Mitselou Niki, Uchida Amiko, Roelstraete Bjorn, Melén Erik, Garber John J, Ludvigsson Jonas F
Department of Pediatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Division of Gastroenterology, Hepatology & Nutrition, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Clin Transl Allergy. 2025 Jun;15(6):e70068. doi: 10.1002/clt2.70068.
There are limited data on the relationship between eosinophilic esophagitis (EoE) and asthma. We aimed to assess the risk of asthma in EoE patients compared with matched controls and siblings.
Through the ESPRESSO study, a Swedish nationwide population-based histopathology cohort, we identified EoE patients diagnosed between 1989 and 2017 (n = 1146) and up to 5 age- and sex-matched controls (n = 5022). Cox regression generated hazard ratios (HRs) for developing asthma. We compared EoE patients with sibling controls.
The median age at EoE diagnosis was 42 years. During a median follow-up of 3.8 years, 140 EoE patients (28.1/1000 person-years) and 174 controls (7.2/1000 person-years) developed asthma (HR = 3.96; 95% confidence interval [CI] = 3.16-4.96, p < 0.001). An increased risk of asthma was seen in the first 10 years after EoE diagnosis but not thereafter. EoE patients diagnosed in childhood or young adulthood were at a particularly high risk of asthma (HR = 4.74; 95% CI = 2.93-7.67, p < 0.001 and HR = 5.84; 95% CI = 3.68-9.29, p < 0.001, respectively). Compared with their non-EoE siblings, EoE patients were at a 5-fold increased risk of asthma (HR = 4.97; 95% CI = 3.13-7.92, p < 0.001).
EoE patients are at an increased risk of asthma compared with the general population, which is unlikely to be entirely explained through unmeasured intrafamilial factors given that the positive association remained in sibling analyses. Physicians caring for EoE should have a high awareness of concomitant asthma.
关于嗜酸性粒细胞性食管炎（EoE）与哮喘之间关系的数据有限。我们旨在评估与匹配的对照组和兄弟姐妹相比，EoE患者患哮喘的风险。
通过ESPRESSO研究，这是一项基于瑞典全国人群的组织病理学队列研究，我们确定了1989年至2017年间诊断出的EoE患者（n = 1146）以及多达5名年龄和性别匹配的对照组（n = 5022）。Cox回归分析得出患哮喘的风险比（HRs）。我们将EoE患者与兄弟姐妹对照组进行比较。
EoE诊断时的中位年龄为42岁。在中位随访3.8年期间，140名EoE患者（28.1/1000人年）和174名对照组（7.2/1000人年）患哮喘（HR = 3.96；95%置信区间[CI] = 3.16 - 4.96，p < 0.001）。在EoE诊断后的前10年中观察到哮喘风险增加，但之后未增加。在儿童期或青年期诊断出的EoE患者患哮喘的风险特别高（HR分别为4.74；95% CI = 2.93 - 7.67，p < 0.001和HR = 5.84；95% CI = 3.68 - 9.29，p < 0.001）。与非EoE的兄弟姐妹相比，EoE患者患哮喘的风险增加了5倍（HR = 4.97；95% CI = 3.13 - 7.92，p < 0.001）。
与普通人群相比，EoE患者患哮喘的风险增加，鉴于在兄弟姐妹分析中仍存在正相关，这一现象不太可能完全由未测量的家族内因素来解释。治疗EoE的医生应高度警惕合并哮喘的情况。
