Mechanisms of allergy and clinical immunologyEosinophilic gastrointestinal disease and peanut allergy are alternatively associated with IL-5+ and IL-5− TH2 responses
Section snippets
Subjects
Subjects were 18 to 60 years of age. Subjects with EG had peak tissue eosinophil counts of ≥44 eosinophils/high power field (hpf) in gastric or duodenal biopsies (see this article's Table E1 in the Online Repository at www.jacionline.org). The diagnosis of EG was based on typical gastrointestinal symptoms, tissue eosinophilia in stomach or duodenal biopsy specimens, and the exclusion of other causes of gut eosinophilia, including helminth infection. Crohn disease was excluded by lack of typical
Results
Of the 17 subjects with EG enrolled, 13 were designated as having AEG and 4 as having NA-EG on the basis of the presence of multiple food hypersensitivities in the former (Table I). Subjects with PA had significantly higher peanut-specific IgE than did subjects with AEG (16 vs 1.2 kIU/L; P = .028).
After serial gating to identify viable CD4+ T cells (Fig 1, A-D), we used the rapid upregulation of CD154 and cytokines to identify food antigen–specific T cells.18, 19 CD154+, cytokine+ cells were
Discussion
Both classic food allergy and EGIDs are associated with IgE and TH2 responses to food allergens, yet have distinct clinical manifestations of anaphylaxis and tissue eosinophilia, respectively. In this study we examined whether these clinical differences are associated with different TH2 cytokine expression patterns. We thus investigated food allergen–specific T-cell cytokine responses at the single-cell level and demonstrate that TH2 responses can be divided into 2 subpopulations on the basis
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Supported by the National Institute of Allergy and Infectious Diseases, NIH, Intramural Research Program.
Protocol clinicaltrials.gov identifiers: NCT00084097, NCT00001756, NCT00557895.
Disclosure of potential conflict of interest: C. Prussin owned stock in Affymetrix and receives research support from NIAID/NIH. The rest of the authors have declared that they have no conflict of interest.