Cianferoni Antonella, Spergel Jonathan M
Divisions of Allergy and Immunology, Department of Pediatrics, The Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, ARC 1216H, 3615 Civic Center Blvd, Philadelphia, PA 19104, USA.
Immunotherapy. 2014;6(3):321-31. doi: 10.2217/imt.14.3.
Eosinophilic esophagitis (EoE) is a clinical pathologic disease characterized by symptoms of esophageal dysfunction and eosinophilia of the esophagus. When the diagnosis is confirmed, it is important to treat the eosinophilic inflammation not only to control the presenting symptoms, but also to prevent acute and chronic complications. The pathogenesis of EoE is most likely a mixed IgE and non-IgE food-mediated reaction, where Th2 cytokines drive esophageal eosinophilia as in other atopic diseases. Hence, it is not surprising that therapy is based on inflammation control, with steroids (oral or topical) and/or food antigen avoidance. However, these treatment options are not specific, reduce the quality of life of patients and have significant side effects, therefore, there is an ongoing effort to design more specific immunotherapies. In this review, we review standard and immunotherapeutic options for EoE treatment, such as anti-IL-5, anti-TNFα, anti-IgE, anti-CRTH, oral allergy desensitization and environmental immunotherapy.
嗜酸性粒细胞性食管炎（EoE）是一种临床病理疾病，其特征为食管功能障碍症状和食管嗜酸性粒细胞增多。确诊后，治疗嗜酸性粒细胞炎症不仅对于控制当前症状很重要，而且对于预防急慢性并发症也很重要。EoE的发病机制很可能是混合性IgE和非IgE食物介导的反应，其中Th2细胞因子像在其他特应性疾病中一样驱动食管嗜酸性粒细胞增多。因此，基于炎症控制，使用类固醇（口服或局部）和/或避免食物抗原进行治疗并不奇怪。然而，这些治疗选择并不特异，会降低患者的生活质量且有显著副作用，因此，人们一直在努力设计更特异的免疫疗法。在本综述中，我们回顾了EoE治疗的标准和免疫治疗选择，如抗IL-5、抗TNFα、抗IgE、抗CRTH、口服过敏脱敏疗法和环境免疫疗法。
