Frontiers in Immunology (Apr 2024)

Circulating immunome fingerprint in eosinophilic esophagitis is associated with clinical response to proton pump inhibitor treatment

  • Lola Ugalde-Triviño,
  • Lola Ugalde-Triviño,
  • Francisca Molina-Jiménez,
  • Francisca Molina-Jiménez,
  • Juan H-Vázquez,
  • Carlos Relaño-Rupérez,
  • Carlos Relaño-Rupérez,
  • Carlos Relaño-Rupérez,
  • Laura Arias-González,
  • Laura Arias-González,
  • Laura Arias-González,
  • Laura Arias-González,
  • Sergio Casabona,
  • Sergio Casabona,
  • María Teresa Pérez-Fernández,
  • María Teresa Pérez-Fernández,
  • Verónica Martín-Domínguez,
  • Verónica Martín-Domínguez,
  • Jennifer Fernández-Pacheco,
  • Jennifer Fernández-Pacheco,
  • Alfredo J. Lucendo,
  • Alfredo J. Lucendo,
  • Alfredo J. Lucendo,
  • Alfredo J. Lucendo,
  • David Bernardo,
  • David Bernardo,
  • Cecilio Santander,
  • Cecilio Santander,
  • Cecilio Santander,
  • Pedro Majano,
  • Pedro Majano,
  • Pedro Majano,
  • Pedro Majano

DOI
https://doi.org/10.3389/fimmu.2024.1374611
Journal volume & issue
Vol. 15

Abstract

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ObjectivesThe aim of the study was to characterize the circulating immunome of patients with EoE before and after proton pump inhibitor (PPI) treatment in order to identify potential non-invasive biomarkers of treatment response.MethodsPBMCs from 19 healthy controls and 24 EoE patients were studied using a 39-plex spectral cytometry panel. The plasmacytoid dendritic cell (pDC) population was differentially characterized by spectral cytometry analysis and immunofluorescence assays in esophageal biopsies from 7 healthy controls and 13 EoE patients.ResultsInterestingly, EoE patients at baseline had lower levels of circulating pDC compared with controls. Before treatment, patients with EoE who responded to PPI therapy had higher levels of circulating pDC and classical monocytes, compared with non-responders. Moreover, following PPI therapy pDC levels were increased in all EoE patients, while normal levels were only restored in PPI-responding patients. Finally, circulating pDC levels inversely correlated with peak eosinophil count and pDC count in esophageal biopsies. The number of tissue pDCs significantly increased during active EoE, being even higher in non-responder patients when compared to responder patients pre-PPI. pDC levels decreased after PPI intake, being further restored almost to control levels in responder patients post-PPI.ConclusionsWe hereby describe a unique immune fingerprint of EoE patients at diagnosis. Moreover, circulating pDC may be also used as a novel non-invasive biomarker to predict subsequent response to PPI treatment.

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