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. 2024 Dec;154(6):1523-1533.
doi: 10.1016/j.jaci.2024.07.025. Epub 2024 Aug 14.

Interactions between eosinophils and IL-5Rα-positive mast cells in nonadvanced systemic mastocytosis

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Interactions between eosinophils and IL-5Rα-positive mast cells in nonadvanced systemic mastocytosis

Guillaume Lefèvre et al. J Allergy Clin Immunol. 2024 Dec.

Abstract

Background: Bidirectional interactions between eosinophils and mast cells (MCs) have been reported in various allergic diseases. Bone marrow (BM) eosinophilia, and to a lesser extent blood eosinophilia, is common in systemic mastocytosis (SM), but its significance remains unknown.

Objective: We described blood and BM eosinophil characteristics in SM.

Methods: A large collection of BM biopsy samples was analyzed using immunohistochemical staining and whole-slide imaging. Eosinophil and extracellular granules were detected by eosinophil peroxidase (EPX) staining and MCs by KIT staining. Complementary analyses were conducted using flow cytometry and immunofluorescence.

Results: Eosinophil infiltrates and large areas of eosinophil degranulation were observed within or around BM MC infiltrates in SM. EPX staining surface, highlighting intact eosinophils and eosinophil degranulation, was higher in nonadvanced SM (n = 37 BM biopsy samples) compared with both controls (n = 8, P = .0003) and advanced SM (n = 24, P = .014). In nonadvanced SM, positive correlations were observed between serum tryptase levels and percentages of eosinophil counts in BM aspirations (Spearman r coefficient r = 0.38, P = .038), eosinophils count in BM biopsy samples (r = 0.45, P = .007), EPX staining (r = 0.37, P = .035), and eosinophil degranulation (r = 0.39, P = .023). Eosinophil counts in BM biopsy samples also correlated with MC counts (r = 0.47, P = .006) and KIT staining surface (r = 0.49, P = .003). BM MCs expressed IL-5 receptor and other usual eosinophil cytokine/chemokine receptors, and blood eosinophils displayed several increased surface markers compared with controls, suggesting an activated state.

Conclusion: Our data suggest possible cross talk between MCs and eosinophils, supporting MC tryptase release and MC activation-related symptoms. This suggests a rationale for targeting eosinophils in nonadvanced SM not fully controlled by other therapies.

Keywords: Eosinophil; mast cell; systemic mastocytosis.

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Conflict of interest statement

Disclosure statement Funding provided by GSK (ISS 10889). The authors are solely responsible for final content and interpretation. Disclosure of potential conflict of interest: O. Hermine received research funds from Blueprint, AB Science, Alexion, and BMS; and is cofounder and shareholder of Innatherys and AB Science. D. Launay received consulting fees from AstraZeneca. G. Lefèvre received consulting fees from AstraZeneca, GSK, and Sanofi; and research funds from AstraZeneca and GSK. J. Rossignol received consulting fees from Blueprint and research funds from Novartis. D. Staumont-Salle received consulting fees from AstraZeneca, GSK, Novartis, and Sanofi-Regeneron. The rest of the authors declare that they have no relevant conflicts of interest.

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