Crohn's immune response Allergy and Eosinophilic esophagitis

[my little penguin]

This report describes a pediatric patient with complete resolution of EoE, a predominantly TH2 disease, after development of CD, a predominantly TH1 disease. This suggests that skewing of the immune response toward an opposing T helper phenotype can significantly alter these disease states. We cannot rule out the possibility that EoE resolved spontaneously in this patient, although it is worth noting that EoE resolved when CD was diagnosed and the CD appeared to involve the esophagus. In addition, not only was EoE resolved but also the patient's asthma, peanut allergy, and IgE levels improved with the development of CD.Both EoE and CD are idiopathic diseases in which a dysregulated mucosal immune response causes inflammation. Evidence from human and animal studies point to CD being a TH1-type disease with a TH17 component (9). The observed cytokine profile of EoE is compatible with that of a TH2 disease (2). Our case provides compelling evidence that development of CD coincided with resolution of both EoE and other atopic diseases. Improvement in symptoms and diagnostic markers has been sustained for more than 2 years. Seasonal variation is likely not a factor in this case because the patient was diagnosed with CD during the same calendar month as the previous endoscopy showing EoE. High-dose proton pump inhibitors may also alter EoE (10), but our patient never received proton pump inhibitor therapy.We postulate that the TH2 environment of immune cells and cytokines in this atopic adolescent was reversed with development of a dominant TH1 disease. One published report describes a similar case of an atopic woman who had a history of severe CD (11). Three years later, she was diagnosed as having EoE, although her CD was described as mildly active. This report supports the possibility that TH2 skewing occurred, whereas CD was quiescent. The case described in this report provides evidence that the predominance of T helper lymphocyte response may influence EoE when more than 1 disease is present.

Impact of Crohn Disease on Eosinophilic Esophagitis: Evidence for an Altered TH1-TH2 Immune Response

from
http://journals.lww.com/jpgn/Fulltext/2011/08000/Impact_of_Crohn_Disease_on_Eosinophilic.17.aspx

:dog:

 

[Farmwife]

?????????
Ok soooooooooooo, Someone like Grace that has ALLL these things will have them go away when CD takes over???????? Oh GREAT, WIN, WIN!:yfaint:

I'm I reading this right or did I just show the world how dumb I am. (crohnsinct, hush)

 

[jmckinley]

I read it the same way Farmwife...

 

[my little penguin]

same here but it was ONE pediatric patient and one adult patient
not a complete study

WOuld explain my kid's decrease in food allergies we were told he could not out grow and improving asthma for no other reason.

 

[killcolitis]

Interesting - as per our GI CD is no longer considered th1 and it's more likely to be th2 mediated so I wonder how that would fit into this?

 

[crohnsinct]

Oh come on......I really can't comment?

It was only one patient and they say all over the study it "suggests". I wouldn't count on it but it is aninteresting study and worthy of a big HMMMM and a search from time to time of more of the same. I wouldn't go praying on full blown CD just yet.

 

[Dexky]

…and in this corner, the challenger, TH1…

Never thought there'd be a reason to :dusty: for CD!