Research Updates January 31, 2019 A paper published in the January issue of Annals of Allergy & Immunology describes case reports of patients who developed IgE-mediated allergic reactions and anaphylaxis after reintroducing foods following an elimination diet for EoE. “It appears there is a small, but real, risk of a more serious IgE type food reaction developing in EoE patients after a period of restriction,” the authors noted. “Means to identify those at risk is needed and will help direct which patients should have in-office, physician supervised, graded food challenges, continued restriction, or at home food reintroduction. Further epidemiologic and immunologic studies are needed to gain insight into this increasingly recognized phenomenon.” APFED HOPE Grant recipient Dr. Ting Wen recently completed his research project titled, “Defining Esophageal Lymphocyte Phenotype and Function in Eosinophilic Esophagitis.” “The T helper lymphocyte type 2 (Th2) is a type of white blood cell capable of producing Th2 cytokines and that supports accumulation of another type of white blood cell, eosinophils,” Dr. Wen explains. “We found that certain human gastrointestinal bacteria metabolites (short-chain fatty acids) could enhance the Th2 cytokine production by Th2 lymphocytes, potentially causing EoE, and our proposed studies are expected to provide a detailed understanding of the regulatory role of short-chain fatty acids to Th2 cytokine production by Th2 lymphocytes.” Knopp Biosciences LLC is advancing its investigational drug, dexpramipexole, into Phase 2 development in severe asthma and Phase 3 development in hypereosinophilic syndrome (HES). Read more. In a recent publication in the Journal of Immunology, researchers find that Charcot–Leyden Crystals (CLCs), which are protein crystals that can form after the degranulation of eosinophils and appear and persist in tissues of patients who have eosinophilic disorders, may play a role in sustaining inflammation. Learn more. A recent paper published in the American Journal of Gastroenterology discusses the relationship between EoE and achalasia, as well as other esophageal motility abnormalities. The researchers suggest that EoE may manifest in a mucosal-predominant or muscle-predominant form, each associated with different clinical manifestations. Learn more. A publication in the journal Gut describes associations with childhood obesity and antibiotics, histamine-2 receptor antagonists (H2RAs), and proton pump inhibitors (PPIs) used during the first two years of life. The authors note that alterations in gut microbiota are linked to obesity, and early exposure to antibiotics and acid suppressants may alter the microbiota and in turn increase the likelihood of weight gain. Read more.