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成人嗜酸性粒细胞性食管炎及其治疗进展。

Adult eosinophilic esophagitis and advances in its treatment.

作者信息

Grando Martina, De Pauli Silvia, Miotti Giovanni, Balbi Massimiliano, Zeppieri Marco

机构信息

Department of Internal Medicine, Azienda Sanitaria Friuli Occidentale, San Vito al Tagliamento 33078, Italy.

Department of Internal Medicine, Azienda Sanitaria Friuli Occidentale, Pordenone 33170, Italy.

出版信息

World J Methodol. 2023 Jun 20;13(3):59-66. doi: 10.5662/wjm.v13.i3.59.

Abstract

Eosinophilic esophagitis (EoE) is a chronic eosinophil inflammation that seems to be T helper type 2 antigen-driven. The disease is one of several eosinophilic gastrointestinal disorders in which there appears to be inflammation of the gastrointestinal tract without any apparent underlying causes. Differential diagnosis needs to be made with gastroesophageal reflux, which is characterized by chronic inflammation due to gastric refluxate from disorders related to motility. EoE, however, is considered a chronic allergic inflammatory disorder related to destructive tissue remodeling. There seems to be a higher prevalence of EoE in Western countries. It is typically found in atopic male individuals. Physiopathological risk factors include atopy, environmental factors, esophageal epithelial barrier dysfunctions, EoE can cause several symptoms that include retrosternal burning sensation, dysphagia, food impaction, chronic reflux symptoms, nausea, and vomiting. Early diagnosis, which requires a biopsy to assess for esophageal inflammation, is essential for proper treatment. The aim of our brief overview is to summarize the current literature regarding the characteristics, diagnosis, complications, mechanisms of pathology, clinical features, influence of comorbidities, and treatment in patients with EoE.

摘要

嗜酸性食管炎(EoE)是一种慢性嗜酸性粒细胞炎症,似乎由2型辅助性T细胞抗原驱动。该疾病是几种嗜酸性粒细胞性胃肠疾病之一,其胃肠道出现炎症但无任何明显的潜在病因。需要与胃食管反流进行鉴别诊断,胃食管反流的特征是由与动力相关疾病导致的胃反流物引起的慢性炎症。然而,EoE被认为是一种与破坏性组织重塑相关的慢性过敏性炎症性疾病。在西方国家,EoE的患病率似乎更高。它通常见于特应性男性个体。生理病理危险因素包括特应性、环境因素、食管上皮屏障功能障碍。EoE可导致多种症状,包括胸骨后烧灼感、吞咽困难、食物嵌塞、慢性反流症状、恶心和呕吐。早期诊断需要活检以评估食管炎症,这对恰当治疗至关重要。我们简要综述的目的是总结目前关于EoE患者的特征、诊断、并发症、病理机制、临床特征、合并症的影响及治疗的文献。

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Eosinophilic Esophagitis.嗜酸性粒细胞性食管炎。
Immunol Allergy Clin North Am. 2021 Nov;41(4):587-598. doi: 10.1016/j.iac.2021.07.011.
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Diagnosis and treatment of eosinophilic esophagitis.嗜酸粒细胞性食管炎的诊断与治疗。
J Allergy Clin Immunol. 2020 Jan;145(1):1-7. doi: 10.1016/j.jaci.2019.11.011.
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Eosinophilic Esophagitis: Review and Update.嗜酸性食管炎:综述与更新
Front Med (Lausanne). 2018 Oct 9;5:247. doi: 10.3389/fmed.2018.00247. eCollection 2018.
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Eosinophilic esophagitis: pathophysiology and its clinical implications.嗜酸性粒细胞性食管炎:病理生理学及其临床意义。
Am J Physiol Gastrointest Liver Physiol. 2018 Nov 1;315(5):G879-G886. doi: 10.1152/ajpgi.00174.2018. Epub 2018 Sep 13.

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