Institute for Immunology and Immune Health.
Immunology Graduate Group, Perelman School of Medicine, University of Pennsylvania.
Curr Opin Pediatr. 2024 Dec 1;36(6):668-673. doi: 10.1097/MOP.0000000000001406. Epub 2024 Sep 20.
PURPOSE OF REVIEW: This review aims to provide an overview of the current understanding of eosinophilic gastrointestinal disorders (EGIDs) and the role of the epithelium in influencing disease pathogenesis to inform and devise future therapeutic strategies. RECENT FINDINGS: Changes in epithelial cell structure, functions, and integrity are observed in EGIDs. In eosinophilic esophagitis (EoE), the esophageal epithelium has been shown to play key roles in perpetuating the inflammatory response in EoE through the expression of pro-inflammatory cytokines and immunological cell-surface proteins. Similar mechanisms appear to exist in the other EGIDs, including eosinophilic gastritis (EoG), eosinophilic enteritis (EoN), and eosinophilic colitis (EoC). Because of the increasing rarity of each non-EoE EGID, research focusing on how the epithelium is modulating disease in each lower gastrointestinal compartment is still in its rudimentary stages. SUMMARY: While there has been significant progress in understanding the role of the epithelium in EoE, further research is needed to obtain a better understanding of the mechanisms mediating epithelial-immune crosstalk in non-EoE EGIDs. Using EoE-epithelial cell research to inform future EGID investigations could lead to the development of new therapeutic interventions, such as targeted therapies to restore epithelial barrier function and reduce inflammation, to improve rare disease-patient quality of life.
目的综述:本文旨在概述嗜酸性粒细胞性胃肠道疾病(EGIDs)的现有认识,以及上皮细胞在影响疾病发病机制方面的作用,为未来的治疗策略提供信息和依据。
最近的发现:在 EGIDs 中观察到上皮细胞结构、功能和完整性的变化。在嗜酸性食管炎(EoE)中,食管上皮通过表达促炎细胞因子和免疫细胞表面蛋白,在 EoE 中的炎症反应中发挥关键作用。在其他 EGIDs 中,包括嗜酸性胃炎(EoG)、嗜酸性肠炎(EoN)和嗜酸性结肠炎(EoC),似乎也存在类似的机制。由于每种非 EoE EGID 的罕见性增加,针对下消化道每个部位上皮如何调节疾病的研究仍处于初级阶段。
总结:虽然人们对上皮在 EoE 中的作用有了重大的认识进展,但仍需要进一步的研究来更好地理解介导非 EoE EGIDs 中上皮-免疫相互作用的机制。利用 EoE-上皮细胞研究为未来的 EGID 研究提供信息,可能会开发出新的治疗干预措施,如靶向治疗以恢复上皮屏障功能和减少炎症,从而提高罕见病患者的生活质量。
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