Eosinophilic esophagitis – epidemiology, clinical manifestations and current therapy menagement
DOI:
https://doi.org/10.12775/JEHS.2023.13.05.006Keywords
eosinophilic esophagitis EoE, eosinophilia, gastroenterologyAbstract
Eosinophilic esophagitis (EoE) is a chronic inflammatory disease, which in recent years has shown a clear upward trend of incidence and prevalence in the general population. The symptoms of EoE are very heterogeneous as well as therapy management of this entity which often causes problems in the clinical approach to the patient. Adults most often suffer from dysphagia, while children usually present non-specific symptoms such as food refusal, vomiting, nausea, etc.. Currently, we have many therapeutic paths that change the course of the disease, but high expectations are also placed on new biological drugs. This publication attempts to summarize the current state of knowledge about epidemiology, age-related clinical presentation, and therapeutic strategy of eosinophilic esophagitis.
References
Iwańczak B, Iwańczak F. Nowe Zalecenia Dotyczące Diagnostyki i Leczenia Eozynofilowego Zapalenia Przełyku u dzieci i Dorosłych. Dev Period Med. 2018;22(4):379. doi:10.34763/DEVPERIODMED.20182204.379384
Landres RT, Kuster GGR, Strum WB. Eosinophilic esophagitis in a patient with vigorous achalasia. Gastroenterology. 1978;74(6):1298-1301. doi:10.1016/0016-5085(78)90710-2
Winter HS, Madara JL, Stafford RJ, Grand RJ, Quinlan JE, Goldman H. Intraepithelial Eosinophils: A New Diagnostic Criterion for Reflux Esophagitis. Gastroenterology. 1982;83(4):818-823. doi:10.1016/S0016-5085(82)80011-5
Furuta GT. Eosinophils in the esophagus: acid is not the only cause. J Pediatr Gastroenterol Nutr. 1998;26(4):468-471. doi:10.1097/00005176-199804000-00021
Dhar A, Haboubi HN, Attwood SE, et al. British Society of Gastroenterology (BSG) and British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN) joint consensus guidelines on the diagnosis and management of eosinophilic oesophagitis in children and adults. Gut. 2022;71(8):1459. doi:10.1136/GUTJNL-2022-327326
Dellon ES, Hirano I. Epidemiology and Natural History of Eosinophilic Esophagitis. Gastroenterology. 2018;154(2):319-332.e3. doi:10.1053/J.GASTRO.2017.06.067
Arias A, Pérez-Martínez I, Tenías JM, Lucendo AJ. Systematic review with meta-analysis: the incidence and prevalence of eosinophilic oesophagitis in children and adults in population-based studies. Aliment Pharmacol Ther. 2016;43(1):3-15. doi:10.1111/APT.13441
Navarro P, Arias Á, Arias-González L, Laserna-Mendieta EJ, Ruiz-Ponce M, Lucendo AJ. Systematic review with meta-analysis: the growing incidence and prevalence of eosinophilic oesophagitis in children and adults in population-based studies. Aliment Pharmacol Ther. 2019;49(9):1116-1125. doi:10.1111/APT.15231
Clinical manifestations and diagnosis of eosinophilic esophagitis (EoE) - UpToDate. Accessed January 7, 2023. https://www-1uptodate-1com-12h8mosxu1023.han.bg.umw.edu.pl/contents/clinical-manifestations-and-diagnosis-of-eosinophilic-esophagitis-eoe?search=Eosinophilic Esophagitis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1
Lucendo AJ, Molina-Infante J, Arias Á, et al. Guidelines on eosinophilic esophagitis: evidence-based statements and recommendations for diagnosis and management in children and adults. United Eur Gastroenterol J. 2017;5(3):335. doi:10.1177/2050640616689525
Sgouros SN, Bergele C, Mantides A. Eosinophilic esophagitis in adults: a systematic review. Eur J Gastroenterol Hepatol. 2006;18(2):211-217. doi:10.1097/00042737-200602000-00015
Straumann A, Bussmann C, Zuber M, Vannini S, Simon HU, Schoepfer A. Eosinophilic esophagitis: analysis of food impaction and perforation in 251 adolescent and adult patients. Clin Gastroenterol Hepatol. 2008;6(5):598-600. doi:10.1016/J.CGH.2008.02.003
Desai TK, Stecevic V, Chang CH, Goldstein NS, Badizadegan K, Furuta GT. Association of eosinophilic inflammation with esophageal food impaction in adults. Gastrointest Endosc. 2005;61(7):795-801. doi:10.1016/S0016-5107(05)00313-5
Visaggi P, Savarino E, Sciume G, et al. Eosinophilic esophagitis: clinical, endoscopic, histologic andtherapeutic differences and similarities between children andadults. Therap Adv Gastroenterol. 2021;14. doi:10.1177/1756284820980860
Miehlke S. Clinical features of Eosinophilic esophagitis in children and adults. Best Pract Res Clin Gastroenterol. 2015;29(5):739-748. doi:10.1016/J.BPG.2015.09.005
García-Compeán D, González González JA, Marrufo García CA, et al. Prevalence of eosinophilic esophagitis in patients with refractory gastroesophageal reflux disease symptoms: A prospective study. Dig Liver Dis. 2011;43(3):204-208. doi:10.1016/J.DLD.2010.08.002
Spergel JM, Brown-Whitehorn TF, Beausoleil JL, et al. 14 years of eosinophilic esophagitis: clinical features and prognosis. J Pediatr Gastroenterol Nutr. 2009;48(1):30-36. doi:10.1097/MPG.0B013E3181788282
Noel RJ, Putnam PE, Rothenberg ME. Eosinophilic esophagitis. N Engl J Med. 2004;351(9):940-941. doi:10.1056/NEJM200408263510924
Mukkada VA, Haas A, Maune NC, et al. Feeding dysfunction in children with eosinophilic gastrointestinal diseases. Pediatrics. 2010;126(3). doi:10.1542/PEDS.2009-2227
Debrosse CW, Franciosi JP, King EC, et al. Long-term outcomes in pediatric-onset esophageal eosinophilia. J Allergy Clin Immunol. 2011;128(1):132-138. doi:10.1016/J.JACI.2011.05.006
Simon D, Cianferoni A, Spergel JM, et al. Eosinophilic esophagitis is characterized by a non-IgE-mediated food hypersensitivity. Allergy. 2016;71(5):611-620. doi:10.1111/ALL.12846
Molina-Infante J, Lucendo AJ. Dietary therapy for eosinophilic esophagitis. J Allergy Clin Immunol. 2018;142(1):41-47. doi:10.1016/J.JACI.2018.02.028
Arias Á, González-Cervera J, Tenias JM, Lucendo AJ. Efficacy of dietary interventions for inducing histologic remission in patients with eosinophilic esophagitis: A systematic review and meta-analysis. Gastroenterology. 2014;146(7):1639-1648. doi:10.1053/j.gastro.2014.02.006
Kelly KJ, Lazenby AJ, Rowe PC, Yardley JH, Perman JA, Sampson HA. Eosinophilic esophagitis attributed to gastroesophageal reflux: improvement with an amino acid-based formula. Gastroenterology. 1995;109(5):1503-1512. doi:10.1016/0016-5085(95)90637-1
Delaney AL, Arvedson JC. Development of swallowing and feeding: prenatal through first year of life. Dev Disabil Res Rev. 2008;14(2):105-117. doi:10.1002/DDRR.16
Molina-Infante J, Martin-Noguerol E, Alvarado-Arenas M, Porcel-Carreño SL, Jimenez-Timon S, Hernandez-Arbeiza FJ. Selective elimination diet based on skin testing has suboptimal efficacy for adult eosinophilic esophagitis. J Allergy Clin Immunol. 2012;130(5):1200-1202. doi:10.1016/J.JACI.2012.06.027
Wolf WA, Jerath MR, Sperry SLW, Shaheen NJ, Dellon ES. Dietary elimination therapy is an effective option for adults with eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2014;12(8):1272-1279. doi:10.1016/J.CGH.2013.12.034
Gonsalves N, Yang GY, Doerfler B, Ritz S, Ditto AM, Hirano I. Elimination diet effectively treats eosinophilic esophagitis in adults; food reintroduction identifies causative factors. Gastroenterology. 2012;142(7). doi:10.1053/J.GASTRO.2012.03.001
Molina-Infante J, Bredenoord AJ, Cheng E, et al. Proton Pump Inhibitor-Responsive Oesophageal Eosinophilia: An Entity Challenging Current Diagnostic Criteria for Eosinophilic Oesophagitis. Gut. 2016;65(3):524. doi:10.1136/GUTJNL-2015-310991
Sayej WN, Patel R, Baker RD, Tron E, Baker SS. Treatment with high-dose proton pump inhibitors helps distinguish eosinophilic esophagitis from noneosinophilic esophagitis. J Pediatr Gastroenterol Nutr. 2009;49(4):393-399. doi:10.1097/MPG.0B013E31819C4B3E
Ngo P, Furuta GT, Antonioli DA, Fox VL. Eosinophils in the esophagus--peptic or allergic eosinophilic esophagitis? Case series of three patients with esophageal eosinophilia. Am J Gastroenterol. 2006;101(7):1668-1670. doi:10.1111/J.1572-0241.2006.00562.X
Molina-Infante J, Ferrando-Lamana L, Ripoll C, et al. Esophageal eosinophilic infiltration responds to proton pump inhibition in most adults. Clin Gastroenterol Hepatol. 2011;9(2):110-117. doi:10.1016/J.CGH.2010.09.019
Cheng E, Zhang X, Huo X, et al. Omeprazole blocks eotaxin-3 expression by oesophageal squamous cells from patients with eosinophilic oesophagitis and GORD. Gut. 2013;62(6):824-832. doi:10.1136/GUTJNL-2012-302250
van Rhijn BD, Weijenborg PW, Verheij J, et al. Proton pump inhibitors partially restore mucosal integrity in patients with proton pump inhibitor-responsive esophageal eosinophilia but not eosinophilic esophagitis. Clin Gastroenterol Hepatol. 2014;12(11):1815-1823.e2. doi:10.1016/J.CGH.2014.02.037
Abe Y, Sasaki Y, Yagi M, Yaoita T, Nishise S, Ueno Y. Diagnosis and treatment of eosinophilic esophagitis in clinical practice. Clin J Gastroenterol. 2017;10(2):87-102. doi:10.1007/S12328-017-0725-4
Schaefer ET, Fitzgerald JF, Molleston JP, et al. Comparison of oral prednisone and topical fluticasone in the treatment of eosinophilic esophagitis: a randomized trial in children. Clin Gastroenterol Hepatol. 2008;6(2):165-173. doi:10.1016/J.CGH.2007.11.008
Murali AR, Gupta A, Attar BM, Ravi V, Koduru P. Topical steroids in eosinophilic esophagitis: Systematic review and meta-analysis of placebo-controlled randomized clinical trials. J Gastroenterol Hepatol. 2016;31(6):1111-1119. doi:10.1111/JGH.13281
Sawas T, Dhalla S, Sayyar M, Pasricha PJ, Hernaez R. Systematic review with meta-analysis: pharmacological interventions for eosinophilic oesophagitis. Aliment Pharmacol Ther. 2015;41(9):797-806. doi:10.1111/APT.13147
Chuang MY, Chinnaratha MA, Hancock DG, et al. Topical Steroid Therapy for the Treatment of Eosinophilic Esophagitis (EoE): A Systematic Review and Meta-Analysis. Clin Transl Gastroenterol. 2015;6(3). doi:10.1038/CTG.2015.9
Tan N Di, Xiao YL, Chen MH. Steroids therapy for eosinophilic esophagitis: Systematic review and meta-analysis. J Dig Dis. 2015;16(8):431-442. doi:10.1111/1751-2980.12265
Richter JE. Esophageal dilation in eosinophilic esophagitis. Best Pract Res Clin Gastroenterol. 2015;29(5):815-828. doi:10.1016/J.BPG.2015.06.015
Netzer P, Gschossmann JM, Straumann A, Sendensky A, Weimann R, Schoepfer AM. Corticosteroid-dependent eosinophilic oesophagitis: azathioprine and 6-mercaptopurine can induce and maintain long-term remission. Eur J Gastroenterol Hepatol. 2007;19(10):865-869. doi:10.1097/MEG.0B013E32825A6AB4
Straumann A, Conus S, Grzonka P, et al. Anti-interleukin-5 antibody treatment (mepolizumab) in active eosinophilic oesophagitis: a randomised, placebo-controlled, double-blind trial. Gut. 2010;59(1):21-30. doi:10.1136/GUT.2009.178558
Spergel JM, Rothenberg ME, Collins MH, et al. Reslizumab in children and adolescents with eosinophilic esophagitis: Results of a double-blind, randomized, placebo-controlled trial. J Allergy Clin Immunol. 2012;129(2):456-463.e3. doi:10.1016/j.jaci.2011.11.044
Limketkai BN, Shah SC, Hirano I, Bellaguarda E, Colombel JF. Epidemiology and implications of concurrent diagnosis of eosinophilic oesophagitis and IBD based on a prospective population-based analysis. Gut. 2019;68(12):2152-2160. doi:10.1136/GUTJNL-2018-318074
Straumann A, Bussmann C, Conus S, Beglinger C, Simon HU. Anti-TNF-alpha (infliximab) therapy for severe adult eosinophilic esophagitis. J Allergy Clin Immunol. 2008;122(2):425-427. doi:10.1016/J.JACI.2008.06.012
Clayton F, Fang JC, Gleich GJ, et al. Eosinophilic esophagitis in adults is associated with IgG4 and not mediated by IgE. Gastroenterology. 2014;147(3):602-609. doi:10.1053/J.GASTRO.2014.05.036
Hirano I, Dellon ES, Hamilton JD, et al. Efficacy of Dupilumab in a Phase 2 Randomized Trial of Adults With Active Eosinophilic Esophagitis. Gastroenterology. 2020;158(1):111-122.e10. doi:10.1053/J.GASTRO.2019.09.042
Hirano I, Collins MH, Assouline-Dayan Y, et al. RPC4046, a Monoclonal Antibody Against IL13, Reduces Histologic and Endoscopic Activity in Patients With Eosinophilic Esophagitis. Gastroenterology. 2019;156(3):592-603.e10. doi:10.1053/J.GASTRO.2018.10.051
Kuang FL, Legrand F, Makiya M, et al. Benralizumab for PDGFRA-Negative Hypereosinophilic Syndrome. N Engl J Med. 2019;380(14):1336-1346. doi:10.1056/NEJMOA1812185
Schneider A, Rubinstein A. BENRALIZUMAB INTENDED FOR EOSINOPHILIC ASTHMA LEADS TO COMPLETE RESOLUTION OF EOSINOPHILIC EOSPHAGITIS. Ann Allergy, Asthma Immunol. 2018;121(5):S127. doi:10.1016/j.anai.2018.09.422
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Konrad Dendys, Jan Bieniasz, Marcel Kazzi, Michał Puła, Marta Wychota
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 442
Number of citations: 0