Friday Morning - Dr. Butterfield

Following Dr. Theoharides INTENSE talk we got to take a break (which I think everyone’s brains needed).

Then up next was Dr. Joseph Butterfield from the Mayo Clinic.  He talked about the Mayo Clinic program for the study of Mast Cell and Eosinophilic Disorders.

His first slide said

• Ok, I’ve got mastocytosis, why are they interested in both mast cells and this other cell (eosinophil)?


• Ok, I’ve got eosinophilia, why are they interested in both eosinophils and this other cell (mast cell)?

And the next slide said

Some things just go together.  And had a picture of peanut butter and jelly. 

Which I thought was funny, because I’m guessing many of us with mast cell diseases and eosinophilia can’t eat peanut butter… or probably jelly.  LOL

What are eosinophils?

• Inflammatory cells that:


• Originate in the bone marrow


•    - Circulate briefly in the blood


•        Wind up in the tissue especially GI tract, lung, skin


• Eosin (acidic red dye) + -phil (having an attraction for)


• Normal numbers </= 500/mm³


• Greatly increased (>1500/mm³) in: over 80 disorders: parasitic and certain fungal infections, immune deficiency, allergic diseases, skin disorders, toxic reactions to ingested agents, connective tissue diseases, certain cancers and myeloproliferative disorders, “hypereosinophilic syndromes”

What are the functions of eosinophils?

• Despite over 100 years of research there is still debate about the function of eosinophils.


• We can live without them.


• Pro-inflammatory/host defense functions: asthma, paracsitic disorders


• OR


• Modulation of Local Immunity And/or Remodeling/Repair the “LIAR” hypotesis


• Commonly increased in atopic disorders such as asthma, allergic rhinits, nasal polyps, atopic dermatis


• With eosinophil #’s > 1500/mm³ [hypereosinophilia] a different “universe” of problems is encountered.

Mast Cells – a growing list of activites

• 
  Locations: [tissue dwelling] perivascular, connective tissues, mucosal surfaces


• Actions:

         -Adaptive immunity-migration of dedritic cells: T cell responses
        -Autoimmune diseases
            Inflammatory arthritis; multiple sclerosis; bullous pemphigoid, glomerulonephritis
        -Innate immunity to bacterial and parasitic infections
        -Other:  wound healing, fibrosis, angiogenesis, atherosclerosis, ischemic tissue injury
        -Asthma
        -IgE-mediated allergic reactions
            Anaphylaxis
            Uticaria & Angioedema

The Mast Cell-Eosinophil Axis

• Mast cells and eosinophils co-localize in disorders such as allergic asthma, parasitic infections, eosinophilic esophagitis, chronic gastritis, GI neoplasms, inflammatory bowel disease


• MC & Eosinophils interact
   -Via soluble mediators
   -Via cell-to-cell contact

So, Dr. Butterfield said that mast cells and eosinophils are frequently found together in clinical disorders.  The mediators that mast cells release affect eosinophils.  And eosinophil products affect mast cells.  Understanding how to interfere with the mutually supportive mast cell-eosinophil axis could lead to improved methods of treating disorders of each cell type.

It was a very interesting talk, and I wish I understood the science better!  It definitely makes sense that eosinophils and mast cells could interact and each could make the other worse.  Definitely an interesting combination of cells to look at.