Association between atopic manifestations and eosinophilic esophagitis
Association between atopic manifestations and eosinophilic esophagitis
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DOI：
10.1016/j.anai.2017.02.006
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发表时间：
2017-05-01
影响因子：
5.9
通讯作者：
Lucendo, Alfredo J.
中科院分区：
文献类型：
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作者：
Gonzalez-Cervera, Jesus;Arias, Angel;Lucendo, Alfredo J.
背景：嗜酸性食管炎(EoE)曾多次与特应性表现有关，在这些患者中报告的特应性症状比普通人群更常见。目的：系统地评估EoE与特应性之间关联的证据和强度。方法：我们对MEDLINE、EMBASE和SCOPUS数据库进行了系统的搜索，以进行病例对照研究，比较特应性食管炎患者和代表一般人群的对照受试者中特应性疾病的发生率。使用随机效应荟萃分析，我们计算了对哮喘、特应性鼻炎和湿疹的概括性估计，包括95%的可信区间(CI)。结果：在确定的2954篇参考文献中，数据来自21项研究，包括53,542名EoE患者和54,759名对照。大多数研究都没有从结构上考虑EoE患者或对照患者特应性的诊断标准。总体而言，过敏性鼻炎在EoE患者中显著高于对照组(优势比[OR]，5.09；95%CI，2.91-8.90；I-2=86.7%)，哮喘(OR，3.01；95%CI，1.96-4.62；I-2=84.5%)和湿疹(OR，2.85；95%CI，1.87-4.34；I-2=57.1%)。食物过敏和其他特应性情况也被评估。在EoE中关于变应性鼻炎和湿疹的研究没有发现显著的发表偏倚。结论：尽管指出了特应性鼻炎和EoE之间的显著关联，但大多数研究没有提供特应性鼻炎的标准化诊断标准。进一步的研究应该为这种情况提供明确和标准化的定义。试验注册：www.crd.york.ac.uk/Propero试验标识：CRD42016036161。(C)2017年美国过敏、哮喘和免疫学学院。爱思唯尔公司出版，版权所有。
Background: Eosinophilic esophagitis (EoE) has repeatedly been associated with atopic manifestations, which are reported more frequently in these patients than in the general population.Objective: To systematically assess the evidence and strength of the associations between EoE and atopy.Methods: We performed a systematic search of the MEDLINE, EMBASE, and SCOPUS databases for case-control studies comparing the frequency of atopic diatheses among patients with EoE and control subjects representing the general population without EoE. Using random-effects meta-analyses, we calculated summary estimates, including 95% confidence intervals (CIs), for bronchial asthma, atopic rhinitis, and eczema. Publication bias risks were assessed by means of funnel plot analysis and specific statistical tests.Results: Of the 2,954 references identified, data were collected from 21 studies, including a total of 53,542 patients with EoE and 54,759 controls. The criteria for defining a diagnosis of atopy in patients with EoE or controls was not structurally considered in most of the studies. Overall, allergic rhinitis was significantly more common among patients with EoE compared with control subjects (odds ratio [OR], 5.09; 95% CI, 2.91-8.90; I-2 = 86.7%) as were bronchial asthma (OR, 3.01; 95% CI, 1.96-4.62; I-2 = 84.5%) and eczema (OR, 2.85; 95% CI, 1.87-4.34; I-2 = 57.1%). Food allergies and other atopic conditions were also assessed. No significant publication bias was found for studies dealing with allergic rhinitis and eczema in EoE.Conclusion: Despite pointing to a significant association between atopy and EoE, most of the studies provided no normalized diagnostic criteria for atopy. Further research should provide clear and standardized definitions of such conditions. Trial Registration: www.crd.york.ac.uk/PROSPERO Trial Identifier: CRD42016036161. (C) 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.