Precision medicine in eosinophilic esophagitis

Area of Science:

• Immunology
• Gastroenterology
• Genetics

Background:

• Eosinophilic esophagitis (EoE) is a prevalent chronic immune-mediated esophageal disease.
• Current diagnosis and management are invasive and empiric, leading to delays and trial-and-error treatments.
• EoE is increasingly recognized as a heterogeneous condition with diverse biological drivers.

Purpose of the Study:

• To review the current patient journey for EoE.
• To explore opportunities for integrating precision medicine strategies throughout the EoE disease continuum.
• To discuss future directions for diagnostics and targeted therapies in EoE.

Main Methods:

• Review of recent advances in EoE epidemiology, genetics, molecular profiling, and immunology.
• Examination of emerging tools like polygenic risk scores, molecular endotyping, and biomarkers.
• Discussion of antigen-specific immune pathways.

Main Results:

• EoE heterogeneity suggests distinct biological drivers.
• Emerging tools may improve risk stratification and reduce reliance on endoscopy.
• Precision medicine can align therapy with individual disease biology.

Conclusions:

• Precision medicine holds promise for improving EoE diagnosis and management.
• Future research should focus on defining antigen-specific immune pathways for next-generation therapies.
• Integrating precision strategies can lead to more individualized and effective EoE treatment.