Original articleAlimentary tractProton Pump Inhibitors Partially Restore Mucosal Integrity in Patients With Proton Pump Inhibitor–Responsive Esophageal Eosinophilia but Not Eosinophilic Esophagitis
Section snippets
Study Subjects
In this prospective study, we included 16 adult patients with suspected EoE (>15 eosinophils/high-power field [eos/hpf], predominant symptoms of dysphagia and/or food impaction, and endoscopic signs of EoE), and 11 healthy controls. Based on peak eosinophil counts after PPI, patients were divided into 2 subgroups: responders (PPI-REE, ≤10 eos/hpf) and nonresponders (EoE, >10 eos/hpf) (Figure 1). Patients were recruited consecutively from the outpatient clinic of our hospital. Healthy controls
Subject characteristics
We consecutively included 16 patients (13 men) with suspected EoE, and 11 controls (7 men). No patients were excluded or dropped out after enrolment in the study. The median age at first endoscopy was 42 years (IQR, 32–46 y) for patients and 35 years (IQR, 29–53 y) for controls (P = .6). None of the controls had abnormalities on endoscopy. Based on peak eosinophil counts after PPI, 8 patients (6 men) were classified as PPI-REE (range, 0–10 eos/hpf), and 8 patients (7 men) were classified as EoE
Discussion
This study investigated the esophageal mucosal integrity in patients with PPI-REE and EoE. By using structural and functional measurements we found that the esophageal mucosal integrity was impaired, to a similar extent, in patients with PPI-REE and EoE. Furthermore, acid suppression with PPIs partially restored mucosal integrity parameters and decreased inflammation in patients with PPI-REE, but not in patients with EoE.
In this study, we showed passage of molecules that were 40,000 daltons
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Conflicts of interest These authors disclose the following: Albert Bredenoord has received research funding from AstraZeneca, Endostim, Medical Measurement Systems, and Shire, and has received speaker fees from Medical Measurement Systems and Shire; and Wouter de Jonge has received funding from Glaxo Smith Kline. The remaining authors disclose no conflicts.
Funding A.J.B. and W.J.d.J. are supported by The Netherlands Organization for Scientific Research (Nederlandse Organisatie voor Wetenschappelijk Onderzoek).