Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Division of Allergy and Immunology, Children's Hospital Philadelphia, University of Pennsylvania, Philadelphia, PA, USA.
Allergy. 2016 May;71(5):611-20. doi: 10.1111/all.12846. Epub 2016 Feb 25.
Eosinophilic esophagitis (EoE) is a chronic disease characterized clinically by symptoms of esophageal dysfunction and histologically by eosinophil-predominant inflammation. EoE is frequently associated with concomitant atopic diseases and immunoglobulin E (IgE) sensitization to food allergens in children as well as to aeroallergens and cross-reactive plant allergen components in adults. Patients with EoE respond well to elemental and empirical food elimination diets. Recent research has, however, indicated that the pathogenesis of EoE is distinct from IgE-mediated food allergy. In this review, we discuss the individual roles of epithelial barrier defects, dysregulated innate and adaptive immune responses, and of microbiota in the pathogenesis of EoE. Although food has been recognized as a trigger factor of EoE, the mechanism by which it initiates or facilitates eosinophilic inflammation appears to be largely independent of IgE and needs to be further investigated. Understanding the pathogenic role of food in EoE is a prerequisite for the development of specific diagnostic tools and targeted therapeutic procedures.
嗜酸性粒细胞性食管炎（EoE）是一种以食管功能障碍为临床特征，以嗜酸性粒细胞为主的炎症为组织学特征的慢性疾病。EoE 常与同时发生的特应性疾病和儿童对食物过敏原的免疫球蛋白 E（IgE）致敏以及成人对气传过敏原和交叉反应性植物过敏原成分有关。EoE 患者对元素和经验性食物消除饮食反应良好。然而，最近的研究表明，EoE 的发病机制与 IgE 介导的食物过敏不同。在这篇综述中，我们讨论了上皮屏障缺陷、调节不良的先天和适应性免疫反应以及微生物群在 EoE 发病机制中的作用。尽管食物已被认为是 EoE 的触发因素，但它引发或促进嗜酸性粒细胞炎症的机制似乎在很大程度上独立于 IgE，需要进一步研究。了解食物在 EoE 中的致病作用是开发特定诊断工具和靶向治疗程序的前提。
