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TOPLINE:

Adults with eosinophilic esophagitis (EoE) showed elevated levels of various food allergen–specific antibodies other than immunoglobulin G4 (IgG4), challenging the focus on IgG4 as a solitary marker of the disease.

METHODOLOGY:

• Researchers analyzed data from 147 adults recruited at EoE clinics of the University Hospital Zürich, Zürich, Switzerland.
• Participants were categorized into those with active EoE (mean age, 40 years), those with inactive EoE (mean age, 46.4 years), and control individuals without EoE (mean age, 38.9 years).
• Blood samples were collected to measure the levels of total IgG and various antibody isotypes against common food allergens such as casein, whey, wheat, and egg extracts.

TAKEAWAY:

• Patients with EoE had significantly higher casein-specific IgG levels than control individuals, but casein-specific IgG4 levels did not significantly differ between the groups.
• Levels of wheat- and egg-specific IgG and IgG4 differed significantly across groups.
• When the researchers focused on the role of cow’s milk allergens, they found, for instance, that patients with active EoE had significantly higher levels of various specific IgG and IgA antibodies against the casein allergen Bos d 9 than control individuals.
• Both patients with active EoE and inactive EoE had elevated IgG2, IgG4, and IgA1 levels against beta-casein allergen Bos d 11 (A1 variant), but total IgG increased only in those with active EoE.

IN PRACTICE:

“Our findings reveal a broad food-elicited humoral immune response in EoE, which challenges the prevailing focus on IgG4 as a solitary marker of disease,” the authors wrote. “By highlighting the presence of multiple antibody isotypes against cow’s milk allergens and suggesting local antibody production, our study lays the groundwork for future investigations into the immunopathogenesis of EoE.”

SOURCE:

Willem van de Veen, PhD, with the University of Zurich’s Swiss Institute of Allergy and Asthma Research in Davos, Switzerland, was the corresponding author of the study, wh ich was published online on April 14 in Clinical & Experimental Allergy. 

LIMITATIONS:

The study had a cross-sectional design and a relatively small control group of 14 participants. The researchers lacked detailed data on allergy testing for each patient. Additionally, the study included only adults, limiting its generalizability to children. 

DISCLOSURES:

The research was supported by Promedica Stiftung, the Swiss National Science Foundation, and the EoE Foundation in Switzerland. Some of the authors disclosed serving on advisory boards for research centers or receiving research grants, consulting fees, or speaking fees from pharmaceutical companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.