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Eosinophilic esophagitis: latest insights from diagnosis to therapy
Author(s) -
Schoepfer Alain,
Blanchard Carine,
Dawson Heather,
Lucendo Alfredo,
Mauro Aurelio,
Ribi Camillo,
Safroneeva Ekaterina,
Savarino Edoardo V.,
Penagini Roberto
Publication year - 2018
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/nyas.13731
Subject(s) - eosinophilic esophagitis , medicine , eosinophilia , disease , intensive care medicine , natural history , esophagitis , proton pump inhibitor , allergy , dermatology , immunology , pathology , reflux
Eosinophilic esophagitis (EoE) represents a chronic, local immune‐mediated esophageal disease, characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil‐predominant inflammation. Other systemic and local causes of esophageal eosinophilia should be excluded. Clinical manifestations or pathologic data should not be interpreted in isolation. EoE was first described as a distinct disease entity in 1993. Most patients are diagnosed with underlying food allergies. The first diagnostic and therapeutic guidelines were published in 2007 with a first update in 2011. In 2017, new international guidelines were published based on the GRADE methodology. These guidelines provide, among many other topics, insights on the role of proton pump inhibitor‐responsive esophageal eosinophilia. Over the last two decades, considerable progress was made by stakeholders regarding the understanding of EoE's pathogenesis, genetic background, natural history, allergy workup, standardization of assessment of disease activity, evaluation of minimally invasive diagnostic tools, and new therapeutic approaches. This brief review provides further insights into latest diagnostic and therapeutic advances.