Eosinophilic gastroenteritis.
Eosinophilic gastroenteritis.
复制标题
DOI：
10.1007/s11894-002-0006-2
复制
发表时间：
2002-10-01
影响因子：
--
通讯作者：
J Talley, Nicholas
中科院分区：
文献类型：
--
作者：
Daneshjoo, Rahim;J Talley, Nicholas
嗜酸性粒细胞性胃肠炎是一种罕见的原因不明的胃肠道 (GI) 疾病，其特征是胃肠道中嗜酸性粒细胞浸润。嗜酸性粒细胞在组织中积聚，并可能释放高细胞毒性颗粒蛋白，导致严重的组织损伤，这是嗜酸性粒细胞性胃肠炎的特征。嗜酸性粒细胞趋化因子可能与趋化剂和细胞因子（包括白细胞介素 3 和 5 以及粒细胞-巨噬细胞集落刺激因子）结合，在将嗜酸性粒细胞招募到组织中发挥作用。食物过敏，尤其是儿童过敏，可能是一个触发因素，而基于氨基酸的饮食可能会有所帮助。肠道中嗜酸性粒细胞的积累是食物引起的胃肠道疾病的一个常见特征，可以通过涉及 Th2 细胞、各种细胞因子和趋化因子的复杂分子网络进行调节。嗜酸性粒细胞性胃肠炎根据受累部位的不同，具有广泛的临床表现。它可能与肠易激综合征或消化不良相混淆，并且在极少数情况下，类似于胰腺炎或阑尾炎。诊断很重要，通常由病理学家做出。嗜酸性粒细胞性胃肠炎是一种可以治疗的疾病；尽管复发很常见，但患者通常对类固醇治疗有反应。非肠溶布地奈德是一种局部作用的皮质类固醇，肾上腺抑制风险很小，可以替代，但需要更多经验。有前途的治疗嗜酸性粒细胞性胃肠炎的新药包括孟鲁司特（一种选择性白三烯受体拮抗剂）和supplalast tosilate（一种选择性Th2细胞因子抑制剂，对过敏引起的嗜酸性粒细胞浸润和IgE产生具有抑制作用）。尽管它可能是一种单独的疾病，但已经积累了更多的经验，并且消除或基于特定氨基酸的饮食似乎有助于治疗。
Eosinophilic gastroenteritis is a rare gastrointestinal (GI) disorder of undetermined cause characterized by infiltration of eosinophils in the GI tract. Eosinophils accumulate in tissues and may release highly cytotoxic granular proteins, which cause severe tissue damage characteristic of eosinophilic gastroenteritis. Eotaxin may play a role in the recruitment of eosinophils into tissue in combination with chemoattractants and cytokines, including interleukin 3 and 5 and granulocyte-macrophage colony-stimulating factor. Food allergy, especially in children, can be a triggering factor, and an amino acid-based diet may be helpful. Accumulation of eosinophils in the gut is a common feature in food-induced GI disorders that can be regulated through a complex molecular network involving Th2 cells, various cytokines, and chemokines. Eosinophilic gastroenteritis has a wide spectrum of clinical presentation depending on the site of involvement. It may be confused with irritable bowel syndrome or dyspepsia and, rarely, mimics pancreatitis or appendicitis. Diagnosis is important and is usually made by a pathologist. Eosinophilic gastroenteritis is a treatable disease; patients generally respond to steroid therapy, although relapse is common. Non-enteric-coated budesonide, a locally acting corticosteroid with little risk of adrenal suppression, may be substituted, although more experience is needed. Promising new drugs for eosinophilic gastroenteritis include montelukast, a selective leukotriene receptor antagonist, and suplaplast tosilate, a selective Th2 cytokine inhibitor with inhibitory effects on allergy-induced eosinophilic infiltration and IgE production. Although it is likely a separate disease, more experience has accumulated, and an elimination or specific amino acid-based diet appears to be helpful in treatment.