Atkins Dan, Furuta Glenn T, Liacouras Chris A, Spergel Jonathan M
Gastrointestinal Eosinophilic Diseases Program, Children's Hospital Colorado, Aurora, CO, USA.
Section of Allergy-Immunology, Children's Hospital Colorado, Aurora, CO, USA.
Pediatr Allergy Immunol. 2017 Jun;28(4):312-319. doi: 10.1111/pai.12715. Epub 2017 May 4.
Eosinophilic esophagitis (EoE) is one of the most common causes of reflux-like symptoms and feeding problems in children and food impaction and dysphagia in adults with a prevalence of 1:2500. Therapeutic options include diet, use of swallowed corticosteroids, or dilation. In the last several years, recent clinical and translational researches have identified some common and distinctive features, for example, the varying response to diet and medications. As EoE shares some characteristics with both asthma and inflammatory bowel disease, the advances in these fields suggest that various phenotypes may also exist in patients with EoE. Here, we provide a rationale for EoE phenotypes and provide some suggestions for potential phenotypes based on histology, molecular signature, response to therapy or dietary therapy.
嗜酸性粒细胞性食管炎(EoE)是儿童反流样症状和喂养问题以及成人食物嵌塞和吞咽困难的最常见原因之一,患病率为1:2500。治疗选择包括饮食调整、吞咽皮质类固醇药物的使用或扩张治疗。在过去几年中,近期的临床和转化研究已经确定了一些共同和独特的特征,例如对饮食和药物的不同反应。由于EoE与哮喘和炎症性肠病有一些共同特征,这些领域的进展表明EoE患者中也可能存在各种表型。在此,我们阐述了EoE表型的基本原理,并根据组织学、分子特征、对治疗或饮食疗法的反应,对潜在表型提出了一些建议。