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首页> 外文期刊>Journal of clinical gastroenterology >IgG4 is Elevated in Eosinophilic Esophagitis but Not in Gastroesophageal Reflux Disease Patients
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IgG4 is Elevated in Eosinophilic Esophagitis but Not in Gastroesophageal Reflux Disease Patients

机译：IgG4在嗜酸性食管炎中升高，但不在胃食管反流病患者中升高

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Background:For eosinophilic esophagitis (EoE) recently an association with immunoglobulin (Ig)G4 rather than IgE has been reported. Gastroesophageal reflux disease (GERD) is the most important differential diagnosis of EoE. We compared esophageal IgG4 plasma cell infiltration and serum IgG4 levels of EoE patients (before and after budesonide therapy) with GERD patients.Methods:Prospectively collected serum samples of 17 EoE patients before and after 8 weeks of therapy with budesonide (1mg BID) were analyzed for total and antigen-specific IgG4 and IgE levels. Also, immunohistochemical analysis of total and IgG4-positive plasma cells was performed on esophageal biopsies of these patients. In total, 14 GERD patients without histologic proof of eosinophilic infiltration were taken as a control group.Results:Total IgG4 serum levels in EoE patients were significantly higher than in GERD patients (121.0 vs. 71.2mg/dL; P=0.038) and decreased under budesonide therapy (121.0 vs. 104.2mg/dL; P=0.019). IgE levels did not differ significantly between all groups. In EoE patients also a high number of esophageal IgG4-positive plasma cells was detected and significantly reduced under therapy (29.1 vs. 0.1 IgG4-positive cells; P<0.001). In GERD patients no relevant esophageal plasma cell infiltration could be seen.Conclusions:In EoE patients elevated systemic IgG4 serum levels compared with GERD patients can be seen and decrease under topical steroid therapy. Also, local IgG4 plasma cells expression is high in EoE, but not in GERD patients and normalize under therapy. These findings are further proof for a possible association of EoE with IgG4.
机译：背景：对于嗜酸性食管炎（EOE），最近报道了与免疫球蛋白（Ig）G4而不是IgE的关系。胃食管反流疾病（GERD）是eoe最重要的鉴别诊断。与GERD患者进行食管IgG4血浆细胞浸润和血清IgG4血清IgG4水平的EOE患者（前后）。方法：分析了在疗法（1mg BID）治疗前后17名EOE患者的血清样品（1mg BID）。对于总和抗原特异性IgG4和IgE水平。此外，对这些患者的食管活组织检查进行了总量和IgG4阳性血浆细胞的免疫组化分析。总共14个GERD患者没有组织学证明嗜酸性渗透性浸润的患者作为对照组在预皂苷疗法（121.0 vs.104.2mg / dl; p = 0.019）下。所有群体之间的IgE水平没有显着差异。在EOE患者中，在治疗中检测到大量食道IgG4阳性血浆细胞并显着降低（29.1 vs.01g4阳性细胞; P <0.001）。在GERD患者中，没有相关的食管血浆细胞浸润。结论：在EOE患者中，与GERD患者相比，在肠果类固醇治疗下可以看到和降低升高的系统性IgG4血清水平。此外，局部IgG4血浆细胞表达在eoe中高，但不在GERD患者中，并在治疗下标准化。这些发现是eoe与IgG4的可能缔合的进一步证明。

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