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Immune cells in food allergy and mental illness in epileptics

Immune cells in food allergy and mental illness in epileptics

Also this week MedZine brings you the latest medical news on various medical specialisms. In this editorial two striking studies are highlighted. The first describes the role of basophils in food-induced allergic inflammation in the esophagus. The second shows that mental illness is linked to early death risk in patients with epilepsy.

Rare immune cells in eosinophilic esophagitis

Eosinophilic esophagitis (EoE) is a food allergy-associated disease that affects children and adults and is caused by inflammation in response to trigger foods as eggs, nuts, milk, wheat, and soy. A study published by Artis and colleagues in Nature Medicine  describes a role of basophils in the induction of EoE. Previously, thymic stromal lymphopoietin (TSLP)-gene defects were associated with EoE in children. Now, the researchers found that sensitization to egg and peanut protein, in association with increased levels of TSLP, led to the mobilization of a rare type of immune cell called basophils. Interestingly, if TSLP or basophilic responses to food allergens were inhibited in mice, the esophageal inflammation improved dramatically. Moreover, exaggerated TSLP and basophil responses were observed in the esophageal biopsy tissues of pediatric and adult patients with EoE. Pediatric EoE patients with TSLP mutations have increased basophil responses in their blood compared to EoE patients that lacked this mutation. The findings suggest that TSLP and basophils may promote the development or persistence of inflammation in the esophagus in response to food-induced allergic reactions. TSLP and basophils could potentially be targeted to treat EoE patients.

Mental illness heightens death risk in people with epilepsy

Epilepsy is associated with high rates of premature mortality. A study by Fazel and colleagues, published in The Lancet, shows that an increased risk for early death in epileptics is associated with mental illness. In a 4-year study with almost 70,000 Swedish patients with epilepsy, mental illness and deaths were compared to controls. During this period, 9% (6,155) of people with epilepsy died compared to 0.7% (4,892) of people from the general population. Almost 16% of deaths in people with epilepsy were caused by external causes (suicides, vehicle and non-vehicle accidents, and assaults). Most of these were caused by suicides. Of the patients who died of external causes 75% also had a diagnosis of mental disorder, with substance abuse (56%) and depression (23%) being the largest contributors. The figures are considerably higher than previously thought and have important implications for epilepsy management. Improving the identification, monitoring and treatment of psychiatric problems in epilepsy patients could make an important contribution to reducing the risk of premature death, according to the researchers.

Sources: Eurekalert, Nature Medicine and The Lancet

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