Our Research
We focus on the role of eosinophils and lymphocytes in eosinophilic gastrointestinal disease (EGID), as well as a variety of other eosinophilic disorders such as medication-induced eosinophilia vs. DRESS and hypereosinophilic syndromes (HES).
We create well-characterized patient cohorts and collect both clinical data and biological samples from human research subjects in cross-sectional and longitudinal studies.
Eosinophilic gastrointestinal disorders (EGIDs) of the upper GI tract are predominantly food-triggered chronic eosinophilic disorders with profoundly negative impact on quality of life. When left untreated, both eosinophilic esophagitis and eosinophilic gastroenteritis lead to progressive scarring of the affected GI tract segments. Predictive, non-invasive diagnostic testing and treatments are sorely lacking. Two types of immune cells, eosinophils and specialized T cells, have long been implicated in EGID pathogenesis, but numerous questions remain unanswered about their roles.
Eosinophils are associated with a variety of different allergic conditions.
(Image created with Biorender)
Are eosinophils instigators, bystanders or helpers in these diseases?
The GI tract is the largest repository for tissue eosinophils but many other eosinophilic disorders accompanied by excessive blood eosinophilia do not present with GI symptoms. Similarly, these specialized T cells, initially attributed to EGID, are recently thought to be biomarkers in food allergy and hay fever, conditions clinically distinct from EGID. Preliminary evidence suggests there are unique blood eosinophil signatures in EGIDs that distinguish them from blood eosinophils in other eosinophilic disorders, and that specialized circulating Th2 cells in EGIDs differ from those identified in more traditional IgE-mediated atopic conditions.
Our goals are to define (1) unique blood eosinophil signatures in EGID that distinguish it from other eosinophil-associated disorders or atopic disorders with blood eosinophilia; (2) Precisely identify the specialized Th2 cells in EGID as compared to food allergy. Findings will deepen our understanding of EGID pathogenesis, provide potential non-invasive EGID-specific diagnostic or disease activity biomarkers, and transform how as allergist-immunologists, we conceptualize disease pathogenesis in other eosinophilic disorders (e.g. allergic asthma) and food-associated disorders (e.g. food allergy).
Classic food allergy and food-triggered EGIDS differ in symptoms, diagnosis and treatment. (Image created with Biorender)
Are the allergic T cells different in these conditions too?