Eosinophilic gastrointestinal disorders, a new epidemic

Area of Science:

• Gastroenterology
• Immunology
• Pathology

Background:

• Eosinophilic gastrointestinal disorders (EGID) are a growing group of conditions characterized by eosinophilic infiltration of the gastrointestinal tract.
• While eosinophilic esophagitis (EoE) has been extensively studied, other EGID, such as eosinophilic gastritis, enteritis, and colitis, remain underdiagnosed and undertreated.

Purpose of the Study:

• To review current knowledge on primary EGID, focusing on pathogenesis, diagnosis, and treatment.
• To highlight the challenges in diagnosing and managing non-EoE EGID compared to EoE.

Main Methods:

• Literature review of primary EGID.
• Analysis of pathogenesis, clinical presentation, diagnostic criteria, and therapeutic options for EoE and non-EoE EGID.

Main Results:

• Epithelial barrier dysfunction and type 2 inflammation are key in EoE; mechanisms for distal EGID are less understood.
• Diagnosis relies on biopsy, but thresholds for distal EGID are imperfect. Treatment for EoE is established, including dupilumab.
• Management of non-EoE EGID lacks standardization, often relying on systemic corticosteroids, immunomodulators, and limited biologics.

Conclusions:

• EGID are a heterogeneous group of diseases, with EoE being the most studied.
• Non-EoE EGID are rare, understudied, and require further research.
• Development of validated outcome measures is crucial for advancing clinical trials and therapies for non-EoE EGID.