Pathophysiological bases of eosinophilic esophagitis therapy

Area of Science:

• Gastroenterology
• Immunology
• Allergy

Background:

• Eosinophilic esophagitis (EoE) is a chronic inflammatory condition characterized by eosinophil infiltration of the esophageal mucosa.
• EoE is not responsive to proton pump inhibitor therapy and presents with varied endoscopic findings.
• The link between EoE and allergies is increasingly recognized, particularly after allergen exposure.

Purpose of the Study:

• To comprehensively review the symptoms, risk factors, diagnostic methods, and pathogenesis of EoE.
• To analyze current and emerging treatment options for EoE, considering its rising incidence and prevalence.
• To highlight the multidisciplinary approach required for managing EoE, especially in pediatric cases.

Main Methods:

• A comprehensive literature review was conducted.
• Analysis included symptoms, risk factors, diagnosis, pathogenesis, and treatment options for EoE.
• Focus was placed on incidence, prevalence, and management strategies.

Main Results:

• Topical corticosteroids are effective in resolving clinical and histological manifestations of EoE.
• Dietary modifications show greater benefit in children than adults.
• EoE frequently recurs, necessitating prolonged treatment.

Conclusions:

• EoE management requires a multidisciplinary team including gastroenterologists, pathologists, allergists, and dietitians.
• Topical corticosteroids are the primary treatment, with prolonged therapy advised due to high recurrence rates.
• Investigational therapies like immunotherapy are under study, but their efficacy and safety are undetermined.