Electron microscopy elucidates eosinophil degranulation patterns in patients with eosinophilic esophagitis Hedieh Saffari, PhD, Laura H. Hoffman, BSc,

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Presentation transcript:

Electron microscopy elucidates eosinophil degranulation patterns in patients with eosinophilic esophagitis Hedieh Saffari, PhD, Laura H. Hoffman, BSc, Kathryn A. Peterson, MD, John C. Fang, MD, Kristin M. Leiferman, MD, Leonard F. Pease, PhD, Gerald J. Gleich, MD Journal of Allergy and Clinical Immunology Volume 133, Issue 6, Pages 1728-1734.e1 (June 2014) DOI: 10.1016/j.jaci.2013.11.024 Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Eosinophil with normal granules; no evidence of cytoplasmic vesiculation, including sombrero vesicles; and fully intact cytoplasmic membrane. A-C, Individual, intact, membrane-bound cytoplasmic granules. Journal of Allergy and Clinical Immunology 2014 133, 1728-1734.e1DOI: (10.1016/j.jaci.2013.11.024) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Eosinophil with intact cytoplasmic membrane showing reversal of granule core staining and cytoplasmic vesiculation. A, C, and D, Reversal of granule core staining with radiolucent core areas. B, Intact normal-appearing granule with an adjacent sombrero vesicle to the right. Journal of Allergy and Clinical Immunology 2014 133, 1728-1734.e1DOI: (10.1016/j.jaci.2013.11.024) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 3 Eosinophil showing partial cytoplasmic membrane disruption (>20%), granules with reversal of core staining, and overall increased cytoplasmic vesiculation. A, Intact granule and cytoplasmic vesiculation. B, Cytoplasmic vesicles. C, Cytoplasmic granule with reversal of core staining. Journal of Allergy and Clinical Immunology 2014 133, 1728-1734.e1DOI: (10.1016/j.jaci.2013.11.024) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 4 Eosinophil showing fully disrupted cell membrane and cytoplasmic vesiculation. A-C, Numerous sombrero vesicles as part of tubulovesicular development. Journal of Allergy and Clinical Immunology 2014 133, 1728-1734.e1DOI: (10.1016/j.jaci.2013.11.024) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 5 Eosinophil granules in epithelial intercellular spaces. Journal of Allergy and Clinical Immunology 2014 133, 1728-1734.e1DOI: (10.1016/j.jaci.2013.11.024) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 6 Venn diagram of the average percentage of findings in esophageal eosinophils from patients with EoE (n = 900 eosinophils) by means of transmission electron microscopy scored by 3 observers based on membrane integrity, cytoplasmic vesiculation, and reversal of granule core staining. Journal of Allergy and Clinical Immunology 2014 133, 1728-1734.e1DOI: (10.1016/j.jaci.2013.11.024) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 7 Percentage of eosinophils with cytoplasmic vesicles and granule abnormalities from electron microscopy of 9 patients with EoE. The averages and SDs (error bars) of the 3 graders (H.S., L.H.H., and G.J.G.) are reported. PMD, Piecemeal degranulation. Journal of Allergy and Clinical Immunology 2014 133, 1728-1734.e1DOI: (10.1016/j.jaci.2013.11.024) Copyright © 2014 American Academy of Allergy, Asthma & Immunology Terms and Conditions