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Barrett’s esophagus is negatively associated with eosinophilic esophagitis in Japanese subjects

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Abstract

Background

Although both eosinophilic esophagitis (EoE) and Barrett’s esophagus (BE) are considered to be associated with T helper (Th) 2-mediated immune responses, the association between EoE and BE is unclear. We investigated the clinical relationship between EoE and BE.

Methods

We conducted a single-center retrospective observational study. The study included 95 patients with EoE and randomly selected age- and sex-matched controls who underwent esophagogastroduodenoscopy during a medical health check-up at Osaka City University in a ratio of 1:2 for comparison. We compared the clinical characteristics and the prevalence rate of BE, reflux esophagitis (RE), hiatal hernia, and atrophic gastritis between EoE patients and controls by univariate analysis. Furthermore, we performed multivariate logistic regression analysis to investigate the association of these factors with EoE.

Results

On univariate analysis, the prevalence rate of BE was significantly lower in patients with EoE than in controls (2.1% vs. 13.2%; p = 0.00528). In contrast, the prevalence rate of RE was higher in EoE patients than in controls, but it was not statistically significant (absence and Grades A, B, and C: 74.7%, 18.9%, 5.3%, and 1.1% vs. 83.7%, 12.6%, 3.7%, and 0%; p = 0.193, respectively). Multivariate analysis showed that BE was negatively associated with EoE (odds ratio: 0.132; 95% confidence interval: 0.0302–0.573; p = 0.00686).

Conclusions

BE is negatively associated with EoE in Japanese subjects. The mechanism behind the inverse relationship between EoE and BE should be examined.

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References

  1. Abe Y, Nomura E, Sato T, Ueno Y. The diagnosis of eosinophilic esophagitis. Gastroenterol Endosc. 2014;56:3378–93.

    Google Scholar 

  2. Liacouras CA, Furuta GT, Hirano I, et al. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol. 2011;128:3–20.

    Article  PubMed  Google Scholar 

  3. Safroneeva E, Coslovsky M, Kuehni CE, et al. Eosinophilic oesophagitis: relationship of quality of life with clinical, endoscopic and histological activity. Aliment Pharmacol Ther. 2015;42:1000–10.

    Article  CAS  PubMed  Google Scholar 

  4. Fujiwara Y, Sugawa T, Tanaka F, et al. A multicenter study on the prevalence of eosinophilic esophagitis and PPI-responsive esophageal eosinophilic infiltration. Intern Med. 2012;51:3235–9.

    Article  PubMed  Google Scholar 

  5. Fujishiro H, Amano Y, Kushiyama Y, et al. Eosinophilic esophagitis investigated by upper gastrointestinal endoscopy in Japanese patients. J Gastroenterol. 2011;46:1142–4.

    Article  PubMed  Google Scholar 

  6. Stewart MJ, Shaffer E, Urbanski SJ, et al. The association between celiac disease and eosinophilic esophagitis in children and adults. BMC Gastroenterol. 2013;13:96.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Sherrill JD, Gao PS, Stucke EM, et al. Variants of thymic stromal lymphopoietin and its receptor associate with eosinophilic esophagitis. J Allergy Clin Immunol. 2010;126:160–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Fitzgerald RC, Onwuegbusi BA, Bajaj-Elliott M, et al. Diversity in the oesophageal phenotypic response to gastro-oesophageal reflux: immunological determinants. Gut. 2002;50:451–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Kohata Y, Fujiwara Y, Machida H, et al. Role of Th-2 cytokines in the development of Barrett’s esophagus in rats. J Gastroenterol. 2011;46:883–93.

    Article  CAS  PubMed  Google Scholar 

  10. Lucendo AJ, Molina-Infante J, Arias Á, et al. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United Eur Gastroenterol J. 2017;5:335–58.

    Article  Google Scholar 

  11. Japan Esophageal Society. Japanese classification of esophageal cancer, 11th Edition: part II and III. Esophagus. 2017;14:37–65.

    Article  Google Scholar 

  12. Matsuzaki J, Suzuki H, Asakura K, et al. Etiological difference between ultrashort- and short-segment Barrett’s esophagus. J Gastroenterol. 2011;46:332–8.

    Article  PubMed  Google Scholar 

  13. Lundell LR, Dent J, Bennett JR, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut. 1999;45:172–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Kimura K, Takemoto T. An endoscopic recognition of the atrophic border and its significance in chronic gastritis. Endoscopy. 1969;1:87–97.

    Article  Google Scholar 

  15. Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transpl. 2013;48:452–8.

    Article  CAS  Google Scholar 

  16. Francalanci P, De Angelis P, Minnei F, et al. Eosinophilic esophagitis and Barrett’s esophagus: an occasional association or an overlap disease? Esophageal ‘double trouble’ in two children. Digestion. 2008;77:16–9.

    Article  PubMed  Google Scholar 

  17. Mukkada V, Atkins D, Furuta GT. Uncertain association of Barrett’s esophagus with eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2008;6:832–3.

    Article  PubMed  Google Scholar 

  18. Saboorian MH, Genta RM, Marcus PB, et al. Inverse association of esophageal eosinophilia and Barrett esophagus. J Clin Gastroenterol. 2012;46:752–7.

    Article  PubMed  Google Scholar 

  19. Kim HP, Vance RB, Shaheen NJ, et al. The prevalence and diagnostic utility of endoscopic features of eosinophilic esophagitis: a meta-analysis. Clin Gastroenterol Hepatol. 2012;10:988–96.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Manabe N, Haruma K, Imamura H, et al. Does short-segment columnar-lined esophagus elongate during a mean follow-up period of 5.7 years? Dig Endosc. 2011;23:166–72.

    Article  PubMed  Google Scholar 

  21. Sun D, Wang X, Gai Z, et al. Bile acids but not acidic acids induce Barrett’s esophagus. Int J Clin Exp Pathol. 2015;8:1384–92.

    CAS  PubMed  PubMed Central  Google Scholar 

  22. Rothenberg ME. Molecular, genetic, and cellular bases for treating eosinophilic esophagitis. Gastroenterology. 2015;148:1143–57.

    Article  CAS  PubMed  Google Scholar 

  23. Palles C, Chegwidden L, Li X, et al. Polymorphisms near TBX5 and GDF7 are associated with increased risk for Barrett’s esophagus. Gastroenterology. 2015;148:367–78.

    Article  CAS  PubMed  Google Scholar 

  24. Wang KK, Sampliner RE. Updated guidelines 2008 for the diagnosis, surveillance and therapy of Barrett’s esophagus. Am J Gastroenterol. 2008;103:788–97.

    Article  PubMed  Google Scholar 

  25. Amano Y, Ishimura N, Furuta K, et al. Which landmark results in a more consistent diagnosis of Barrett’s esophagus, the gastric folds or the palisade vessels? Gastrointest Endosc. 2006;64:206–11.

    Article  PubMed  Google Scholar 

  26. Watari J, Hori K, Toyoshima F, et al. Association between obesity and Barrett’s esophagus in a Japanese population: a hospital-based, cross-sectional study. BMC Gastroenterol. 2013;13:143.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

ST, FT, and YF were involved in study conception and design. ST and FT had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of data analysis. KO and SF acquired the data. ST and FT analyzed and interpreted the data. Drafting of the manuscript was performed by ST and FT. Critical revision of the manuscript for important intellectual content was conducted by ST, FT, KO, SH, YN, NK, KT, HY, TT, SF, TW, and YF. All authors have approved the final draft of this manuscript.

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Authors and Affiliations

  1. Department of Gastroenterology, Graduate School of Medicine, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka, 545-8585, Japan

    Shingo Takashima, Fumio Tanaka, Koji Otani, Shuhei Hosomi, Yasuaki Nagami, Noriko Kamata, Koichi Taira, Hirokazu Yamagami, Tetsuya Tanigawa, Toshio Watanabe & Yasuhiro Fujiwara

  2. Premier Preventive Medicine, Graduate School of Medicine, Osaka City University, Osaka, Japan

    Fumio Tanaka, Koji Otani & Shinya Fukumoto

Authors
  1. Shingo Takashima
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  2. Fumio Tanaka
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  3. Koji Otani
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  4. Shuhei Hosomi
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  5. Yasuaki Nagami
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  6. Noriko Kamata
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  7. Koichi Taira
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  8. Hirokazu Yamagami
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  9. Tetsuya Tanigawa
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  10. Shinya Fukumoto
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  11. Toshio Watanabe
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  12. Yasuhiro Fujiwara
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Corresponding author

Correspondence to Fumio Tanaka.

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Ethical Statement

This study was conducted in accordance with the Declaration of Helsinki and its amendments. The study protocol was approved by the Ethics Committee of the Osaka City University Graduate School of Medicine (No. 3951).

Conflict of interest

The authors declare no conflict of interests for this article.

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Takashima, S., Tanaka, F., Otani, K. et al. Barrett’s esophagus is negatively associated with eosinophilic esophagitis in Japanese subjects. Esophagus 16, 168–173 (2019). https://doi.org/10.1007/s10388-018-0648-2

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  • DOI: https://doi.org/10.1007/s10388-018-0648-2

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