Pathogenesis, Diagnosis and Treatment of Eosinophilic Esophagitis

DOI Web Site Web Site 14 References
  • Fujiwara Yasuhiro
    Department of Gastroenterology, Osaka City University Graduate School of Medicine

Bibliographic Information

Other Title
  • 消化器科領域における好酸球性疾患
  • ショウカキカ リョウイキ ニ オケル コウサンキュウセイ シッカン

Search this article

Abstract

<p>Eosinophilic esophagitis (EoE) is a chronic allergic disease defined as the presence of esophageal symptoms such as food impaction and dysphagia and intraepithelial eosinophil infiltration ≥15 per high-power field on biopsy specimens. Although a clinical condition similar to EoE that responds to PPI was earlier referred to as PPI-responsive esophageal eosinophilia (PPI-REE), several studies have shown similar pathogenesis between PPI-REE and EoE. Therefore, recent guidelines propose that the definition of EoE not require unresponsiveness to PPI, indicating that PPI-REE should be included in EoE. EoE is rare but has been increasing in Japan, especially cases found incidentally during health check-ups. The pathogenesis of EoE includes genetic susceptibility as well as environmental factors, and divides into an inflammation phase of eosinophil infiltration with TSLP, IL-13, and eotaxin-3, and a fibrostenotic phase of submucosal fibrosis with TGF-β1 and periostin. PPI is effective in approximately two-thirds of EoE cases, and most other cases are successfully treated with steroid swallowing therapy. In Western countries, the six food elimination diet, balloon dilation, and biologics are reported as therapeutic options.</p>

Journal

References(14)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top