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Pathophysiological bases of eosinophilic esophagitis therapy.

Abstract
Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of unknown etiology, presenting a dense mucosal infiltration of eosinophils that is not reversible with proton pump inhibitor therapy. Endoscopy has reported EoE commonly polymorphous disease with subtle mucosal changes, accompanied by variations in the caliber of the esophagus. The suggestion of EoE as an allergic disease is still short of evidence and recently, it has only been confirmed that the esophagus mucosal layer infiltrated by eosinophils may determine an association with allergy after exposure to allergens. A comprehensive review of symptoms, risk factors, diagnoses and mechanisms involved in the pathogenesis of EoE was carried out, with an analysis of the different treatment options available for this disease firmly maximizing in incidence and prevalence. The management of EoE is multidisciplinary and can involve gastroenterologists, pathologists, allergists and dietitians, particularly in pediatric patients, because dietary food restrictions appear to be more beneficial in children versus adults. EoE can successfully be treated with topical corticosteroids, which eliminate the clinical manifestations and histological lesions in most cases. Prolonged treatment is advised for EoE because it recurs frequently, particularly on discontinuation of therapy. Experimental treatments using immunotherapy are being investigated, but their safety and efficacy are yet to be defined.
AuthorsRicardo Moreno-Borque, Javier P Gisbert, Cecilio Santander
JournalInflammation & allergy drug targets (Inflamm Allergy Drug Targets) Vol. 12 Issue 1 Pg. 46-53 (Feb 2013) ISSN: 2212-4055 [Electronic] United Arab Emirates
PMID23110509 (Publication Type: Journal Article)
Chemical References
  • Adrenal Cortex Hormones
Topics
  • Adrenal Cortex Hormones (therapeutic use)
  • Child
  • Endoscopy
  • Eosinophilic Esophagitis (diagnosis, etiology, physiopathology, therapy)
  • Eosinophils (drug effects, metabolism, pathology)
  • Feeding Behavior
  • Humans
  • Immunotherapy (methods)
  • Mucous Membrane (pathology)
  • Prevalence
  • Risk Factors

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