Proton-Pump Inhibitor Treatment in Eosinophilic Esophagitis is Associated with Decreased Eosinophil Degranulation

Abstract

Eosinophilic esophagitis (EoE) is an increasingly recognized disorder whose diagnosis is based on histologic demonstration of eosinophilic inflammation. We previously reported improvement of symptoms in children with EoE on long-term proton-pump inhibitor (PPI) monotherapy despite persistent eosinophilic inflammation. We sought to determine whether PPI monotherapy in children with EoE is associated with decreased eosinophil degranulation. Ten children with EoE had esophageal biopsies assessed for eosinophil, mast cell and Langerhans cell concentration and eosinophil degranulation at diagnosis and following PPI treatment. There was no significant difference in cell concentrations between initial and one-year follow-up. A significant decrease in number of free lying granules was observed at the one-year follow-up biopsies. Prolonged PPI therapy in EoE is associated with decreased eosinophil degranulation.