Recent advances in the pathological understanding of eosinophilic esophagitis

Expert Rev Gastroenterol Hepatol. 2015;9(12):1501-10. doi: 10.1586/17474124.2015.1094372. Epub 2015 Oct 15.

Abstract

Eosinophilic esophagitis (EoE) is a chronic allergen-mediated inflammatory disease of the esophagus. This inflammation leads to feeding difficulties, failure to thrive and vomiting in young children, and causes food impaction and esophageal stricture in adolescents and adults. In the 20 years since EoE was first described, we have gained a great deal of knowledge regarding the genetic predisposition of disease, the inflammatory milieu associated with EoE and the long-term complications of chronic inflammation. Herein, we summarize the important breakthroughs in the field including both in vitro and in vivo analysis. We discuss insights that we have gained from large-scale unbiased genetic analysis, a multitude of genetically and chemically altered mouse models of EoE and most importantly, the results of clinical trials of various pharmacologic agents. Understanding these successes and failures may be the key to developing more effective therapeutic strategies.

Keywords: IL-13; T cells; eosinophilic esophagitis; fibrosis; thymic stromal lymphopoietin.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Basophils / immunology
  • Calpain / genetics
  • Cellular Microenvironment
  • Cytokines / genetics
  • Cytokines / metabolism
  • Dysbiosis / complications
  • Eosinophilic Esophagitis / genetics*
  • Eosinophilic Esophagitis / immunology*
  • Eosinophilic Esophagitis / pathology
  • Esophagus / pathology*
  • Fibrosis
  • Genetic Predisposition to Disease
  • Humans
  • Immunoglobulin E / metabolism
  • Interleukin-13 / metabolism
  • Interleukin-5 / metabolism
  • Mast Cells / immunology
  • Mucous Membrane / physiopathology
  • Neoplasm Proteins / genetics
  • Nuclear Proteins / genetics
  • Receptors, Cytokine / metabolism
  • Repressor Proteins / genetics
  • Th2 Cells / immunology*

Substances

  • CRLF2 protein, human
  • Cytokines
  • EMSY protein, human
  • Interleukin-13
  • Interleukin-5
  • Neoplasm Proteins
  • Nuclear Proteins
  • Receptors, Cytokine
  • Repressor Proteins
  • Immunoglobulin E
  • CAPN14 protein, human
  • Calpain
  • thymic stromal lymphopoietin