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嗜酸性食管炎管理的近期趋势:一项系统评价

Recent Trends in the Management of Eosinophilic Esophagitis: A Systematic Review.

作者信息

Dutta Priyata, Shah-Riar Prince, Bushra Sumaita Sadida, Haque Sharar Naiarin, Rafa Zahin Islam, Hawa Fadi, Chakrabarty Swarna, Dev Nath Supti, Afrin Humayra, Shama Nishat, Khair Farzana, Maisha Sadia, Kapuria Progga, Dam Barna

机构信息

Internal Medicine, Trinity Health Ann Arbor, Ypsilanti, USA.

Internal Medicine, Ibn Sina Medical College, Dhaka, BGD.

出版信息

Cureus. 2023 Aug 9;15(8):e43221. doi: 10.7759/cureus.43221. eCollection 2023 Aug.

DOI:10.7759/cureus.43221
PMID:37692685
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10490439/
Abstract

Eosinophilic esophagitis (EoE) is a chronic immune-mediated condition characterized by inflammation and eosinophilic accumulation of the esophagus, resulting in dysphagia and food impaction. While the exact etiology of EoE remains unclear, it is believed to be triggered by food allergens and dynamic environmental factors, resulting in various clinical manifestations, from inflammation to fibrosis. Although clinical presentation varies with age, the number of eosinophils in esophagogastroduodenal endoscopy remains the diagnostic gold standard. While diet elimination, proton pump inhibitors (PPIs), topical corticosteroids, and biological therapy are promising treatment options for EoE, there are insufficient data to determine the optimal therapeutic treatment approach. Combination therapies - the use of dietary therapies in conjunction with other treatment modalities, such as PPIs, topical corticosteroids, or biologic agents - have also emerged as a potential management strategy for EoE. In this systematic review, we attempt to highlight the recent advances in EoE therapies and provide updated guidance to their management. From 2017 to 2022, we conducted a comprehensive electronic search of PubMed (MEDLINE) using specific keywords related to our objective and eventually included a total of 44 articles.

摘要

嗜酸性食管炎(EoE)是一种慢性免疫介导性疾病,其特征为食管炎症和嗜酸性粒细胞积聚,可导致吞咽困难和食物嵌塞。虽然EoE的确切病因尚不清楚,但据信是由食物过敏原和动态环境因素引发的,会导致从炎症到纤维化的各种临床表现。尽管临床表现因年龄而异,但食管胃十二指肠内镜检查中的嗜酸性粒细胞数量仍是诊断的金标准。虽然饮食排除、质子泵抑制剂(PPI)、局部皮质类固醇和生物疗法是EoE很有前景的治疗选择,但尚无足够数据确定最佳治疗方法。联合疗法——将饮食疗法与其他治疗方式(如PPI、局部皮质类固醇或生物制剂)结合使用——也已成为EoE的一种潜在管理策略。在本系统评价中,我们试图突出EoE治疗的最新进展,并为其管理提供最新指导。2017年至2022年,我们使用与我们的目标相关的特定关键词对PubMed(MEDLINE)进行了全面的电子检索,最终共纳入44篇文章。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae48/10490439/eef39d1cd033/cureus-0015-00000043221-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae48/10490439/48292b635eee/cureus-0015-00000043221-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae48/10490439/90527b7eb5ac/cureus-0015-00000043221-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae48/10490439/566d42735102/cureus-0015-00000043221-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae48/10490439/eef39d1cd033/cureus-0015-00000043221-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae48/10490439/48292b635eee/cureus-0015-00000043221-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae48/10490439/90527b7eb5ac/cureus-0015-00000043221-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae48/10490439/566d42735102/cureus-0015-00000043221-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae48/10490439/eef39d1cd033/cureus-0015-00000043221-i04.jpg

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2
Efficacy of Elimination Diets in Eosinophilic Esophagitis: A Systematic Review and Meta-analysis.消减法在嗜酸性粒细胞性食管炎中的疗效:系统评价和荟萃分析。
Clin Gastroenterol Hepatol. 2023 Aug;21(9):2197-2210.e3. doi: 10.1016/j.cgh.2023.01.019. Epub 2023 Jan 31.
3
Dietary and Nutritional Support in Gastrointestinal Diseases of the Upper Gastrointestinal Tract (I): Esophagus.
消化道疾病的饮食与营养支持(一):上消化道——食管。
Nutrients. 2022 Nov 14;14(22):4819. doi: 10.3390/nu14224819.
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Allergy-Test-Based Elimination Diets for the Treatment of Eosinophilic Esophagitis: A Systematic Review of Their Efficacy.基于过敏测试的排除饮食疗法治疗嗜酸性粒细胞性食管炎:疗效的系统评价
J Clin Med. 2022 Sep 24;11(19):5631. doi: 10.3390/jcm11195631.
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Rebuilding trust in proton pump inhibitor therapy.重建质子泵抑制剂治疗的信任。
World J Gastroenterol. 2022 Jun 28;28(24):2667-2679. doi: 10.3748/wjg.v28.i24.2667.
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