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Eosinophilic esophagitis: unclear roles of IgE and eosinophils.

Abstract Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the oesophagus. Recognized as a distinct entity only two decades ago, the emergence of the disease along with the availability of new technologies has rapidly opened new research avenues and outlined the main features of the pathogenesis of EoE. Yet, each advance in our understanding of the disease has raised new questions about the previous consensus. Currently, new subsets of the disease challenge our diagnostic criteria. For instance, it was believed that EoE did not respond to proton pump inhibitor (PPI) therapy; however, it has now been shown that a substantial proportion of EoE patients indeed respond to PPIs. In addition, a new subset of patients not even presenting eosinophil infiltrates in the oesophagus has also been described. Moreover, approaches for better understanding the heritability of the disease bring into question the dogma of predominant genetic involvement. Furthermore, the specificity and sensitivity of allergy testing for targeted food avoidance is highly controversial, and the production of specific antibodies in EoE now includes IgG4 in addition to IgE. In conclusion, EoE is perceived as 'a moving target' and the aim of this review was to summarize the current understanding of EoE pathogenesis.
PMID
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Authors

Mayor MeshTerms
Keywords

Eosinophilic esophagitis

eosinophils

immunoglobulin E

pathogenesis

Journal Title journal of internal medicine
Publication Year Start




PMID- 28425585
OWN - NLM
STAT- In-Process
DA  - 20170420
LR  - 20170420
IS  - 1365-2796 (Electronic)
IS  - 0954-6820 (Linking)
VI  - 281
IP  - 5
DP  - 2017 May
TI  - Eosinophilic esophagitis: unclear roles of IgE and eosinophils.
PG  - 448-457
LID - 10.1111/joim.12568 [doi]
AB  - Eosinophilic esophagitis (EoE) is a chronic inflammatory disease of the
      oesophagus. Recognized as a distinct entity only two decades ago, the emergence
      of the disease along with the availability of new technologies has rapidly opened
      new research avenues and outlined the main features of the pathogenesis of EoE.
      Yet, each advance in our understanding of the disease has raised new questions
      about the previous consensus. Currently, new subsets of the disease challenge our
      diagnostic criteria. For instance, it was believed that EoE did not respond to
      proton pump inhibitor (PPI) therapy; however, it has now been shown that a
      substantial proportion of EoE patients indeed respond to PPIs. In addition, a new
      subset of patients not even presenting eosinophil infiltrates in the oesophagus
      has also been described. Moreover, approaches for better understanding the
      heritability of the disease bring into question the dogma of predominant genetic 
      involvement. Furthermore, the specificity and sensitivity of allergy testing for 
      targeted food avoidance is highly controversial, and the production of specific
      antibodies in EoE now includes IgG4 in addition to IgE. In conclusion, EoE is
      perceived as 'a moving target' and the aim of this review was to summarize the
      current understanding of EoE pathogenesis.
CI  - (c) 2016 The Association for the Publication of the Journal of Internal Medicine.
FAU - Blanchard, C
AU  - Blanchard C
AD  - Nestle Research Center, Lausanne, Switzerland.
FAU - Simon, D
AU  - Simon D
AD  - Department of Dermatology, Inselspital, Bern University Hospital, Bern,
      Switzerland.
FAU - Schoepfer, A
AU  - Schoepfer A
AD  - Division of Gastroenterology, Centre Hospitalier Universitaire Vaudois (CHUV),
      Lausanne, Switzerland.
FAU - Straumann, A
AU  - Straumann A
AD  - Swiss EoE Clinic and EoE Research Network, Olten, Switzerland.
FAU - Simon, H-U
AU  - Simon HU
AD  - Institute of Pharmacology, University of Bern, Bern, Switzerland.
LA  - eng
PT  - Journal Article
DEP - 20161107
PL  - England
TA  - J Intern Med
JT  - Journal of internal medicine
JID - 8904841
OTO - NOTNLM
OT  - Eosinophilic esophagitis
OT  - eosinophils
OT  - immunoglobulin E
OT  - pathogenesis
EDAT- 2017/04/21 06:00
MHDA- 2017/04/21 06:00
CRDT- 2017/04/21 06:00
AID - 10.1111/joim.12568 [doi]
PST - ppublish
SO  - J Intern Med. 2017 May;281(5):448-457. doi: 10.1111/joim.12568. Epub 2016 Nov 7.

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