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Detection of Eosinophilic Cell-Free Granules Based on Expression of Ccr3 and Mbp Markers in Esophageal Biopsy Specimens of Patients With Suspected and Confirmed Eosinophilic Esophagitis Publisher



Ebrahimi S1 ; Khatami S1 ; Mahjoub FE2, 3 ; Monajemzadeh M4 ; Yousefi A5 ; Hosseini A6 ; Khoshmirsafa M7 ; Mousavinasab FS8 ; Mansouri M9 ; Shabani M1 ; Mesdaghi M1, 6, 9
Authors
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Authors Affiliations
  1. 1. Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Department of Pathology, Bahrami Children Hospital, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Roshan Azma Pathobiology Lab (Private Lab), Tehran, Iran
  4. 4. Department of Pathology, Children Medical Center, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Pediatric Gastroenterology, Rasul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
  6. 6. Pediatric Gastroenterology, Hepatology8 and Nutrition Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  7. 7. Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
  8. 8. Department of Biomedical Science, Georgia State University, Atlanta, GA, United States
  9. 9. Department of Allergy and Clinical Immunology, Mofid Children’s Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: Pediatric Gastroenterology, Hepatology and Nutrition Published:2025


Abstract

Purpose: Eosinophilic esophagitis (EoE) is the most well-known eosinophilic gastrointestinal disorder (EGID) characterized by the presence of a high number eosinophils within the esophageal epithelium and the clinical signs. Biopsies of patients with suspected EoE may not show a high number of eosinophils, however the presence of granules may help with the diagnosis. This study aims to evaluate the presence of cell-free eosinophil granules in the esophageal tissue of patients with suspected and confirmed EoE to accelerate the diagnosis and treatment of patients with low eosinophil count. Methods: Fifteen patients with confirmed EoE and 15 suspected of EoE were included in this study. Patients' esophageal tissue biopsies were stained using immunohistochemistry (IHC) to identify eosinophils and their cell-free granules. For testing, anti-major basic protein (MBP) and anti-chemokine receptor type 3 (CCR3) were used as primary antibodies and a double-staining kit containing secondary antibodies conjugated to the enzyme and related chromogens were used. Results: Cell-free granules with different degrees were observed in 53.3% and 93.3% of suspected and confirmed EoE samples, respectively. Furthermore, in esophageal biopsy of 73.3% of patients with suspected and 93.3% of patients with a definitive diagnosis of EoE, basal layer hyperplasia (BLH) was recognized. Conclusion: The results of the present study showed that IHC can be applied to detect cell-free eosinophil granules in esophageal tissue. Observation of granules and basal cell hyperplasia in biopsies of suspected EoE patients whose eosinophil count is below the threshold can be valuable findings to make a definitive diagnosis for these patients. © 2025 by The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition