Treatment of gastric eosinophilia by epicutaneous immunotherapy in piglets sensitized to peanuts

Abstract

Background

Eosinophilic Gastrointestinal Disorders (EGIDs) are hypersensitivity disorders frequently triggered by food allergy and manifested by mucosal eosinophilic infiltration at any level of the gastro-intestinal tract. This study established a model of gastric eosinophilia in peanut-sensitized piglets to evaluate the efficacy of epicutaneous immunotherapy (EPIT) for its treatment.

Methods

Experiments were carried out in piglets first sensitized by 3 intra-peritoneal injections of peanut protein extract (PPE) with adjuvant, and then given PPE orally for 10 days, a sequence leading to gastric eosinophilia assessed by endoscopy. For 3 months, 8 piglets received active EPIT, using Viaskin^® loaded with PPE, applied daily on the ear, while 8 received placebo EPIT (Placebo). Piglets were exposed to a second 10-day period of PPE orally. Lesions were scored by endoscopy on the last day of PPE exposure. After sacrifice, all parts of the digestive tract were analysed by a pathologist unaware of the piglets' status. IgE response was measured and mechanistic parameters were analyzed in the spleen.

Results

After sensitization, a significant increase of total IgE was observed in sensitized compared to naive animals (61.1±13.3 vs 27.8±6 ng/mL, p<0.01). Following oral intake of PPE, sensitized piglets developed moderate gastritis compared to naive piglets (1.5 vs 1.0, median score). After 3 months of immunotherapy, median IgE was significantly reduced in EPIT vs placebo piglets (61.4±16.3 vs 105.9±25.6 ng/mL, p<0.01). Active EPIT significantly reduced gastric mucosal lesions induced by PPE oral intake (macroscopic score 0 [0-2] vs 2 [1-3], p<0.01, respectively active vs placebo) and gastric mucosa eosinophils counts (239 eosinophils/mm² [59-645] vs 2554 eosinophils/mm² [462-8057], p<0.01, respectively active vs placebo). GATA-3, IL-5 and eotaxin mRNA expression decreased significantly after EPIT (p<0.05).

Conclusions

This study describes a large animal model of gastric eosinophil in peanut-sensitized piglets. Utilizing this model, we demonstrated the efficacy of EPIT in treating peanut-induced EGIDs.

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Issue Information

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Asthma comorbidities and making progress with food allergy

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Forthcoming Meetings

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Study of efficacy and safety of noncultured, extracted follicular outer root sheath cell suspension transplantation in the management of stable vitiligo

Abstract

Background

Noncultured, extracted follicular outer root sheath suspension (NC-EHF-ORS-CS) is a recently introduced technique for the treatment of stable vitiligo.

Objective

To study the clinical efficacy of this technique and to determine the viability and cell composition of the suspension.

Methods

Twenty-five patients with stable vitiligo were included in this prospective study. Fifty follicles were extracted from occipital scalp and were incubated with trypsin–ethylenediaminetetraacetic acid to separate outer root sheath cells. The cell suspension was filtered and centrifuged to obtain a cell pellet, which was resuspended and applied to the dermabraded recipient area. Cell viability of the suspension was assessed using trypan blue staining, and markers of keratinocyte stem cells (CD200) and melanocytes (S100) were evaluated using flow cytometry and immunocytochemistry, respectively.

Results

At 6 months, the mean (±SD) repigmentation was 52 ± 25.1%, and >75% repigmentation was seen in 8/25 (32%) patients. Mean percentage cell viability of the suspension was 80 ± 17.2% with a mean concentration of CD200 + and S100 + cells being 7.91 ± 8.68% and 9.93 ± 1.22% (n = 3), respectively. Recipient site infection was seen in 4 of 25 (16%) patients and a color mismatch in 11 of 25 (44%) patients.

Conclusion

NC-EHF-ORS-CS is a useful minimally invasive therapy for vitiligo.

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Acne keloidalis nuchae in Latin America: is there a different phenotype?

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Nevus trichilemmocysticus

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