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嗜酸性粒细胞性食管炎:诊断与治疗的最新观点。

Eosinophilic esophagitis: Current concepts in diagnosis and management.

机构信息

Department of Medicine, Section of Gastroenterology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

Department of Medicine, King Khalid University, Abha, Saudi Arabia.

出版信息

Saudi J Gastroenterol. 2024 Jul 1;30(4):210-227. doi: 10.4103/sjg.sjg_50_24. Epub 2024 May 16.

DOI:10.4103/sjg.sjg_50_24
PMID:38752302
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11379248/
Abstract

Eosinophilic esophagitis is an antigen-mediated chronic inflammatory disorder that has risen in incidence and prevalence over the past 2 decades. The clinical presentation is variable and consists of mainly esophageal symptoms such as dysphagia, heartburn, food impaction, and vomiting. Current management relies on dietary elimination, proton-pump inhibitors, and topical corticosteroids with different response rates and relapses after treatment discontinuation. With a better understanding of the underlying pathophysiology, many molecules emerged recently as targeted treatment including dupilumab (IL4/IL13 blocker), as the first FDA-approved biological treatment, which has changed the management paradigm.

摘要

嗜酸性粒细胞性食管炎是一种抗原介导的慢性炎症性疾病,在过去 20 年中其发病率和患病率有所上升。临床表现多种多样,主要为食管症状,如吞咽困难、烧心、食物嵌塞和呕吐。目前的治疗方法主要是饮食排除、质子泵抑制剂和局部皮质类固醇,其治疗反应率和停药后复发率各不相同。随着对潜在病理生理学的更好理解,许多分子最近作为靶向治疗出现,包括度普利尤单抗(IL4/IL13 阻滞剂),这是首个获得 FDA 批准的生物治疗药物,它改变了治疗模式。

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Gastro Hep Adv. 2022 Apr 14;1(4):596-600. doi: 10.1016/j.gastha.2022.04.002. eCollection 2022.
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The Index of Severity for Eosinophilic Esophagitis (I-SEE) Reflects Longitudinal Clinicopathologic Changes in Children.嗜酸细胞性食管炎严重指数(I-SEE)反映了儿童的纵向临床病理变化。
Clin Gastroenterol Hepatol. 2024 Apr;22(4):732-740.e1. doi: 10.1016/j.cgh.2023.09.015. Epub 2023 Sep 22.
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Predictors of histologic response to mepolizumab in pediatric eosinophilic esophagitis.
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Eur J Gastroenterol Hepatol. 2023 Oct 1;35(10):1131-1136. doi: 10.1097/MEG.0000000000002623. Epub 2023 Jul 31.
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Medical treatment of eosinophilic esophagitis.嗜酸粒细胞性食管炎的治疗。
Cochrane Database Syst Rev. 2023 Jul 20;7(7):CD004065. doi: 10.1002/14651858.CD004065.pub4.
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Esophageal biomechanics assessed by impedance planimetry (EndoFLIPTM) in healthy subjects and in patients with eosinophilic esophagitis. Normality values.阻抗平面测量法(EndoFLIPTM)评估健康受试者和嗜酸性食管炎患者的食管生物力学。正常值。
Rev Esp Enferm Dig. 2023 Dec;115(12):693-699. doi: 10.17235/reed.2023.9560/2023.
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Mepolizumab for treatment of adolescents and adults with eosinophilic oesophagitis: a multicentre, randomised, double-blind, placebo-controlled clinical trial.美泊利单抗治疗青少年和成人嗜酸性食管炎:一项多中心、随机、双盲、安慰剂对照临床试验。
Gut. 2023 Oct;72(10):1828-1837. doi: 10.1136/gutjnl-2023-330337. Epub 2023 Jul 9.
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