T-helper 2 cytokines, transforming growth factor β1, and eosinophil products induce fibrogenesis and alter muscle motility in patients with eosinophilic esophagitis

Florian Rieder, Ilche Nonevski, Jie Ma, Zhufeng Ouyang, Gail West, Cheryl Protheroe, Giovanni Depetris, Anja Schirbel, James Lapinski, John Goldblum, Tracey Bonfield, Rocio Lopez, Karen Harnett, James Lee, Ikuo Hirano, Gary Falk, Piero Biancani, Claudio Fiocchi*

*Corresponding author for this work

Research output: Contribution to journalArticle

69 Scopus citations

Abstract

Background & Aims Patients with eosinophilic esophagitis (EoE) often become dysphagic from the combination of organ fibrosis and motor abnormalities. We investigated mechanisms of dysphagia, assessing the response of human esophageal fibroblasts (HEFs), human esophageal muscle cells (HEMCs), and esophageal muscle strips to eosinophil-derived products. Methods Biopsy specimens were collected via endoscopy from the upper, middle, and lower thirds of the esophagus of 18 patients with EoE and 21 individuals undergoing endoscopy for other reasons (controls). Primary cultures of esophageal fibroblasts and muscle cells were derived from 12 freshly resected human esophagectomy specimens. Eosinophil distribution was investigated by histologic analyses of full-thickness esophageal tissue. Active secretion of EoE-related mediators was assessed from medium underlying mucosal biopsy cultures. We quantified production of fibronectin and collagen I by HEF and HEMC in response to eosinophil products. We also measured the expression of intercellular adhesion molecule-1 and vascular cell adhesion molecule-1 by, and adhesion of human eosinophils to, HEFs and HEMCs. Eosinophil products were tested in an esophageal muscle contraction assay. Results Activated eosinophils were present in all esophageal layers. Significantly higher concentrations of eosinophil-related mediators were secreted spontaneously in mucosal biopsy specimens from patients with EoE than controls. Exposure of HEFs and HEMCs to increasing concentrations of eosinophil products or co-culture with eosinophils caused HEFs and HEMCs to increase secretion of fibronectin and collagen I; this was inhibited by blocking transforming growth factor β1 and p38 mitogen-activated protein kinase signaling. Eosinophil binding to HEFs and HEMCs increased after incubation of mesenchymal cells with eosinophil-derived products, and decreased after blockade of transforming growth factor β1 and p38 mitogen-activated protein kinase blockade. Eosinophil products reduced electrical field-induced contraction of esophageal muscle strips, but not acetylcholine-induced contraction. Conclusions In an analysis of tissues samples from patients with EoE, we linked the presence and activation state of eosinophils in EoE with altered fibrogenesis and motility of esophageal fibroblasts and muscle cells. This process might contribute to the development of dysphagia.

Original languageEnglish (US)
Pages (from-to)1266-1277.e9
JournalGastroenterology
Volume146
Issue number5
DOIs
StatePublished - May 2014

Keywords

  • Immune Regulation
  • Keywords
  • Primary Human Cells
  • Swallowing
  • Transmural Disease

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Rieder, F., Nonevski, I., Ma, J., Ouyang, Z., West, G., Protheroe, C., Depetris, G., Schirbel, A., Lapinski, J., Goldblum, J., Bonfield, T., Lopez, R., Harnett, K., Lee, J., Hirano, I., Falk, G., Biancani, P., & Fiocchi, C. (2014). T-helper 2 cytokines, transforming growth factor β1, and eosinophil products induce fibrogenesis and alter muscle motility in patients with eosinophilic esophagitis. Gastroenterology, 146(5), 1266-1277.e9. https://doi.org/10.1053/j.gastro.2014.01.051