Eosinophilic esophagitis (EoE) is an allergic disease of the esophagus. Its incidence has increased with the higher prevalence of Gastroesophageal reflux disease (GERD). Both the conditions have similar clinical presentations, though the pathogenesis appears to be different. Forkhead box P3 (FOXP3)-positive regulatory T cells (Tregs) have been reported to have a key role in immune tolerance and control of Th2-biased responses in some allergic diseases.

A study was thus conducted to determine the differences in Treg induction between EoE and GERD and ascertain if the difference was associated with the clinicopathological findings of patients with EoE.

In all, 30 patients with EoE and 30 patients with GERD were included in the study. Investigators compared patient characteristics, including endoscopic and pathological findings, between the two groups. Immunohistochemistry helped detect T lymphocytes and Tregs. Tregs were identified using CD3 + FOXP3 + staining, while T cells were defined as CD3 + cells.

EoE patients had a significantly lower ratio of Tregs/CD3 + T cells in the esophageal epithelium compared to GERD patients (9.9% vs. 23.6%, P = 0.0000012). On comparing the ratio of Tregs/CD3 + T cells by age, gender, endoscopic findings, and histological findings in patients with EoE showed that there was a significant difference in gender.

To conclude, Treg induction was found to be impaired, and the effect was more marked in male adult patients with EoE compared to GERD patients.

Source: Ayaki M, Manabe N, Nakamura J, et al. A Retrospective Study of the Differences in the Induction of Regulatory T Cells between Adult Patients with Eosinophilic Esophagitis and Gastroesophageal Reflux Disease. Dig Dis Sci. 2022 Jan 15.