A Role for Pathogenesis-Related Proteins in Poly-Sensitized Allergic Patients with Eosinophilic Esophagitis: Clinical and Endoscopic Features

Objective: Eosinophilic Esophagitis (EoE) is a chronic inflammatory disease of the esophagus often associated with atopy. Most EoE patients are poly-sensitized to inhalant and food allergens. Sensitization to pan-allergens is also frequent but their role in EoE is unclear. The aim of the study was to investigate the role of sensitization toward pathogenesis-related proteins (PR) in patients with EoE, and its relationship with clinical and endoscopic features. Methods: A group of poly-sensitized patients was retrospectively analyzed, and clinical, endoscopic, and histological differences were compared between patients’ sensitized and non-sensitized to PR-10 proteins. Results: Dysphagia was more frequent in patients sensitized to PR-10 compared with non-sensitized subjects (83% vs. 42%, p=0.032) while other presenting symptoms did not significantly differ between the two groups. The mean esophageal eosinophil peak was significantly higher in PR-10-sensitized patients (p=0.047). As far as endoscopic findings were concerned, no difference was found between the two groups. Conclusion: Sensitization to plant-food allergens such as PR-10 proteins seems relevant in poly-sensitized patients suffering from EoE and needs to be evaluated in order to test the result of an appropriate elimination diet.