis (EE). Since epidermal allergen sensitization has been recently implicated in the pathogenesis of experimental asthma, we examined the ability of epidermal sensitization to also result in esophageal eosinophilia. Methods We developed a novel model for skin sensitization in which 100μg of Aspergilus fumigatus antigen (Asp) or Saline was topically applied to the shaved upper backs of mice on six occasions over the course of two weeks. One week following sensitization, mice from both groups were given a single intranasal challenge with Asp or Saline (n=4 mice per treatment). Results Epidermal sensitization to Asp caused a 4 to 5-fold increase in serum IgE levels compared to Saline. Additionally, following a single intranasal Asp challenge, epidermal sensitization to Asp resulted in pulmonary inflammation and significantly elevated eosinophils in both bronchoalveolar lavage fluid (BALF) (57.6 ± 8.4×104 vs. 0.2 ± 0.17×104 per lung) and in the esophagus (24.3 ± 7 vs. 4.4 ± 3 per mm2) compared to Saline-challenged mice (p=0.001). Conclusion Epidermal sensitization can prime for aeroallergen induced eosinophilic esophagitis providing a novel link between cutaneous and mucosal allergic responses.