Abstract
We previously demonstrated that the percentage of blood eosinophils that are associated with platelets and thus positive for CD41 (integrin αIIb-subunit) correlates with and predicts peak eosinophil count (PEC) in biopsies of eosinophilic esophagitis (EoE) patients after treatment. Thus, flow cytometric determination of CD41+ eosinophils is a potential measure of EoE disease activity. Determinants of association of platelets with eosinophils and other leukocytes in EoE are largely unknown. The objectives of this study were to test the hypotheses that platelets associate with blood leukocytes other than eosinophils in EoE and that such associations also predict EoE activity. Whole blood flow cytometry was performed on samples from 25 subjects before and after two months of standard of care EoE treatment. CD41 positivity of cells within gates for eosinophils, neutrophils, monocytes, lymphocytes, and natural killer cells was compared. We found that percent CD41+ neutrophils, monocytes, and eosinophils correlated with one another such that principal component analysis of the five cell types identified “myeloid” and “lymphoid” factors. Percent CD41+ neutrophils or monocytes, or the myeloid factor, like CD41+ eosinophils, correlated with PEC after treatment, and CD41+ neutrophils or the myeloid factor predicted PEC < 6/high power field after treatment, albeit with lower area under the curve than for CD41+ eosinophils. We conclude that the processes driving platelets to associate with eosinophils in EoE also drive association of platelets with neutrophils and monocytes and that association of platelets with all three cell types is related to disease activity. Clinicaltrials.gov identifier: NCT02775045.
Highlights
Eosinophilic esophagitis (EoE) is a chronic inflammatory disease that is characterized by symptoms of esophageal dysfunction and eosinophilic infiltration of the esophageal mucosa and has increased in incidence and prevalence during the last couple of decades [1,2]
We recently demonstrated by flow cytometry that the percentage of blood eosinophils positive for CD41 correlated with peak eosinophil count (PEC) per microscopic high power field (HPF) of esophageal biopsies from EoE patients after standard of care treatment [3]
Percent CD41+ neutrophils, monocytes, lymphocytes, or natural killer (NK) cells was determined by examining gatings (S1 Fig) in archived flow cytometry data gathered on whole blood samples from 25 University of Wisconsin (UW)-Madison EoE patients at visits 1 (V1) before and 2 (V2) eight weeks after standard of care EoE treatment [3]
Summary
Eosinophilic esophagitis (EoE) is a chronic inflammatory disease that is characterized by symptoms of esophageal dysfunction and eosinophilic infiltration of the esophageal mucosa and has increased in incidence and prevalence during the last couple of decades [1,2]. The standard for assessing disease activity is endoscopy and pathological examination of esophageal biopsy specimens. Platelet-leukocyte association in EoE collection and analysis, decision to publish, or preparation of the manuscript
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