Eosinophilic esophagitis (EoE) is an increasingly recognized allergic disease associated with
dysphagia and esophageal
fibrosis. We aimed to determine expression patterns of specific eosinophil
integrins that promote eosinophilic infiltration of the esophageal epithelium, and to determine how key EoE-related
cytokines influence eosinophil activation and survival. Esophageal and peripheral eosinophils were isolated from 20 adult subjects with EoE for immunophenotyping and
integrin profiling using multicolor flow cytometry and immunohistochemistry. Expression signatures of eosinophil
integrins were further assessed by immunohistochemistry using serial sections of esophageal biopsy specimens. Purified eosinophils were used to assess the effect of EoE-relevant
cytokines and recombinant
periostin on expression of known eosinophil
integrins and eosinophil survival and activation. We found that resting eosinophils express high levels of the β2-pairing
integrins αL and αM, and lower levels of α4, α6 and α4β7. The migration of peripheral eosinophils to the esophagus is characterized by the specific induction of αM, and a significant increase in the proportion of αM in high-activity conformation.
Periostin, a secreted
extracellular matrix protein that is significantly overexpressed in EoE, enhances eosinophil survival, and this effect is mediated by αM interaction.
Integrin αM is a specific marker of activated tissue eosinophils in EoE, and promotes eosinophil survival through interactions with
periostin. The ability of αMβ2 to mediate eosinophil tissue residency via
periostin represents a key mechanism for disease development and a potential therapeutic target in EoE.