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Updated: Aug 6, 2026
03:23
Three-Dimensional Cell Culture Models to Investigate the Epithelial Barrier in Eosinophilic Esophagitis
Published on: May 10, 2024
Eosinophilic esophagitis - more than eosinophils?
Fabian Luca Meichtry1,2, Thomas Greuter1,2
1Università della Svizzera italiana, Faculty of Biomedical Sciences.
Current Opinion in Gastroenterology
|July 24, 2026
Summary
Eosinophilic esophagitis (EoE) encompasses variants with significant esophageal inflammation but low eosinophil counts. These EoE variants highlight the need for broader diagnostic criteria beyond eosinophilia.
Area of Science:
- Gastroenterology
- Immunology
- Pathology
Background:
- Eosinophilic esophagitis (EoE) is a chronic, type 2 inflammatory disease causing dysphagia.
- Diagnosis traditionally relies on esophageal eosinophilia, but EoE variants with low/no eosinophils are emerging.
- This challenges the central role of eosinophils in EoE pathogenesis.
Purpose of the Study:
- To review current understanding of non-eosinophilic EoE variants.
- To position these variants within the broader EoE spectrum.
- To discuss implications for diagnosis and management.
Main Methods:
- Review of current literature on EoE variants.
- Analysis of molecular and longitudinal data.
- Comparison of inflammatory signatures and disease progression.
Main Results:
- EoE is a Th2-mediated disorder involving genetic, epithelial, and immune factors.
- Three EoE variants (EoE-like, lymphocytic, nonspecific esophagitis) show EoE symptoms below diagnostic eosinophil thresholds.
- These variants have distinct inflammatory profiles and can transition to classical EoE.
Conclusions:
- Clinically significant esophageal inflammation and remodeling occur without high eosinophil counts.
- Recognition of EoE variants impacts biopsy strategy and histologic assessment.
- Broader monitoring and therapy are needed to prevent fibrostenotic complications.
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