Division of Allergy and Immunology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio.
Division of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio.
J Allergy Clin Immunol. 2024 Jun;153(6):1472-1484. doi: 10.1016/j.jaci.2024.03.013. Epub 2024 Mar 28.
Eosinophilic gastrointestinal diseases (EGIDs) are a group of diseases characterized by selective eosinophil infiltration of the gastrointestinal (GI) tract in the absence of other causes of eosinophilia. These diseases are generally driven by type 2 inflammation, often in response to food allergen exposure. Among all EGIDs, the clinical presentation often includes a history of atopic disease with a variety of GI symptoms. EGIDs are traditionally separated into eosinophilic esophagitis (EoE) and non-EoE EGIDs. EoE is relatively better understood and now associated with clinical guidelines and 2 US Food and Drug Administration-approved treatments, whereas non-EoE EGIDs are rarer and less well-understood diseases without US Food and Drug Administration-approved treatments. Non-EoE EGIDs are further subclassified by the area of the GI tract that is involved; they comprise eosinophilic gastritis, eosinophilic enteritis (including eosinophilic duodenitis), and eosinophilic colitis. As with other GI disorders, the disease presentations and mechanisms differ depending on the involved segment of the GI tract; however, the differences between EoE and non-EoE EGIDs extend beyond which GI tract segment is involved. The aim of this article is to summarize the commonalities and differences between the clinical presentations and disease mechanisms for EoE and non-EoE EGIDs.
嗜酸性粒细胞性胃肠道疾病(EGID)是一组以胃肠道(GI)组织中嗜酸性粒细胞选择性浸润为特征的疾病,而无其他嗜酸性粒细胞增多的原因。这些疾病通常由 2 型炎症驱动,通常是对食物过敏原暴露的反应。在所有的 EGID 中,临床表现在常有特应性疾病史和各种胃肠道症状。EGID 传统上分为嗜酸性食管炎(EoE)和非 EoE EGID。EoE 相对来说理解得更好,现在与临床指南和 2 种美国食品和药物管理局批准的治疗方法相关联,而非 EoE EGID 则更为罕见且理解不足,没有美国食品和药物管理局批准的治疗方法。非 EoE EGID 进一步根据涉及的 GI 道区域进行分类;它们包括嗜酸性胃炎、嗜酸性肠炎(包括嗜酸性十二指肠炎)和嗜酸性结肠炎。与其他胃肠道疾病一样,疾病表现和机制取决于涉及的胃肠道节段;然而,EoE 和非 EoE EGID 之间的区别不仅限于涉及的胃肠道节段。本文的目的是总结 EoE 和非 EoE EGID 的临床表型和疾病机制之间的共同和不同之处。