Expression of transforming growth factor β1, transforming growth factor type I and II receptors, and TNF-α in the mucosa of the small intestine in infants with food protein–induced enterocolitis syndrome

Abstract Background: TNF-α secreted by activated T cells is known to increase intestinal permeability, whereas transforming growth factor (TGF) β has the ability to protect the epithelial barrier. Objective: We determined the expression of TGF-β1, its receptors, and TNF-α on the mucosa of small intestine to investigate their roles in the pathogenesis of food protein–induced enterocolitis syndrome (FPIES). Methods: Twenty-eight infants diagnosed with FPIES by means of clinical criteria and challenge test results were included. Immunohistochemical stains for TGF-β1, type 1 and 2 TGF-β receptors, and TNF-α on duodenal biopsy specimens were performed. Results: TGF-β1 expression was generally depressed in patients. Expression of type 1 TGF-β receptor was significantly lower in the patients who had villous atrophy compared with expression in those patients who did not ( P r = –0.59, P P Conclusion: Our results suggest that decreased countering activity of TGF-β1 against T-cell cytokines is implicated in the pathogenesis of FPIES. The significantly lower expression of type 1 TGF-β receptor compared with type 2 receptor suggests the differential contribution of each receptor to the diverse biologic activities of TGF-β in the intestinal epithelium. (J Allergy Clin Immunol 2002;109:150-4.)