How To Cure Eosinophils
What is the Treatment for Eosinophilic Disorders? – Eosinophilic disorders are often misdiagnosed and misunderstood because the symptoms are shared with a number of conditions. Though these conditions are lifelong, the disease activity and symptoms of these disorders can be effectively managed in many cases by the dedicated and consistent care of families and healthcare professionals, such as the multidisciplinary team of specialists at the Cincinnati Center for Eosinophilic Disorders (CCED), who are researching improved treatments and a cure,
- At present, the two main treatments for eosinophilic disorders, such as eosinophilic gastrointestinal disorders (EGIDs) and hypereosinophilic syndrome (HES) are medications and dietary therapy.
- Medications and dietary therapy can be used singly or together.
- Which treatments are used depends on the eosinophilic condition.
What is the treatment for eosinophilic esophagitis (EoE) ? EoE responds well to topical steroids, emerging biologic therapy, and/or dietary therapy. Esophageal dilation is sometimes used to relieve dysphagia, a common symptom of EoE. What is the treatment for eosinophilic gastritis (EoG) ? EoG responds well to systemic steroids, but how EoG responds to dietary therapy is not yet known and understudied due to low EoG prevalence.
- What is the treatment for eosinophilic enteritis (EoN)? EoN responds well to systemic steroids, but how EoN responds to dietary therapy is not yet known and understudied due to low EoN prevalence.
- What is the treatment for eosinophilic colitis (EoC) ? EoC responds well to systemic steroids, but how EoC responds to dietary therapy is not yet known and understudied due to low EoC prevalence.
What is the treatment for hypereosinophilic syndrome (HES)? HES responds well to systemic steroids. Dietary therapy is not a treatment option for HES.
Contents
How can I reduce eosinophils?
Glucocorticoids are the most effective current therapy used to reduce eosinophil numbers in the blood and tissue (Table 1), but the pleiotropic effects of corticosteroids can result in potentially harmful side effects and limit their therapeutic use.
Can eosinophilia be cured naturally?
Natural treatment – Natural treatments may help manage your symptoms, but they won’t cure eosinophilic esophagitis. Some herbal remedies, such as licorice and chamomile, may help reduce acid reflux symptoms. Acupuncture and relaxation techniques such as meditation can also help prevent reflux.
- Other strategies to try at home include raising the head of your bed to prevent reflux, making efforts to maintain a moderate weight, and avoiding foods that you know cause heartburn.
- While these strategies do not address the underlying cause of the eosinophil buildup, they could help keep you more comfortable.
Always talk with your doctor before starting any new treatment, especially any new herbal remedies,
Can you get rid of eosinophils?
What are the treatments for eosinophilic esophagitis (EoE)? – There is no cure for EoE. Treatments can manage your symptoms and prevent further damage. The two main types of treatments are medicines and diet. Medicines used to treat EoE are:
Steroids, which can help control inflammation. These are usually topical steroids, which you swallow either from an inhaler or as a liquid. Sometimes doctors prescribe oral steroids (pills) to treat people who have serious swallowing problems or weight loss. Acid suppressors such as proton pump inhibitors (PPIs), which may help with reflux symptoms and decrease inflammation.
Dietary changes for EoE include:
Elimination diet. If you are on an elimination diet, you stop eating and drinking certain foods and beverages for several weeks. If you are feeling better, you add the foods back to your diet one at a time. You have repeat endoscopies to see whether or not you are tolerating those foods. There are different types of elimination diets:
With one type, you first have an allergy test. Then you stop eating and drinking the foods you are allergic to. For another type, you eliminate foods and drinks that commonly cause allergies, such as dairy products, egg, wheat, soy, peanuts, tree nuts and fish/shellfish.
Elemental diet. With this diet, you stop eating and drinking all proteins. Instead, you drink an amino acid formula. Some people who do not like the taste of the formula use a feeding tube instead. If your symptoms and inflammation go away completely, you may be able to try adding foods back one at a time, to see whether you can tolerate them.
Which treatment your health care provider suggests depends on different factors, including your age. Some people may use more than one kind of treatment. Researchers are still trying to understand EoE and how best to treat it. If your treatment is not working well enough and you have narrowing of the esophagus, you may need dilation.
What foods reduce eosinophils?
1. Which food reduces Eosinophils? – Fruits and vegetables help in reducing eosinophils. In addition, your immunity is boosted by honey, turmeric, pepper, garlic, and ginger.
Can vitamin C reduce eosinophils?
Conclusions: Vitamin-c reduces the eosinophilic counts in allergic rhinitis.
What vitamins help eosinophils?
Table 2 – Comparison between the groups stratified by the median vitamin D level (24 ng/mL). a
Variable | Vitamin D level | p | |
---|---|---|---|
< 24 ng/mL | ≥ 24 ng/mL | ||
(n = 13) | (n = 13) | ||
Age, years | 10 (9-11) | 8 (7-10) | 0.019 |
Male/female, n/n | 9/4 | 10/3 | 0.658 |
BMI, kg/m 2 | 20 (17-23) | 17 (16-23) | 0.479 |
Daily dose of inhaled corticosteroid, µg | 400 (200-400) | 400 (200-400) | 0.880 |
Uncontrolled asthma | 38% | 30% | 0.999 |
Secondhand smoke | 46% | 31% | 0.688 |
Vitamin D, ng/mL | 19 ± 4 | 30 ± 4 | < 0.001 |
Eosinophils, % | 11 ± 6 | 8 ± 7 | 0.351 |
Eosinophils, cells/µL | 918 ± 464 | 448 ± 382 | 0.042 |
Total IgE, IU/mL | 961 (696-2,283) | 621 (325-940) | 0.046 |
FVC, % predicted | 101 ± 14 | 108 ± 6 | 0.548 |
FEV 1, % predicted | 89 ± 11 | 91 ± 8 | 0.990 |
FEF 25-75, % predicted | 96 ± 23 | 93 ± 20 | 0.905 |
To our knowledge, this is the first study to show that low vitamin D levels are associated with higher absolute eosinophil counts and higher IgE levels in children with asthma in Brazil. However, our results should be interpreted with caution, given that they still do not allow the inference of causality.
An association between vitamin D level and age has been previously observed in children and adolescents, 10 although not in children in Brazil. This could be due to lifestyle (such as getting less sun exposure) and to the increased risk of chronic and inflammatory diseases, which increase the metabolism of vitamin D.8, 9 The role that vitamin D plays at points in the inflammatory cascade in asthma patients is the subject of various ongoing discussions, the outcomes of which have been discrepant.
One study of children with asthma (7-14 years of age) in Brazil did not quantify eosinophils but found an inverse association between the levels of IgE and those of vitamin D, 11 whereas another study of children with asthma (6-14 years of age) in Costa Rica showed that vitamin D levels correlated significantly with IgE levels but not with eosinophil counts.10 In response to corticosteroids, vitamin D restores the capacity of the T cells to secrete IL-10 (a powerful anti-inflammatory cytokine), 10 thus exerting an immunomodulatory effect 19 and indirectly diminishing the production of IgE, 1, 20 given that IgE does not have a VDR and is produced by B lymphocytes.
- Hypothetically, that would explain why there is not a more robust correlation between vitamin D and IgE, in contrast to what has been observed for eosinophils, which have the VDR 20 and are produced directly by the T2-high lymphocytes.
- Given that vitamin D can prolong the survival of eosinophils and increase the expression of membrane receptors that inhibit their apoptosis, 20 there is less need to produce new eosinophils in this scenario, which is a possible explanation for the association between vitamin D and eosinophils.
In view of the median vitamin D level found in our sample (24 ng/mL), the internationally accepted cutoff points for vitamin D may not be applicable to children with asthma in Brazil. It is noteworthy that the vitamin D values generally suggested as sufficient, insufficient, and deficient have been based primarily on bone health, 9 involving presumably healthy people, 10 however without considering the specificities related to sun exposure and age.
The limitations of the present study include the relatively small sample size (which might not be representative of the population of children with asthma and precluded multiple regression analysis for the study of independent associations) and the cross-sectional design, which prevented us from establishing causality.
Therefore, large, multicenter cohort studies involving nutritional surveys are warranted in order to confirm or refute our findings. In conclusion, to our knowledge, this is the first study to show an association between vitamin D levels and eosinophil counts in children with asthma in Brazil.
What to do if eosinophils is high?
What can I expect if I have eosinophilia? – If you have high eosinophils levels, you may need treatment for the underlying condition causing your high levels. There are many causes, ranging from mild and completely safe to more serious. Talk to your healthcare provider to learn more.
A note from Cleveland Clinic Eosinophilia happens when your body produces too many eosinophils. Eosinophils are one of several white blood cells that support your immune system. Many times, people learn they have eosinophilia when they have routine blood tests. A high eosinophil count typically isn’t a cause for alarm.
Your healthcare provider may order additional tests to find out why your eosinophil levels are unusually high. Get useful, helpful and relevant health + wellness information
How long do eosinophils last?
Once the eosinophil has entered the blood, it has a short half-life, ranging from 8 to 18 hours.
Is milk good for eosinophils?
You are here – News Release Monday, February 27, 2023 NIH grantees report results of first multi-site randomized trial comparing the two diets. Eliminating animal milk alone from the diet of adults with eosinophilic esophagitis, or EoE, is as effective at treating the disease as eliminating animal milk plus five other common foods, a clinical trial funded by the National Institutes of Health has found.
For people with EoE whose disease remains active after they forgo animal milk, a more restrictive diet may help them achieve remission, according to the researchers. These findings were published today in the journal The Lancet Gastroenterology & Hepatology, “Diet-based therapy for eosinophilic esophagitis will be much easier to follow for many people if it involves cutting just one food from the diet rather than six,” said Hugh Auchincloss, M.D., acting director of the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH.
EoE is a chronic disease characterized by an overabundance of white blood cells called eosinophil s in the esophagus. Allergic inflammation due to food drives the disease by damaging the esophagus and preventing it from working properly. For people with EoE, swallowing even small amounts of food can be a painful and stressful choking experience.
About 160,000 people in the United States are living with EoE. Excluding certain foods from the diet has been a cornerstone of EoE treatment. During the early 2000s, researchers found that eliminating six common food triggers of esophageal injury—milk, egg, wheat, soy, fish and nuts—substantially reduced signs and symptoms of EoE.
This six-food elimination diet (6FED) became a common approach to managing the disease. In recent years, scientists have conducted small, non-randomized studies of removing one to four of the most common food antigens from the diet to treat EoE, with some success.
However, the relative risks and benefits of eliminating many foods versus a few foods at the start of diet-based therapy remained unclear. The new findings come from the first multi-site, randomized trial comparing the 6FED with a one-food elimination diet (1FED) in adults with EoE. The trial was co-funded by NIAID, the National Center for Advancing Translational Sciences, and the National Institute of Diabetes and Digestive and Kidney Diseases, all part of NIH.
Marc E. Rothenberg, M.D., Ph.D., the senior author of the published study, is director of both the Division of Allergy and Immunology and the Cincinnati Center for Eosinophilic Disorders at Cincinnati Children’s. The trial involved 129 adults ages 18 to 60 years with a confirmed EoE diagnosis, active EoE symptoms, and a high number of eosinophils in esophageal tissue.
Volunteers enrolled in the trial at one of 10 U.S. medical centers that participate in the Consortium of Eosinophilic Gastrointestinal Disease Researchers, part of the NIH-funded Rare Diseases Clinical Research Network. Participants were assigned at random to either the 1FED, which eliminated only animal milk from the diet, or the 6FED.
They followed their assigned diet for six weeks, then underwent an upper endoscopy exam and an esophageal tissue biopsy. If the number of eosinophils in the tissue indicated that EoE was in remission, the participant exited the study. If EoE was not in remission, people who had been on 1FED could advance to 6FED, and people who had been on 6FED could take topical swallowed steroids, both for six weeks, followed by a repeat exam with tissue biopsy.
The investigators found that 34% of participants on 6FED and 40% of participants on 1FED achieved remission after six weeks of diet therapy, a difference that was not statistically significant. The two diets also had a similar impact across several other measures, including reduction in EoE symptoms and effect on quality of life.
Thus, 1FED and 6FED were equally effective at treating EoE, an unexpected finding. The researchers also discovered that nearly half of people who did not respond to 1FED attained remission after treatment with the more restrictive 6FED, while more than 80% of the non-responders to 6FED achieved remission with oral steroids.
- Taken together, the investigators conclude that 1FED is a reasonable first-line diet therapy option in adults with EoE, and that effective therapies are available for people who do not achieve remission after 1FED or 6FED.
- NIAID conducts and supports research—at NIH, throughout the United States, and worldwide—to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses.
News releases, fact sheets and other NIAID-related materials are available on the NIAID website, About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S.
Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov,
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Is eosinophils high any problem?
Eosinophilia (e-o-sin-o-FILL-e-uh) is a higher than normal level of eosinophils. Eosinophils are a type of disease-fighting white blood cell. This condition most often indicates a parasitic infection, an allergic reaction or cancer. You can have high levels of eosinophils in your blood (blood eosinophilia) or in tissues at the site of an infection or inflammation (tissue eosinophilia).
- Tissue eosinophilia may be found in samples taken during an exploratory procedure or in samples of certain fluids, such as mucus released from nasal tissues.
- If you have tissue eosinophilia, the level of eosinophils in your bloodstream is likely normal.
- Blood eosinophilia may be detected with a blood test, usually as part of a complete blood count.
A count of more than 500 eosinophils per microliter of blood is generally considered eosinophilia in adults. A count of more than 1,500 eosinophils per microliter of blood that lasts for several months is called hypereosinophilia.
Can probiotics lower eosinophils?
4. Discussion – EoE is an eosinophil-rich, Th2 antigen-mediated disease of increasing pediatric and adult worldwide prevalence. Diagnosis requires greater than or equal to 15 eosinophils per high-power field on light microscopy, On the other hand, EoE is an allergic inflammatory disease that is triggered by food allergens and characterized by progressive esophageal dysfunction.
- Gut microbiota plays a beneficial role in food digestion, development of the immune system, control/growth of the intestinal epithelial cells, and their differentiation,
- Dysregulation of gut microbiota (dysbiosis) has also been found to be associated with an increased risk of allergies,
- Prescribing probiotics causes a significant change in the intestinal microflora and modulates cytokine secretion and increased intestinal IgA responses.
The modulation of the T helper cell (Th1/Th2) balance is done by probiotics, In general, probiotics are associated with a decrease in inflammation by increasing butyrate production and induction of tolerance with an increase in the ratio of cytokines such as IL-10/IFN- γ, Treg/TGF- β, reducing serum eosinophil levels, and the expression of metalloproteinase-9 which contribute to the improvement of the allergic disease’s symptoms,
- Therefore, probiotic administration along with the main treatments of allergic disease can be effective in improving the symptoms by creating a sufficient balance between intestinal bacteria.
- Probiotics are safe, noninvasive, noncarcinogenic, and nonpathogenic and include bacteria or yeast.
- Probiotic bacteria belong mainly to the group Lactobacillus and Bifidobacterium, especially Lactobacillus acidophilus and Bifidobacterium bifidum.
Some common probiotics, such as Saccharomyces boulardii, are yeast. The findings of this study were compared with other studies and are most likely similar to them. In 2016, a similar study was performed by Holvoet and others in a murine model of EoE. In this EoE model, supplementation with Lactococcus lactis NCC 2287 significantly decreased esophageal and bronchoalveolar eosinophilia.
This was the first study in an animal model to show that a specific probiotic could affect eosinophilic esophagitis, and this was suggested for the treatment of humans with esophagitis, In another study, Kryuchko et al. showed that the use of probiotics is effective in improving the symptoms of eosinophilic gastroenteritis as well as the manifestations of atopic dermatitis,
Also in the United States, Martin et al. showed an improvement in the symptoms of allergic proctocolitis following probiotic use, de Kivit and colleagues showed improvement in the symptoms of allergic gastroenteritis (including eosinophilic gastroenteritis and allergic IBS) after a 4-week period of symbiotic use,
- The results of these studies are consistent with the results of our studies on the improvement of clinical symptoms in patients following probiotic use.
- In another study, probiotic administration in late infancy showed a significantly lower incidence of eczema in the probiotic group compared to the placebo group,
A meta-analysis was conducted in 2019 that showed that probiotic supplementation during both the prenatal and postnatal periods reduced the incidence of AD in infants and children. These findings suggest that starting probiotic treatment during gestation and continuing through the first 6 months of the infant’s life may be of benefit in the prevention of AD,
- Another study was performed in 2018 by Sharma and Im.
- They reported that probiotics could be used as a drug to modulate the immune system and the therapeutic target recommended for the treatment of allergic diseases such as atopic dermatitis and food allergies,
- Based on a study by Krzych-Fałta and others in 2018, the use of probiotics in the Polish population showed no protective effect on any of the evaluated disorders in early childhood.
Conversely, over the age of 14 years, probiotic formulations exhibit health-promoting effects and may lower the risk of allergic diseases, In this study, we investigated the effect of synbiotic on the improvement of clinical symptoms in these patients, and it is noteworthy that no such study has been performed on these patients.
The findings of this study were compared with other studies and are most likely similar to them. It is observed that in the case group, those taking probiotics, the total severity score of symptoms decreased significantly after treatment. After the intervention, the severity score of chest pain was different significantly between the case and control groups.
Also, the mean of total frequency score of symptoms in patients after the intervention decreased significantly in both the control and case groups. The limitations of the current study were the restricted study population and the non-revaluation of the pathologic findings after the treatments due to the invasiveness of endoscopy.
Can low vitamin D cause high eosinophils?
Impact of vitamin D deficiency on increased blood eosinophil counts , March 2018, Pages 25-29 Author links open overlay panel,,,, Under a Creative Commons open access Vitamin D has been increasingly recognized as an immunomodulatory agent. Its deficiency has been associated with immune-mediated diseases such as asthma, rhinitis, and atopic dermatitis.
- These allergic conditions are dependent on T-helper type 2 (Th2) cells secreting interleukins, overproduction of immunoglobulin E (IgE), and eosinophil activation.
- We investigated the association between serum vitamin D levels and blood absolute eosinophil count.
- We carried out a cross-sectional study of 669 men and women referred to a clinical pathology laboratory who underwent 25-hydroxyvitamin D testing and complete blood count analysis on the same day.
Vitamin D levels were stratified into four ranges: severely deficient ( p =,001). The difference was significant between the severe deficiency group and each of the other three groups ( p =,012, p =,002, and p =,001, respectively). There was no statistical difference among the four groups in terms of total leukocyte counts ( p =,151), neutrophils ( p =,177), or lymphocytes ( p =,582).
Eosinophilia Eosinophils Vitamin D Vitamin D deficiency
© 2017 King Faisal Specialist Hospital & Research Centre. Published by Elsevier Ltd. : Impact of vitamin D deficiency on increased blood eosinophil counts
What foods to avoid to reduce eosinophils?
Avoid all forms of fish and shellfish including fish sauce and oyster sauce. Read food labels and avoid foods that ‘may contain’ fish or shellfish. The following tables will show you what you can and can’t eat while on the 6FED, avoiding wheat (W), milk (M), eggs (E), soy (S), nuts (N) and fish/shellfish (F).
What vitamins help eosinophils?
Table 2 – Comparison between the groups stratified by the median vitamin D level (24 ng/mL). a
Variable | Vitamin D level | p | |
---|---|---|---|
< 24 ng/mL | ≥ 24 ng/mL | ||
(n = 13) | (n = 13) | ||
Age, years | 10 (9-11) | 8 (7-10) | 0.019 |
Male/female, n/n | 9/4 | 10/3 | 0.658 |
BMI, kg/m 2 | 20 (17-23) | 17 (16-23) | 0.479 |
Daily dose of inhaled corticosteroid, µg | 400 (200-400) | 400 (200-400) | 0.880 |
Uncontrolled asthma | 38% | 30% | 0.999 |
Secondhand smoke | 46% | 31% | 0.688 |
Vitamin D, ng/mL | 19 ± 4 | 30 ± 4 | < 0.001 |
Eosinophils, % | 11 ± 6 | 8 ± 7 | 0.351 |
Eosinophils, cells/µL | 918 ± 464 | 448 ± 382 | 0.042 |
Total IgE, IU/mL | 961 (696-2,283) | 621 (325-940) | 0.046 |
FVC, % predicted | 101 ± 14 | 108 ± 6 | 0.548 |
FEV 1, % predicted | 89 ± 11 | 91 ± 8 | 0.990 |
FEF 25-75, % predicted | 96 ± 23 | 93 ± 20 | 0.905 |
To our knowledge, this is the first study to show that low vitamin D levels are associated with higher absolute eosinophil counts and higher IgE levels in children with asthma in Brazil. However, our results should be interpreted with caution, given that they still do not allow the inference of causality.
- An association between vitamin D level and age has been previously observed in children and adolescents, 10 although not in children in Brazil.
- This could be due to lifestyle (such as getting less sun exposure) and to the increased risk of chronic and inflammatory diseases, which increase the metabolism of vitamin D.8, 9 The role that vitamin D plays at points in the inflammatory cascade in asthma patients is the subject of various ongoing discussions, the outcomes of which have been discrepant.
One study of children with asthma (7-14 years of age) in Brazil did not quantify eosinophils but found an inverse association between the levels of IgE and those of vitamin D, 11 whereas another study of children with asthma (6-14 years of age) in Costa Rica showed that vitamin D levels correlated significantly with IgE levels but not with eosinophil counts.10 In response to corticosteroids, vitamin D restores the capacity of the T cells to secrete IL-10 (a powerful anti-inflammatory cytokine), 10 thus exerting an immunomodulatory effect 19 and indirectly diminishing the production of IgE, 1, 20 given that IgE does not have a VDR and is produced by B lymphocytes.
- Hypothetically, that would explain why there is not a more robust correlation between vitamin D and IgE, in contrast to what has been observed for eosinophils, which have the VDR 20 and are produced directly by the T2-high lymphocytes.
- Given that vitamin D can prolong the survival of eosinophils and increase the expression of membrane receptors that inhibit their apoptosis, 20 there is less need to produce new eosinophils in this scenario, which is a possible explanation for the association between vitamin D and eosinophils.
In view of the median vitamin D level found in our sample (24 ng/mL), the internationally accepted cutoff points for vitamin D may not be applicable to children with asthma in Brazil. It is noteworthy that the vitamin D values generally suggested as sufficient, insufficient, and deficient have been based primarily on bone health, 9 involving presumably healthy people, 10 however without considering the specificities related to sun exposure and age.
The limitations of the present study include the relatively small sample size (which might not be representative of the population of children with asthma and precluded multiple regression analysis for the study of independent associations) and the cross-sectional design, which prevented us from establishing causality.
Therefore, large, multicenter cohort studies involving nutritional surveys are warranted in order to confirm or refute our findings. In conclusion, to our knowledge, this is the first study to show an association between vitamin D levels and eosinophil counts in children with asthma in Brazil.
What vitamins help eosinophilia?
Key takeaways: –
The vitamin D receptor is enriched in the vicinity of genes that are activated in the esophagus of patients with eosinophilic esophagitis. Vitamin D is a natural antagonist for IL-13, which governs epithelial tissue inflammation in eosinophilic esophagitis. When vitamin D levels are low, the effects of IL-13 are more prominent, active and strong.
Supplementation with vitamin D may alleviate allergic inflammation in the esophagus, whereas a deficiency in vitamin D may lead to a higher risk for eosinophilic esophagitis and other allergic states, according to a study published in Gut, Half of the population in the West is deficient in vitamin D, Marc E. Source: Adobe Stock “We asked what regulates the esophagus in terms of what turns on genes in the esophagus, and we were struck to find that the No.1 transcriptional regulator that showed an extraordinarily high level of statistical significance was the vitamin D receptor,” Rothenberg told Healio. Marc E. Rothenberg As a lipid soluble vitamin, vitamin D can pass through all cell membranes and bind with the intracellular vitamin D receptor, which regulates gene expression. By examining thousands of data sets, Rothenberg explained, he and colleagues found that the vitamin D receptor, which is a transcriptional regulator (by acting as a transcription factor), is enriched in the human genome particularly at the sites of esophageal genes involved in eosinophilic esophagitis.
When we found a strong interplay of the eosinophilic esophagitis transcriptome and the vitamin D receptor. I got excited as a physician scientist, because I know that vitamin D is linked with allergies,” Rothenberg said. “Also, the availability of vitamin D-based drugs provides a potential opportunity for quick clinical translation of these findings.” Using histology, molecular imaging, motif discovery and metagenomic analysis, the researchers determined that the vitamin D receptor interacts with and is a natural antagonist for IL-13, a Th2 cytokine that governs epithelial tissue inflammation in asthma, atopic dermatitis, rhinosinusitis and other allergic diseases including eosinophilic esophagitis,
Specifically, metagenomic analysis revealed that supplementation with vitamin D reversed dysregulation of up to 70% of the transcriptome and epigenetic modifications induced by IL-13 in cells exposed to vitamin D deficient conditions. The researchers found that the interactome between vitamin D receptors and signal transducer and activator of transcription 6 (STAT6) may govern epithelial tissue responses to IL-13 signaling.
“The vitamin D receptor is a known transcription factor. Our findings show that the transcription factor engaged by IL-13, STAT6, and the vitamin D receptor, are actually regulating the same genes, and they regulate those genes mainly in opposite directions,” Rothenberg said. “We showed that vitamin D antagonizes the effect of IL-13 in-vitro and in-vivo, so if you think about it, vitamin D has activity similar to blocking IL-13,” he added.
“It has a physiological role in terms of regulating the IL-13 response, which is very critical in eliciting type 2 inflammatory responses.” When the researchers examined a cohort of patients with EoE, they found that many of these patients had a vitamin D deficiency, Rothenberg said.
- Biopsies revealed that the severity of their disease, including eosinophil levels, histological changes and other features, were inversely proportional to vitamin D levels.
- That provided clinical significance that the murine findings were operational in humans,” Rothenberg said.
- When the researchers manipulated vitamin D levels in mice and in human samples, IL-13 had a particularly remarkable effect when vitamin D levels were low.
“Low vitamin D made the IL-13 effect much more prominent, active and strong,” Rothenberg said. Vitamin D, however, reversed the responses induced by IL-13 that are considered germane to EoE, such as epithelial hyperproliferation, dilated intercellular spaces and improving barrier function in mice with experimental eosinophilic esophagitis.
- When we normalized the vitamin D level, the EoE model became much milder,” Rothenberg said.
- These findings provide a novel therapeutic entry point for type 2 immunity-related diseases in preventive and restorative medicine and therapies, according to the researchers.
- IL-13 blockers now are in clinical use, the researchers continued, and vitamin D can be delivered in oral and topical forms.
But translation to clinical use will require more research, Rothenberg cautioned. “At this stage, I’m not recommending that people take high doses of vitamin D or anything like that. But there might be good reasons to check your vitamin D if you have EoE,” he said.