Division of Pulmonary Medicine, Department of Pediatrics, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA.
Division of Immunology and Infectious Disease, Department of Pediatrics, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA.
Clin Rev Allergy Immunol. 2018 Aug;55(1):65-69. doi: 10.1007/s12016-018-8671-6.
Eosinophilic esophagitis is an atopic disease defined clinically by esophageal symptoms in combination with a dense esophageal eosinophilia. EoE is triggered and maintained by exposure to certain foods and it is known that dietary modification controls symptoms and achieves disease remission. Recently, aeroallergens have been implicated in the pathogenesis of EoE. To examine the role of aeroallergens in EoE, we reviewed the published literature. Sensitization and production of IgE antibodies to foods and aeroallergens in subjects with EoE has been demonstrated. However, the evidence suggests only a minor role for IgE-mediated immune reactions in EoE. There is some evidence to support an association of EoE diagnosis and flares with environmental allergen exposure, and animal studies support the notion that EoE may be induced by exposure to inhalant allergens. Some studies show that newly diagnosed cases of EoE follow a seasonal pollen distribution (summer and spring), but the weight of evidence does not support the seasonal occurrence of diagnosis or worsening of symptoms. Overall, we conclude that the current evidence does not support causality in inhalant allergen exposure and the genesis nor exacerbations of EoE in humans, although there is a possibility that inhalant allergen sensitization could play a modifying role in EoE in the context of cross-reacting food allergens.
嗜酸粒细胞性食管炎是一种特应性疾病，临床上通过食管症状结合食管嗜酸性粒细胞增多来定义。EoE 由暴露于某些食物引发和维持，已知饮食调整可控制症状并实现疾病缓解。最近，气传过敏原被认为与 EoE 的发病机制有关。为了研究气传过敏原在 EoE 中的作用，我们回顾了已发表的文献。已经证明，EoE 患者对食物和气传过敏原存在致敏和 IgE 抗体产生。然而，证据表明 IgE 介导的免疫反应在 EoE 中仅起次要作用。有一些证据支持 EoE 诊断和发作与环境过敏原暴露有关，动物研究支持这样一种观点，即 EoE 可能是由吸入性过敏原暴露引起的。一些研究表明，新诊断的 EoE 病例遵循季节性花粉分布（夏季和春季），但证据权重并不支持诊断或症状恶化的季节性发生。总的来说，我们的结论是，目前的证据并不支持吸入性过敏原暴露与人类 EoE 的发生或恶化之间存在因果关系，尽管在交叉反应性食物过敏原的背景下，吸入性过敏原致敏可能在 EoE 中发挥修饰作用。
