# IgE-Independent Mast Cell Activation by Food-Derived Peptides in Eosinophilic Esophagitis (EoE)

> **NIH NIH R21** · UNIVERSITY OF VIRGINIA · 2021 · $201,875

## Abstract

PROJECT SUMMARY/ABSTRACT
Eosinophilic esophagitis (EoE) is a rapidly emerging chronic disease, predominantly triggered by food
antigens, that progresses from inflammation to fibrosis. Despite the name eosinophilic esophagitis, increasing
evidence suggests that mast cells (MC), which drive fibrosis in conditions such as asthma and scleroderma,
are integral to the pathogenesis of EoE. MCs classically release histamine and other inflammatory mediators
upon cross-linking of immunoglobulin E (IgE), but multiple lines of evidence have demonstrated that EoE is not
mediated by IgE. MCs can also be activated by a range of cationic substances, including opiates, through a
novel G-protein coupled receptor, MAS-related G protein-coupled receptor X2 (MRGPRX2). Milk and wheat
are the two most common triggers of EoE, and digestion of these foods produces homologous 7 amino acid
(AA) peptides, beta-casomorphin (BCM7) and gliadorphin (G7), respectively, that can engage µ opioid
receptors and activate rat peritoneal MCs. Our group recently found that these two peptides also activate
the human LUVA MC line. Using a HEK293 MRGPRX2 transfected cell line, our group further found that
the opiate-like peptides BCM7 and G7 can activate these cells only in the presence of MRGPRX2. This
finding leads to our central hypothesis that MCs are integral to the pathogenesis of EoE, and that non-IgE
mediated activation of MCs occurs through food-induced activation of MRGPRX2. Dr. McGowan proposes to
explore this hypothesis by examining 1) whether BCM7 and G7 activate MCs through MRGPRX2 using
HEK293 cells with and without stably transfected MRGPRX2 and LUVA cells with and without siRNA-mediated
silencing of MRGPRX2; 2) whether BCM7 and G7 stimulation of MCs leads to the production of mediators that
are known to contribute to the fibrosis and eosinophil recruitment seen in EoE; and 3) whether esophageal
MCs in patients with EoE express MRGPRX2 and correlate with fibrotic features.
Elucidating the mechanism by which BCM7 and G7 activate MCs and lead to the inflammation and fibrosis
seen in EoE will have broad implications for our understanding of EoE pathogenesis, as well as other food-
related conditions such as irritable bowel syndrome and non-celiac gluten sensitivity that are also triggered by
milk and wheat ingestion. This is a question with significant public health implications, as BCM7 and G7 are
widely consumed in the United States and other westernized countries, where the prevalence of EoE is
increasing. Demonstrating activation of MCs by these food-derived peptides could lead to a paradigm shift in
the way that we view the pathogenesis and treatment options for this disease.

## Key facts

- **NIH application ID:** 10115609
- **Project number:** 5R21AI151497-02
- **Recipient organization:** UNIVERSITY OF VIRGINIA
- **Principal Investigator:** Emily Clarke McGowan
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $201,875
- **Award type:** 5
- **Project period:** 2020-03-01 → 2023-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10115609

## Citation

> US National Institutes of Health, RePORTER application 10115609, IgE-Independent Mast Cell Activation by Food-Derived Peptides in Eosinophilic Esophagitis (EoE) (5R21AI151497-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10115609. Licensed CC0.

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