Results: 4

1.
Figure 3

Figure 3. From: A novel histological scoring system to evaluate mucosal biopsies from patients with eosinophilic esophagitis.

EPX-mAb based immunohistochemistry provides a quantitatively significant strategy () to distinguish EoE vs. GERD patients. (A) Examination of the scores for individual EPX-mAb based parameters associated with the EoE (Group I), GERD (Group II), and control patients (Group III) found in demonstrated statistical differences (*P<0.001) for each of the parameters comprising the EPX-mAb based algorithm. (B) Statistical assessments (ANOVA with Tukey) of the average total EPX-mAb based staining scores (means ± SEM) for the EoE, GERD, and control patients from demonstrated the utility of this algorithm to distinguish between these patient populations (*P<0.001).

Cheryl Protheroe, et al. Clin Gastroenterol Hepatol. ;7(7):749-755.e11.
2.
Figure 2

Figure 2. EPX-mAb based immunohistochemistry represents a novel strategy to detect eosinophil degranulation and the presence of released eosinophil peroxidase bound to tissue extracellular matrix. From: A novel histological scoring system to evaluate mucosal biopsies from patients with eosinophilic esophagitis.

(A) Low (5×, 20mm2 field of view), (B) medium (16×, 1.8mm2 field of view), and (C) high (40×, 0.29mm2 field of view) microscopic fields of a proximal esophageal biopsy from an EoE patient demonstrate the utility of EPX-mAb based immunohistochemistry to detect eosinophil degranulation (i.e., EPX bound to extracellular matrix) in these biopsies. The results with this biopsy are representative of EoE patients which often display significant eosinophil degranulation. Scale bar = 100 μm.

Cheryl Protheroe, et al. Clin Gastroenterol Hepatol. ;7(7):749-755.e11.
3.
Figure 1

Figure 1. EPX-mAb based immunohistochemistry provides an efficient and rapid strategy to identify intact eosinophils infiltrating biopsies from eosinophil esophagitis patients. From: A novel histological scoring system to evaluate mucosal biopsies from patients with eosinophilic esophagitis.

A comparison of low (5×, 20mm2 field of view) power microscopy of (A) hematoxylin-eosin stained sections and (B) serial sections of the same patient following EPX-mAb based immunohistochemistry demonstrated that this immunohistochemical strategy easily permits the identification of infiltrating eosinophils in multiple biopsies within the field. (C) EPX-mAb based immunohistochemistry permits a rapid evaluation for the presence of intact infiltrating eosinophils of entire esophageal biopsies and the location of focal areas of eosinophil accumulation. The insert photograph in this panel is a high (40×, 0.29mm2 field of view) power field that was quickly/efficiently identified as a focal area of eosinophil accumulation (identified eosinophils are numbered 1–18) without the need of laborious time-consuming cell differential analyses. Scale bar = 100 μm.

Cheryl Protheroe, et al. Clin Gastroenterol Hepatol. ;7(7):749-755.e11.
4.
Figure 4

Figure 4. From: A novel histological scoring system to evaluate mucosal biopsies from patients with eosinophilic esophagitis.

EPX-mAb based immunohistochemistry permits a diagnosis of eosinophilic esophagitis among patients with appropriate clinical symptoms and borderline endoscopic/histological results but who fail to achieve the current guideline recommendations of at least a single focus of ≥15 eosinophils/40× hpf among the available biopsies. Serial sections of proximal esophageal biopsies from (A) patient #44 and (B) patient #46 (see and ( and )) were either stained with hematoxylin/eosin (left panels) or subjected to EPX-mAb based immunohistochemistry (right panels) and photographed at high (40×, 0.29mm2 field of view) power. Although both patients had failed to meet traditional pathology guidelines for a diagnosis of EoE, EPX-mAb based immunohistochemistry detected the presence of extensive eosinophil degranulation in the absence of ≥15 intact eosinophils/40× hpf (0.29mm2 field of view), elevating their EPX-mAb based total score within the range indicating an EoE diagnosis. Scale bar = 50 μm.

Cheryl Protheroe, et al. Clin Gastroenterol Hepatol. ;7(7):749-755.e11.

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