Evidence map›Paper›PMID 29691386›Full record

ArticleClinical and translational gastroenterology2018

Toll-like receptors-mediated pathways activate inflammatory responses in the esophageal mucosa of adult eosinophilic esophagitis.

Ángel Arias, María Vicario, David Bernardo, José M Olalla, Marina Fortea, Ana Montalban-Arques, Pilar Martínez-Fernández, Ana M González-Castro, Teresa Mota-Huertas, Laura Arias-González and 1 more

Open access · goldAbstract read
In one paragraph

Article in Clinical and translational gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 1 pooled it
4.7field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.

  1. The microbiota in eosinophilic esophagitis: A systematic review.Journal of gastroenterology and hepatology · 2022
    Pooled it
  2. Trial
  3. Distinct oesophageal microbiota is associated with paediatric eosinophilic oesophagitis.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026
    Article
  4. The Role of Mucins in Esophageal Inflammatory Diseases.Journal of personalized medicine · 2026
    Review
  5. Article
  6. Review
  7. The oesophagus as an immune organ.Nature reviews. Gastroenterology & hepatology · 2025
    Review
  8. Article
  9. Review
  10. Article
  11. Review
  12. Review
  13. Development and dysfunction of structural cells in eosinophilic esophagitis.The Journal of allergy and clinical immunology · 2024
    Review
  14. The journal of allergy and clinical immunology. Global · 2023
    Article
  15. Eosinophilic esophagitis and esophageal microbiota.Frontiers in cellular and infection microbiology · 2023
    Review
  16. Article
  17. Review
  18. Article
  19. Review
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Ángel AriasResearch Unit, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad. Real, Spain.
María VicarioCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
David BernardoCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
José M OlallaDepartment of Pathology, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad. Real, Spain.
Marina ForteaCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
Ana Montalban-ArquesCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
Pilar Martínez-FernándezInstitute of Medical and Molecular Genetics (INGEMM), Idipaz Research Laboratory, Hospital Universitario La Paz, Madrid, Spain.
Ana M González-CastroCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
Teresa Mota-HuertasDepartment of Pathology, Hospital General La Mancha Centro, Alcázar de San Juan, Ciudad. Real, Spain.
Laura Arias-GonzálezCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
Alfredo J LucendoCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain. alucendo@vodafone.es.
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas · ESHospital General de Tomelloso · ESCentre for Biomedical Network Research on Rare Diseases · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesEsophageal microbiota and regulation of adaptive immunity are increasingly being investigated in eosinophilic esophagitis (EoE). Toll-like receptors (TLRs) play a central role in the initiation and maintenance of innate immune activity. Our objective was to characterize the esophageal and duodenal innate immune response in EoE and its modulation by dietary therapy.

methodsEsophageal and duodenal biopsy samples were collected from 10 adults with untreated EoE, before and after effective treatment with a six-food elimination diet (SFED), and 10 controls with normal esophagus. In all cases, bacterial load (by mRNA expression of 16S), TLRs, mucins, transcription factors, interleukins, components of the NKG2D system, and innate immunity effectors were assessed by qPCR. Protein expression of TLRs were also determined by immunofluorescence.

resultsBacterial load and TLR1, TLR2, TLR4, and TLR9 were overexpressed on biopsies with active EoE compared with controls. Muc1 and Muc5B genes were downregulated while Muc4 was overexpressed. Upregulation of MyD88 and NFκB was found together with IL-1β, IL-6, IL-8, and IL-10 mediators and PER-1, iNOS, and GRZA effectors. NG-K2D components (KLRK1, IL-15, MICB) were also upregulated. In all cases, changes in active EoE were normalized following SFED and mucosal healing. Duodenal samples also showed increased expressions of TLR-1, TLR-2, and TLR-4, but not 16S or any other mediators nor effectors of inflammation.

conclusionsEsophageal TLR-dependent signaling pathways in EoE support the potential implication of microbiota and the innate immune system in the pathogenesis of this disease.

Indexed as

Immunity, InnateAdolescentAdultBacterial LoadDown-RegulationDuodenumEosinophilic EsophagitisEosinophilsEsophageal MucosaFemaleGene ExpressionHumansLeukocyte CountMaleMicrobiotaMiddle AgedToll-Like Receptors

Identifiers

PMID29691386
PMCPMC5915448
OpenAlexW2800305798

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-SA
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.