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Low expression of ICAM-1 in blood eosinophils in patients with active eosinophilic esophagitis

Pérez-Lucendo I1, Gómez Torrijos E2, Donado P3, Melero R1, Feo-Brito F2, Urra JM1

1Immunology, Hospital General Universitario de Ciudad Real, Spain.
2Allergology Medicine, Hospital General Universitario de Ciudad Real, Spain.
3Pediatric Medicine, Hospital General Universitario de Ciudad Real, Spain.

J Investig Allergol Clin Immunol 2021; Vol. 31(4)
doi: 10.18176/jiaci.0489

Background: Eosinophilic esophagitis (EoE) is a chronic and isolated inflammation of the esophagus, defined by an important infiltration of eosinophilic leukocytes. Only the histopathological study determines the diagnosis and evolution of the disease. Therefore, patients must undergo a large number of esophageal biopsies, with the risk involved in the procedure and the necessary resources.
Objective: The presence of active circulating eosinophils, quantifiable through the expression of specific proteins of cellular activation in their membrane, could be a concordant parameter with the histopathological findings that are currently the only valid parameters in EoE studies.
Methods: The activity of peripheral blood eosinophils from patients with EoE was analyzed by identifying five surface molecules (CD69, IL-5Rα, CD44, ICAM-1, CD63) expressed by the active eosinophils by flow cytometry. The results were compared with the infiltrate of eosinophils present in patient’s esophageal biopsies.
Results: ICAM-1 significantly reduced in patients with active EoE compared to no active EoE patients, allergic patients and healthy controls. In these patients, an inverse correlation between the number of eosinophils present in the esophageal biopsy and the percentage of ICAM-1 expression in peripheral blood eosinophils was observed. For the rest of the molecules studied no difference was observed.
Conclusion: The expression of ICAM-1 in blood eosinophils could be a non-invasive marker useful for the diagnosis and assessment of patients with EoE.

Key words: Eosinophilic esophagitis, Eosinophils, Flow cytometry, ICAM-1

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