Environmental factors and eosinophilic esophagitis

Area of Science:

• Gastroenterology
• Immunology
• Environmental Health

Background:

• Eosinophilic esophagitis (EoE) incidence and prevalence have significantly increased in recent decades.
• While genetic factors are being identified, environmental influences are suspected to drive the rapid rise in EoE.
• The exact cause of EoE remains unknown despite advances in understanding its pathogenesis.

Purpose of the Study:

• To review emerging data on environmental risk factors associated with EoE.
• To explore the role of the hygiene hypothesis and dysbiosis in EoE development.
• To discuss geographic and behavioral factors implicated in EoE.

Main Methods:

• Review of existing scientific literature on environmental risk factors for EoE.
• Analysis of studies investigating early-life exposures (antibiotics, acid suppression, C-section).
• Examination of evidence on infectious agents (e.g., Helicobacter pylori), geographic factors, and behavioral influences.

Main Results:

• Early-life exposures like antibiotic use, acid suppression, and cesarean delivery are associated with increased EoE risk.
• Certain infectious agents, such as Helicobacter pylori, show an inverse association with EoE.
• Geographic factors (population density, climate, seasonality) and behavioral elements are also evaluated as potential contributors.

Conclusions:

• Environmental factors, particularly early-life exposures and microbial dysbiosis, are critical in the rising incidence of EoE.
• Further research is needed to understand gene-environment interactions and confirm identified risk factors.
• Understanding these environmental triggers is crucial for developing effective prevention and treatment strategies for EoE.