Department of Gastroenterology, Kaiser Permanente San Francisco, San Francisco, CA, USA.
Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
Curr Opin Pharmacol. 2022 Apr;63:102183. doi: 10.1016/j.coph.2022.102183. Epub 2022 Feb 15.
Eosinophilic esophagitis (EoE) is an antigen-mediated chronic T helper type 2 (Th2)-associated inflammatory disorder that has emerged in the last three decades as an increasingly common cause of esophageal symptoms. Despite rising incidence and prevalence, there are currently no approved therapies for EoE in the United States and only one oral topical corticosteroid approved in Europe and Canada. Current management relies on labor- and endoscopy-intensive dietary elimination, proton-pump inhibitors (PPIs) with only moderate efficacy, and use of inhaled or nebulized topical corticosteroids designed for asthma and limited by accessibility. Fortunately, progress in elucidating the underlying pathophysiology of EoE has led to the development of new therapies derived from molecular targets necessary for disease pathogenesis. We summarize established and emerging medical therapies for EoE, with a focus on new treatments with specific molecular targets that are likely to change EoE management paradigms in the next decade.
嗜酸粒细胞性食管炎（EoE）是一种抗原介导的慢性 T 辅助型 2（Th2）相关炎症性疾病，在过去三十年中作为一种越来越常见的食管症状的病因出现。尽管发病率和患病率不断上升，但目前在美国尚无批准用于 EoE 的治疗方法，在欧洲和加拿大仅有一种口服局部皮质类固醇获得批准。目前的治疗方法依赖于劳动密集型和内镜密集型饮食消除、质子泵抑制剂（PPIs），仅具有中等疗效，以及使用设计用于哮喘的吸入或雾化局部皮质类固醇，但受到可及性的限制。幸运的是，阐明 EoE 潜在病理生理学的进展导致了针对疾病发病机制所需分子靶标的新型治疗方法的发展。我们总结了 EoE 的既定和新兴的医学治疗方法，重点介绍了具有特定分子靶标的新治疗方法，这些方法可能在未来十年改变 EoE 的管理模式。
