The eosinophilic esophagitis and IgG4-related disease involving the esophagus

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Abstract

The study of eosinophilic esophagitis has become a dynamic field with an evolving understanding of the pathogenesis, diagnosis, and treatment. Immunoglobulin G4 (IgG4)-related disease exhibits systemic involvement but very rarely involves the esophagus. The article presents a clinical case: the history of ulcer and stricture of the esophagus in a young man of 17 years. The patient was finally diagnosed with IgG4-related and eosinophilic esophagitis and showed a good response to corticosteroid therapy. We herein report a rare case of dysphagia associated with IgG4-related disease and eosinophilic. We presented a review of modern data on the relationship of eosinophilic esophagitis and pathological IgG4-response.

About the authors

N. V. Bakulina

Mechnikov North-Western State Medical University

Email: lishchuk.nadezhda@mail.ru
ORCID iD: 0000-0003-4075-4096

д.м.н., зав. каф. внутренних болезней, клинической фармакологии и нефрологии ФГБОУ ВО «СЗГМУ им. И.И. Мечникова»

Russian Federation, Saint Petersburg

V. I. Simanenkov

Mechnikov North-Western State Medical University

Email: lishchuk.nadezhda@mail.ru
ORCID iD: 0000-0002-1956-0070

д.м.н., проф. каф. внутренних болезней, клинической фармакологии и нефрологии ФГБОУ ВО «СЗГМУ им. И.И. Мечникова»

Russian Federation, Saint Petersburg

S. L. Vorobyev

National Center for Clinical Morphological Diagnostics

Email: lishchuk.nadezhda@mail.ru
ORCID iD: 0000-0002-7817-9069

к.м.н., дир. Национального центра клинической морфологической диагностики

Russian Federation, Saint Petersburg

S. V. Tikhonov

Mechnikov North-Western State Medical University

Email: lishchuk.nadezhda@mail.ru
ORCID iD: 0000-0001-5720-3528

к.м.н., доц. каф. внутренних болезней, клинической фармакологии и нефрологии ФГБОУ ВО «СЗГМУ им. И.И. Мечникова

Russian Federation, Saint Petersburg

N. B. Lishchuk

Mechnikov North-Western State Medical University

Author for correspondence.
Email: lishchuk.nadezhda@mail.ru
ORCID iD: 0000-0002-0703-9763

ассистент каф. внутренних болезней, клинической фармакологии и нефрологии ФГБОУ ВО «СЗГМУ им. И.И. Мечникова»

Russian Federation, Saint Petersburg

I. G. Bakulin

Mechnikov North-Western State Medical University

Email: lishchuk.nadezhda@mail.ru
ORCID iD: 0000-0002-6151-2021

д.м.н., проф., зав. каф. пропедевтики внутренних болезней, гастроэнтерологии и диетологии им. С.М. Рысса ФГБОУ ВО «СЗГМУ им. И.И. Мечникова»

Russian Federation, Saint Petersburg

References

  1. Трухманов А.С., Ивашкина Н.Ю. Эозинофильный эзофагит. В кн.: Рациональная фармакотерапия заболеваний органов пищеварения. Под ред. В.Т. Ивашкина. 2-е изд. М.: Литтерра, 2011. [Trukhma- nov AS, Ivashkina NY. Eosinophilic esophagitis. Rational pharmacotherapy of digestive diseases. Edited by Ivashkin VT. 2nd edition. Moscow: Litterra, 2011 (In Russ.)].
  2. Lucendo AJ, Molina-Infante J, Arias Á, et al. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United Eur Gastroenterol J. 2017;5(3):335-58. doi: 10.1177/2050640616689525
  3. Dellon ES, Gonsalves N, Hirano I, et al. ACG clinical guideline: evidenced based approach to the diagnosis and management of esophageal eosinophilia and eosinophilic esophagitis. Am J Gastroenterol. 2013;108:679-92.
  4. Ивашкин В.Т., Маев И.В., Трухманов А.С., Лапина Т.Л. Клинические рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению эозинофильного эзофагита. Рос. журн. гастроэнтерол. гепатол. колопроктол. 2018;28(6) [Ivashkin VT, Mayev IV, Trukhmanov AS, Lapina TL. Clinical recommendations of the Russian Gastroenterological Association for the diagnosis and treatment of eosinophilic esophagitis. Ros. zhurn. gastroenterol. gepatol. koloproktol. 2018;28(6) (In Russ.)]. doi: 10.22416/1382-4376-2018-28-6-84-98
  5. Hirano I, Chan ES, Rank MA, et al. AGA Institute and the Joint Task Force on Allergy-Immunology Practice Parameters Clinical Guidelines for the Management of Eosinophilic Esophagitis. Gastroenterology. 2020;158:1776-86. doi: 10.1053/j.gastro.2020.02.038
  6. O’Shea KM, Aceves SS, Dellon ES, et al. Pathophysiology of Eosinophilic Esophagitis. Gastroenterology. 2018;154(2):333-45. doi: 10.1053/j.gastro.2017.06.065
  7. Arias A, Perez-Martinez I, Tenias JM, Lucendo AJ. Systematic review with meta- analysis: the incidence and prevalence of eosinophilic oesophagitis in children and adults in population-based studies. Aliment Pharmacol Ther. 2016;43:3-15. doi: 10.1111/apt.13441
  8. Dellon ES, Hirano I. Epidemiology and Natural History of Eosinophilic Esophagitis. Gastroenterology. 2018;154(2):319-32. doi: 10.1053/j.gastro.2017.06.06
  9. Кайбышева В.О., Эрдес С.И., Кашин С.В. и др. Эозинофильный эзофагит: собственный опыт диагностики и лечения. Экспериментальная и клиническая гастроэнтерология. 2018;158(10) [Kaibysheva VO, Erdes SI, Kashin SV, et al. Eosinophilic esophagitis: own experience in diagnosis and treatment. Experimental and clinical gastroenterology. 2018;158(10) (In Russ.)].
  10. Straumann A, Katzka DA. Diagnosis and Treatment of Eosinophilic Esophagitis. Gastroenterology. 2018;154(2):346-59. doi: 10.1053/j.gastro.2017.05.066
  11. Collins MH, Martin LJ, Alexander ES, et al. Newly developed and validated eosinophilic esophagitis histology scoring system and evidence that it outperforms peak eosinophil count for disease diagnosis and monitoring. Dis Esophagus. 2016. doi: 10.1111/dote.12470
  12. Khan S, Zhu L, Jiang K, et al. Immunoglobulin G4-Related Disease Manifesting as Isolated, Typical and Nontypical Gastroesophageal Lesion: A Research of Literature Review. Digestion. 2019; p. 1-16. doi: 10.1159/000501513
  13. Ивашкин В.Т., Баранская Е.К., Кайбышева В.О. и др. Клинические рекомендации по диагностике и лечению эозинофильного эзофагита. М., 2013 [Ivashkin VT, Baranskaya EK, Kaibysheva VO, et al. Clinical Practice Guidelines for the diagnosis and treatment of eosinophilic esophagitis. Moscow, 2013 (In Russ.)].
  14. Vinit C, Dieme A, Courbage S, et al. Eosinophilic esophagitis: Pathophysiology, diagnosis, and management. Archives de Pédiatrie. 2019;26(3):182-90. doi: 10.1016/j.arcped.2019.02.005
  15. Rothenberg M. Molecular, Genetic, and Cellular Bases for Treating Eosinophilic Esophagitis. Gastroenterology. 2015;148(6):1143-57. doi: 10.1053/j.gastro.2015.02.002
  16. Dellon ES. The Pathogenesis of Eosinophilic Esophagitis: Beyond the Eosinophil. Digestive Diseases and Sciences. 2013;58(6):1445-8. doi: 10.1007/s10620-013-2679-9
  17. Brown-Whitehorn TF, Spergel JM. The link between allergies and eosinophilic esophagitis: implications for management strategies. Expert Rev Clin Immunol. 2010;6:101-9.
  18. Blanchard C, Wang N, Rothenberg ME. Eosinophilic esophagitis: pathogenesis, genetics, and therapy. J Allergy Clin Immunol. 2006;118:1054-9.
  19. Sherrill JD, Rothenberg ME. Genetic dissection of eosinophilic esophagitis provides insight into disease pathogenesis and treatment strategies. J Allergy Clin Immunol. 2011;128:23-32.
  20. Cianferoni A, Spergel JM, Muir A. Recent advances in the pathological understanding of eosinophilic esophagitis. Expert Rev Gastroenterol Hepatol. 2015;9(12):1501-10. doi: 10.1586/17474124.2015.1094372
  21. Hill DA, Spergel JM. The Immunologic Mechanisms of Eosinophilic Esophagitis. Curr Allergy Asthma Rep. 2016;16(2):9. doi: 10.1007/s11882-015-0592-3
  22. Spergel JM. New genetic links in eosinophilic esophagitis. Genome Med. 2010;2(9):60.
  23. Blanchard C, Mingler MK, Vicario M, et al. IL-13 involvement in eosinophilic esophagitis: transcriptome analysis and reversibility with glucocorticoids. J Allergy Clin Immunol. 2007;120:1292-300.
  24. Mishra A, Rothenberg ME. Intratracheal IL-13 induces eosinophilic esophagitis by an IL-5, eotaxin-1, and STAT6-dependent mechanism. Gastroenterology. 2003;125:1419-27.
  25. Blanchard C, Wang N, Stringer KF, et al. Eotaxin-3 and a uniquely conserved gene-expression profile in eosinophilic esophagitis. J Clin Invest. 2006;116:536-47.
  26. Straumann A, Bauer M, Fischer B, et al. Idiopathic eosinophilic esophagitis is associated with a T(H)2-type allergic inflammatory response. J Allergy Clin Immunol 2001;108:954-61.
  27. Clayton F, Fang JC, Gleich GJ, et al. Eosinophilic esophagitis in adults is associated with IgG4 and not mediated by IgE. Gastroenterology. 2014;147(3):602-9.
  28. Aalberse RC, Platts-Mills TA, Rispens T. The Developmental History of IgE and IgG4 Antibodies in Relation to Atopy, Eosinophilic Esophagitis, and the Modified TH2 Response. Curr Allergy Asthma Rep. 2016;16(6):45.
  29. Wright BL, Kulis MD, Guo R, et al. Food-Specific IgG4 Is Associated with Eosinophilic Esophagitis. J Allergy Clin Immunol. 2016;137(2):Ab232Ab232.
  30. Smyrk TC. Pathological features of IgG4-related sclerosing disease. Curr Opin Rheumatol. 2011;23:74-9.
  31. Khosroshahi A, Deshpande V, Stone JH. The clinical and pathological features of IgG(4)-related disease. Curr Rheumatol Rep. 2011;13:473-81.
  32. Kamisawa T, Funata N, Hayashi Y, et al. A new clinicopathological entity of IgG4-related autoimmune disease. J Gastroenterol. 2003;38:982-4.
  33. Koyabu M, Uchida K, Miyoshi H, et al. Analysis of regulatory T-cells and IgG4-positive plasma cells among patients of IgG4-related sclerosing cholangitis and autoimmune liver diseases. J Gastroenterol. 2010;45:732-41.
  34. Tanaka A, Moriyama M, Nakashima H, et al. Th2 and regulatory immune reactions contributes to IgG4 production and the initiation of Mikulicz’s disease. Arthritis Rheum. 2012;64:254-63.
  35. Deshpande V. IgG4-Related Disease of the Gastrointestinal Tract: A 21st Century Chameleon. Arch Pathol Lab Med. 2015;139(6):742-9.
  36. Буеверов А.О., Кучерявый Ю.А. IgG4-ассоциированная болезнь: монография. М.: Форте Принт, 2014 [Bueverov AO, Kucherya- vyy YuA. IgG4-associated disease: monography. Moscow: Forte Print, 2014 (In Russ.)].
  37. Stone JH, Zen Y, Deshpande V. IgG4-related disease. N Engl J Med. 2012;366(6):539-51.
  38. Davies AM, Sutton BJ. Human IgG4: a structural perspective. Immunol Rev. 2015;268(1):139-59.
  39. Lee H, Joo M, Song TJ, et al. IgG4-related sclerosing esophagitis: a case report. Gastrointest Endosc. 2011;73(4):834-7.
  40. Lopes J, Hochwald SN, Lancia N, et al. Autoimmune esophagitis: IgG4-related tumors of the esophagus. J Gastrointest Surg. 2010;14(6):1031-4.
  41. Oh JH, Lee TH, Kim HS, et al. Esophageal Involvement of Immunoglobulin G4-Related Disease: A Case Report and Literature Review. Medicine (Baltimore). 2015;94(50):e2122.
  42. Zukerberg L, Mahadevan K, Selig M. Oesophageal intrasquamous IgG4 deposits: an adjunctive marker to distinguish eosinophilic oesophagitis from reflux oesophagitis. Histopathology. 2016;68:968-76. doi: 10.1111/his.12892
  43. Parfitt JR, Gregor JC, Suskin NG, et al. Eosinophilic esophagitis in adults: distinguishing features from gastroesophageal reflux disease: a study of 41 patients. Mod Pathol. 2006;19:90-6.
  44. Collins MH. Histopathologic features of eosinophilic esophagitis and eosinophilic gastrointestinal diseases. Gastroenterol Clin North Am. 2014;43:257-68.
  45. Wen T, Dellon ES, Moawad FJ, et al. Transcriptome analysis of proton pump inhibitorresponsive esophageal eosinophilia reveals proton pump inhibitor-reversible allergic inflammation. J Allergy Clin Immunol. 2015;135:187-97.
  46. Rosenberg CE, Mingler MK, Caldwell JM, et al. Esophageal IgG4 levels correlate with histopathologic and transcriptomic features in eosinophilic esophagitis. Allergy. 2018;73(9):1892-901. doi: 10.1111/ all.13486.doi: 10.1111/all.13486
  47. Obiorah I, Hussain A, Palese C, Azumi N. IgG4-related disease involving the esophagus: a clinicopathological study. Dis Esophagus. 2017;30:1-7. doi: 10.1093/dote/dox091
  48. Martinez-Valle F, Fernandez-Codina A, Pinal-Fernandez I, et al. IgG4-related disease: evidence from six recent cohorts. Autoimmun Rev. 2016;15:30274-9.
  49. Brito-Zeron P, Bosch X, Ramos-Casals M, Stone JH. IgG4-related disease: advances in the diagnosis and treatment. Best Pract Res Clin Rheumatol. 2016;30:261-78.
  50. Kamisawa T, Okazaki K, Kawa S, et al. Japanese consensus guidelines for management of autoimmune pancreatitis: III. Treatment and prognosis of AIP. J Gastroenterol. 2010;45:471-7.
  51. Khosroshahi A, Bloch DB, Deshpande V, Stone JH. Rituximab therapy leads to rapid decline of serum IgG4 levels and prompt clinical improvement in IgG4-related systemic disease. Arthritis Rheum. 2010;62:1755-62.
  52. Carruthers MN, Topazian MD, Khosroshahi A, et al. Rituximab for IgG4-related disease: a prospective, open-label trial. Ann Rheum Dis. 2015;74:1171-7.
  53. Della-Torre E, Campochiaro C, Bozzolo EP, et al. Methotrexate for maintenance of remission in IgG4-related disease. Rheumatology. 2015;54:1934-6.
  54. Savarino E, Zentilin P, Marabotto E, et al. Drugs for improving esophageal mucosa defense: where are we now and where are we going? Ann Gastroenterol. 2017;30(6):585-91. doi: 10.20524/aog.2017.0187
  55. Gaffney J, Matou-Nasri S, Grau-Olivares M, Slevin M. Therapeutic applications of hyaluronan. Mol Biosyst. 2010;6(3):437-43.
  56. Ialenti A, Di Rosa M. Hyaluronic acid modulates acute and chronic inflammation. Agents Actions. 1994;43(1-2):44-7.
  57. Nolan A, Baillie C, Badminton J, et al. The efficacy of topical hyaluronic acid in the management of recurrent aphthous ulceration. J Oral Pathol Med. 2006;35:461-5.
  58. Kim Y, Kessler SP, Obery DR, et al. Hyaluronan 35kDa treatment protects mice from Citrobacter rodentium infection and induces epithelial tight junction protein ZO-1 in vivo. Matrix Biol. 2017;62:28-39. doi: 10.1016/j.matbio.2016.11.001
  59. Volpi N. Anti-inflammatory activity of chondroitin sulphate: new functions from an old natural macromolecule. Inflammopharmacology. 2011;19(6):299-306.
  60. Souich P, Garcia AG, Verges J, Montell E. Immunomodulatory and anti-inflammatory effects of chondroitin sulphate. J Cell Mol Med. 2009;13:1451-63.
  61. Bonfils S, Dubrasquet M, Lambling A. The inhibition of peptic proteolysis by various polysaccharides. Rev Fr Etud Clin Biol. 1960;5:71-4.
  62. Galzigna L, Previerocoletti MA. Action of sodium chondroitin sulfate on the enzymatic activity of pepsin. Gazz Med Ital. 1965;124:65-7.
  63. Lenzi G, Rapino P, Ferri S. On the behavior of gastric hydrochloric and peptic activity after administration of sodium chondroitin sulfate. Minerva Med. 1963;54:3421-4.
  64. Ramya Devi D, Sandhya P, Vedha Hari BN. Poloxamer: a novel functional molecule for drug delivery and gene therapy. J Pharm Sci Res. 2013;5:159-65.
  65. Dumortier G, Grossiord JL, Agnely F, Chaumeil JC. A review of poloxamer 407 pharmaceutical and pharmacological characteristics. Pharm Res. 2006;23(12):2709-28.
  66. Palmieri B, Corbascio D, Capone S, Lodi D. Preliminary clinical experience with a new natural compound in the treatment of esophagitis and gastritis: symptomatic effect. Trends Med. 2009;9:219-25.
  67. Palmieri B, Merighi A, Corbascio D, et al. Fixed combination of hyaluronic acid and chondroitin-sulphate oral formulation in a randomized double blind, placebo controlled study for the treatment of symptoms in patients with non-erosive gastroesophageal reflux. Eur Rev Med Pharmacol Sci. 2013;17:3272-8.
  68. Savarino V, Pace F, Scarpignato C, Esoxx Study Group Randomised clinical trial: mucosal protection combined with acid suppression in the treatment of non-erosive reflux disease – efficacy of Esoxx, a hyaluronic acid-chondroitin sulphate based bioadhesive formulation. Aliment Pharmacol Ther. 2017;45:631-42.

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