Frequent sensitization to Candida albicans and profilins in adult eosinophilic esophagitis.

Background Eosinophilic esophagitis ( Eo E) is often associated with atopic airway and skin diseases. More than 80% of Eo E patients are sensitized to aero- and/or food allergens. Immunoglobulin ( Ig) E-mediated immune responses to microbes have been reported to be deleterious in connection with atopic diseases. Aim The aim of this study was to obtain a comprehensive overview about the sensitization spectrum of adult Eo E patients. Methods Ig E in sera of 35 patients with active Eo E were analyzed for reactivity to Candida albicans, as well as to a panel of recombinant and purified natural allergen components, using a microarray. Results Ig E sensitization to Candida albicans was found in 43% of Eo E patients. More than 80% of Eo E patients were sensitized to aeroallergens and 22% to food-specific allergen components, whereas 69% of the patients exhibited specific Ig E to cross-reactive allergens. Among the latter, profilins were identified as most frequent Ig E cross-reactive allergen components. Interestingly, dysphagia, the main symptom of adult Eo E patients following rice and/or bread ingestion, was associated with sensitization to cross-reactive allergens such as profilins, pathogenesis-related ( PR) 10 and lipid transfer proteins ( LTP). Intolerance toward meat rarely correlated with sensitization to animal food allergens. Conclusion Candida albicans and cross-reactive plant allergen components, in particular profilins, were identified as frequent sensitizers in adult Eo E patients. Specific elimination therapies are suggested to reveal their actual roles in the pathogenesis of Eo E. [ABSTRACT FROM AUTHOR]