Division of Pediatric Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104-6160, USA.
Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
J Gastroenterol. 2019 Jan;54(1):10-18. doi: 10.1007/s00535-018-1498-3. Epub 2018 Aug 12.
Eosinophilic esophagitis (EoE) is a food allergen-induced inflammatory disorder. EoE is increasingly recognized as a cause of swallowing dysfunction, food impaction and esophageal stricture. Inflammation of the esophageal mucosa involves immune cell infiltrate, reactive epithelial changes and fibroblast activation, culminating in robust tissue remodeling toward esophageal fibrosis characterized by excess collagen deposition in the subepithelial lamina propria. Fibrosis contributes to a unique mechanical property of the EoE-affected esophagus that is substantially stiffer than the normal esophagus. There is a great need to better understand the processes behind esophageal fibrosis in order to foster improved diagnostic tools and novel therapeutics for EoE-related esophageal fibrosis. In this review, we discuss the role of esophageal inflammatory microenvironment that promotes esophageal fibrosis, with specific emphasis upon cytokines-mediated functional epithelial-stromal interplays, recruitment and activation of a variety of effector cells, and tissue stiffness. We then explore the current state of clinical methodologies to detect and treat the EoE-related esophageal stricture.
嗜酸性粒细胞性食管炎（EoE）是一种由食物过敏原引起的炎症性疾病。EoE 越来越被认为是吞咽功能障碍、食物嵌塞和食管狭窄的原因。食管黏膜的炎症涉及免疫细胞浸润、反应性上皮变化和成纤维细胞激活，最终导致强有力的组织重塑，向以过量胶原在黏膜下层沉积为特征的食管纤维化发展。纤维化导致 EoE 受累食管具有独特的机械特性，其硬度明显高于正常食管。为了促进改善 EoE 相关食管纤维化的诊断工具和新疗法，我们非常有必要更好地了解食管纤维化背后的过程。在这篇综述中，我们讨论了促进食管纤维化的食管炎症微环境的作用，特别强调了细胞因子介导的功能性上皮-间质相互作用、各种效应细胞的募集和激活，以及组织硬度。然后，我们探讨了目前用于检测和治疗 EoE 相关食管狭窄的临床方法。
