Calcium Channel Inhibitors (Verapamil and Diltiazem) May Be Useful in Allergic Inflammation of Esophagus

MedicalResearch.com Interview with:

Dr. Rhonda Souza, MDBaylor University Medical CenterCenter for Esophageal ResearchDallas, TX 75246

Dr. Souza

Dr. Rhonda Souza, MD
Baylor University Medical Center
Center for Esophageal Research
Dallas, TX 75246 

MedicalResearch.com: What is the background for this study?  

Response: Eosinophilic esophagitis (EoE) is a modern disorder of the esophagus caused by an allergy to certain foods. EoE causes esophageal symptoms like difficulty swallowing and heartburn and is diagnosed when biopsies of the esophagus taken during endoscopy show numerous eosinophils, which are a type of inflammatory blood cell.  There are few established treatments for EoE.

One such treatment is a diet that eliminates the offending food allergens, and another is to use steroids to reduce the number of eosinophils in the esophagus. However, the most common treatment for adults with eosinophilic esophagitis is to use proton pump inhibitors (PPIs), which block the proton pumps in stomach cells that make acid.  In earlier studies, we found that PPIs also can block proton pumps in esophageal cells.  Those proton pumps are activated by chemicals that the body produces in response to allergens including interleukin (IL)-13 or IL-4.  Il-13 and IL-4, which cause the esophagus to produce eotaxin-3, a molecule that attracts eosinophils. What remained unknown, however, was the mechanism whereby these interleukins activate proton pumps in the EoE esophagus. In our present study, we explored whether IL-4 works by increasing calcium levels in esophageal cells from EoE patients.

MedicalResearch.com: What are the main findings? 

Response: In esophageal cells from patients with eosinophilic esophagitis, we found that IL-4 caused an increase in calcium levels that results in increased production of the eotaxin-3 molecule that draws eosinophils into the esophagus.  We also found that this process can be blocked by drugs called calcium channel inhibitors like Verapamil, which has been in clinical use for decades.

MedicalResearch.com: What should readers take away from your report?

Response: Our findings suggest that calcium channel inhibitors like Verapamil might be a new treatment option for patients with eosinophilic esophagitis. This is important because many patients are concerned about the potential side effects of PPIs and topical steroids, and EoE diets can be very restrictive and difficult to maintain.  A simple and safe treatment option like a calcium channel inhibitor would be welcomed by patients and physicians alike.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: These exciting findings will be the basis for future studies to demonstrate that calcium channel inhibitors can be used to treat eosinophilic esophagitis safely and effectively.  We cannot advise patients to use calcium channel inhibitors until the results of those studies are available. 

MedicalResearch.com: Is there anything else you would like to add? 

Response: The mission of our Center for Esophageal Diseases and Center for Esophageal Research is to provide the highest quality, state-of-the-art clinical care for patients with esophageal diseases, while simultaneously conducting cutting-edge clinical and translational research on esophageal diseases.  Our goals are to advance understanding of esophageal diseases, to improve treatment for patients with esophageal diseases, and to educate patients and physicians about esophageal diseases.

Citation:

166 – L-Type Calcium Channel Inhibitors (Verapamil and Diltiazem) Block Th2-Cytokine-Stimulated Eotaxin-3 Secretion in Esophageal Squamous Cells from Patients with Eosinophilic Esophagitis
Odiase, Eunice et al.
Gastroenterology , Volume 156 , Issue 6 , S-39

https://www.gastrojournal.org/article/S0016-5085(19)36879-9/fulltext

 

 

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