Division of Allergy, Immunology and Rheumatology, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC.
Center for Esophageal Diseases and Swallowing, Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC.
J Allergy Clin Immunol Pract. 2018 Sep-Oct;6(5):1483-1495. doi: 10.1016/j.jaip.2018.06.012. Epub 2018 Jul 3.
The eosinophilic gastrointestinal diseases (EGIDs) represent disorders of the gastrointestinal (GI) tract that result from the local infiltration and aberrant activity of eosinophils and other immune cells. Eosinophilic esophagitis (EoE) is the most well-characterized EGID and is defined by the presence of intraepithelial eosinophils in the esophagus (≥15 eosinophils per high-powered field) and clinical symptoms associated with esophageal dysfunction. The other EGIDs are rare and lack strong data regarding pathogenesis and management. The incidence and prevalence of EoE are increasing, and EoE is now a major cause of upper GI morbidity. Management is multidisciplinary, with collaboration between gastroenterologists, allergists, pathologists, and dieticians, and is aimed at amelioration of symptoms and prevention of long-term complications such as esophageal stricture. Treatment options for EoE include proton pump inhibitors, swallowed topical corticosteroids, and elimination diets. Esophageal dilation is used when esophageal strictures or fibrostenotic changes are present. Additional therapies targeting eosinophils and other mediators of Th2 inflammation are under development and are promising. Treatment options for other EGIDs typically involve corticosteroids or dietary elimination.
嗜酸粒细胞性胃肠道疾病（EGIDs）是指胃肠道（GI）局部浸润和嗜酸性粒细胞及其他免疫细胞异常活动引起的疾病。嗜酸粒细胞性食管炎（EoE）是最典型的 EGIDs，其特征为食管上皮内存在嗜酸性粒细胞（≥每高倍视野 15 个嗜酸性粒细胞）和与食管功能障碍相关的临床症状。其他 EGIDs 较为罕见，其发病机制和治疗方面的数据较少。EoE 的发病率和患病率正在增加，现已成为上消化道发病率的主要原因。EoE 的治疗是多学科的，需要胃肠病学家、过敏学家、病理学家和营养师之间的合作，旨在改善症状和预防食管狭窄等长期并发症。EoE 的治疗选择包括质子泵抑制剂、口服局部皮质类固醇和消除饮食。当存在食管狭窄或纤维性狭窄变化时，使用食管扩张。针对嗜酸性粒细胞和 Th2 炎症其他介质的其他治疗方法正在开发中，前景广阔。其他 EGIDs 的治疗选择通常涉及皮质类固醇或饮食消除。
