Immunoglobulin E (IgE)-mediated allergic sensitization patterns are associated with clinical features of patients with esophageal eosinophilia (EE). Therefore, use of a diagnostic panel that detects multiple allergen-specific IgEs can help to classify these patients, according to a study published in the Journal of Gastroenterology.
Allergen sensitization patterns have been identified in patients diagnosed with IgE-mediated allergic disorders, such as bronchial asthma and seasonal allergic rhinitis. However, the precise patterns of allergic sensitization in patients with EE are not clear.
Researchers in Japan sought to identify allergic sensitization patterns of patients diagnosed with EE using a diagnostic panel of multiple target antigen/allergens and to identify relationships between allergen patterns and clinicopathological features associated with EE.
The researchers classified patients with EE into 3 distinct groups: cluster 1 (n=62) who were minimally sensitized to most allergens except pollen and house dust, cluster 2 (n=30) who were hypersensitized to outdoor and plant allergens, and cluster 3 (n=15) who were hypersensitized to most allergens, especially indoor and animal allergens.
They found that dysphagia was reported among those in clusters 1, 2, and 3 at 35.5%, 46.7%, and 73.3%, respectively, (P=.028) and eosinophilic esophagitis endoscopic reference scores (EREFS) at 3.0, 6.0, and 8.0, respectively, (P<.001) differed significantly between the 3 clusters. Those in cluster 3 had a significantly higher prevalence of dysphagia (35.5% vs 73.3%; P=.030), and higher EREFS with respect to rings (0.3 vs 0.9; P=.003) and strictures (0.0 vs 0.13; P=.011) compared with cluster 1.
The authors concluded, “A diagnostic panel that facilitates the identification of multiple allergen-specific IgEs can be used to generate a consistent explanation of the heterogeneous phenotypes of patients diagnosed with EE.”
Nakata A, Tanaka F, Nadatani Y, et al. Classification of patients with esophageal eosinophilia by patterns of sensitization revealed by a diagnostic assay for multiple allergen-specific IgEs. J Gastroenterol. Published online February 16, 2021. doi:10.1007/s00535-021-01766-3