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Th17 cells reflect colon submucosal pathologic changes in active eosinophilic granulomatosis with polyangiitis.

Tsurikisawa N, Oshikata C, Tsuburai T, Sugano S, Nakamura Y, Shimoda T, Tamama S, Adachi K, Horita A, Saito I, Saito H - BMC Immunol. (2015)

Bottom Line: Th17 cells (%) and serum ICAM-1 levels at onset were greater in EGPA than in CEP.Eosinophilia and colonic submucosal edematous change were greater in EGPA than in CEP.The mechanism of vasculitis in EGPA appears related to increases in serum Th17 cell numbers and ICAM-1 levels and decreases in VEGF levels.

View Article: PubMed Central - PubMed

Affiliation: Departments of Allergy and Respirology, Sagamihara, Kanagawa, Japan. n-tsurikisawa@sagamihara-hosp.gr.jp.

ABSTRACT

Background: Chronic eosinophilic pneumonia (CEP) or eosinophilic gastroenteritis (EG), or both, with asthma precede the onset of eosinophilic granulomatosis with polyangiitis (EGPA) in half of all EGPA patients. It is not known what determines whether patients with CEP or with EG following asthma will develop EGPA.

Methods: We studied 17 EGPA patients and 12 patients with CEP but without EGPA. We assayed serum ICAM-1, VCAM-1, and VEGF, and the percentage of peripheral blood CD4(+) T cells producing IL-17 (Th17 cells), at both onset and remission. We also examined the numbers of submucosal eosinophils and the basement membrane-to-crypt and crypt-to-crypt distance to evaluate edema in the colon submucosa at onset and remission in EGPA and at onset in CEP.

Results: Nine of 12 (75.0%) CEP patients had symptoms or endoscopic findings. Colonic submucosal eosinophil counts and edema in EGPA at onset were greater than at remission or in CEP at onset. Th17 cells (%) and serum ICAM-1 levels at onset were greater in EGPA than in CEP. In EGPA, peripheral blood Th17 cells (%) were significantly correlated with serum ICAM-1 level, colonic submucosal eosinophil count, and degree of edematous change; inversely correlated with serum VEGF level; but not correlated with VCAM-1 level.

Conclusions: Eosinophilia and colonic submucosal edematous change were greater in EGPA than in CEP. The mechanism of vasculitis in EGPA appears related to increases in serum Th17 cell numbers and ICAM-1 levels and decreases in VEGF levels.

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Related in: MedlinePlus

Pathological findings in the large intestine in patients with eosinophilic granulomatosis with polyangiitis (EGPA) (a–c) or chronic eosinophilic pneumonia (CEP) (d–f). Evidence of bleeding was present in the submucosa (a). The number of eosinophils in the submucosa was higher in patients with EGPA (a–c) than in those with CEP (d–f). Edematous changes (expressed as the width of the basement membrane-to-crypt distance or the crypt-to-crypt distance) were more severe in patients with EGPA than in those with CEP
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Fig2: Pathological findings in the large intestine in patients with eosinophilic granulomatosis with polyangiitis (EGPA) (a–c) or chronic eosinophilic pneumonia (CEP) (d–f). Evidence of bleeding was present in the submucosa (a). The number of eosinophils in the submucosa was higher in patients with EGPA (a–c) than in those with CEP (d–f). Edematous changes (expressed as the width of the basement membrane-to-crypt distance or the crypt-to-crypt distance) were more severe in patients with EGPA than in those with CEP

Mentions: We could not find any necrotizing vasculitis or granuloma in small size samples of submucosa from patients with either EGPA or CEP. At disease onset there were significantly more eosinophils in the colonic submucosa of EGPA patients than of CEP patients (P < 0.05) (Table 2, Fig. 2). Submucosal eosinophil counts in EGPA were significantly lower at remission than at onset (P < 0.05). The localization of submucosal edema varied within each patient (Fig. 3). The basement membrane-to-crypt interval and crypt-to-crypt distance reflected the degree of edema in the colonic submucosa. The basement membrane-to-crypt and crypt-to-crypt distance at disease onset were significantly greater in EGPA patients than in CEP patients (P < 0.01) (Fig. 2). In CEP patients, there were few, if any, edematous changes in the submucosa. The basement membrane-to-crypt and crypt-to-crypt distance in EGPA patients were significantly shorter at remission than at onset (P < 0.01) (Table 2).Fig. 2


Th17 cells reflect colon submucosal pathologic changes in active eosinophilic granulomatosis with polyangiitis.

Tsurikisawa N, Oshikata C, Tsuburai T, Sugano S, Nakamura Y, Shimoda T, Tamama S, Adachi K, Horita A, Saito I, Saito H - BMC Immunol. (2015)

Pathological findings in the large intestine in patients with eosinophilic granulomatosis with polyangiitis (EGPA) (a–c) or chronic eosinophilic pneumonia (CEP) (d–f). Evidence of bleeding was present in the submucosa (a). The number of eosinophils in the submucosa was higher in patients with EGPA (a–c) than in those with CEP (d–f). Edematous changes (expressed as the width of the basement membrane-to-crypt distance or the crypt-to-crypt distance) were more severe in patients with EGPA than in those with CEP
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4696253&req=5

Fig2: Pathological findings in the large intestine in patients with eosinophilic granulomatosis with polyangiitis (EGPA) (a–c) or chronic eosinophilic pneumonia (CEP) (d–f). Evidence of bleeding was present in the submucosa (a). The number of eosinophils in the submucosa was higher in patients with EGPA (a–c) than in those with CEP (d–f). Edematous changes (expressed as the width of the basement membrane-to-crypt distance or the crypt-to-crypt distance) were more severe in patients with EGPA than in those with CEP
Mentions: We could not find any necrotizing vasculitis or granuloma in small size samples of submucosa from patients with either EGPA or CEP. At disease onset there were significantly more eosinophils in the colonic submucosa of EGPA patients than of CEP patients (P < 0.05) (Table 2, Fig. 2). Submucosal eosinophil counts in EGPA were significantly lower at remission than at onset (P < 0.05). The localization of submucosal edema varied within each patient (Fig. 3). The basement membrane-to-crypt interval and crypt-to-crypt distance reflected the degree of edema in the colonic submucosa. The basement membrane-to-crypt and crypt-to-crypt distance at disease onset were significantly greater in EGPA patients than in CEP patients (P < 0.01) (Fig. 2). In CEP patients, there were few, if any, edematous changes in the submucosa. The basement membrane-to-crypt and crypt-to-crypt distance in EGPA patients were significantly shorter at remission than at onset (P < 0.01) (Table 2).Fig. 2

Bottom Line: Th17 cells (%) and serum ICAM-1 levels at onset were greater in EGPA than in CEP.Eosinophilia and colonic submucosal edematous change were greater in EGPA than in CEP.The mechanism of vasculitis in EGPA appears related to increases in serum Th17 cell numbers and ICAM-1 levels and decreases in VEGF levels.

View Article: PubMed Central - PubMed

Affiliation: Departments of Allergy and Respirology, Sagamihara, Kanagawa, Japan. n-tsurikisawa@sagamihara-hosp.gr.jp.

ABSTRACT

Background: Chronic eosinophilic pneumonia (CEP) or eosinophilic gastroenteritis (EG), or both, with asthma precede the onset of eosinophilic granulomatosis with polyangiitis (EGPA) in half of all EGPA patients. It is not known what determines whether patients with CEP or with EG following asthma will develop EGPA.

Methods: We studied 17 EGPA patients and 12 patients with CEP but without EGPA. We assayed serum ICAM-1, VCAM-1, and VEGF, and the percentage of peripheral blood CD4(+) T cells producing IL-17 (Th17 cells), at both onset and remission. We also examined the numbers of submucosal eosinophils and the basement membrane-to-crypt and crypt-to-crypt distance to evaluate edema in the colon submucosa at onset and remission in EGPA and at onset in CEP.

Results: Nine of 12 (75.0%) CEP patients had symptoms or endoscopic findings. Colonic submucosal eosinophil counts and edema in EGPA at onset were greater than at remission or in CEP at onset. Th17 cells (%) and serum ICAM-1 levels at onset were greater in EGPA than in CEP. In EGPA, peripheral blood Th17 cells (%) were significantly correlated with serum ICAM-1 level, colonic submucosal eosinophil count, and degree of edematous change; inversely correlated with serum VEGF level; but not correlated with VCAM-1 level.

Conclusions: Eosinophilia and colonic submucosal edematous change were greater in EGPA than in CEP. The mechanism of vasculitis in EGPA appears related to increases in serum Th17 cell numbers and ICAM-1 levels and decreases in VEGF levels.

Show MeSH
Related in: MedlinePlus