Improvement in Esophageal Distensibility in Response to Medical and Diet Therapy in Eosinophilic Esophagitis.
Improvement in Esophageal Distensibility in Response to Medical and Diet Therapy in Eosinophilic Esophagitis.
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DOI：
10.1038/ctg.2017.47
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发表时间：
2017-10-05
影响因子：
3.6
通讯作者：
Pandolfino JE
中科院分区：
文献类型：
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作者：
Carlson DA;Hirano I;Zalewski A;Gonsalves N;Lin Z;Pandolfino JE
我们的目的是评估药物和饮食疗法对使用功能性管腔成像探针（FLIP）评估的食管扩张性的影响，以及食管扩张性变化与嗜酸性食管炎（EoE）临床结果的关联。 EoE 患者在内窥镜检查期间使用 FLIP 进行评估，并在治疗后不进行间隔扩张。评估还包括经验证的患者报告结果（PRO；评分提高 30% 时视为阳性 PRO）、粘膜活检和 EoE 内镜特征评分。分析 FLIP 数据以计算扩张平台 (DP)。总共包括 18 名患者（年龄 19-54 岁；4 名女性）接受局部类固醇 (8)、消除饮食 (6) 和/或质子泵抑制剂（4 名仅接受质子泵抑制剂治疗）治疗。随访测试平均（范围）为 14.6（8-28）周。观察到DP（13.9（12.2-19.2）至16.8mm（15.8-19.2），P=0.007）和峰值嗜酸性粒细胞计数（每个高倍视野（h.p.f.）45（29-65）至23（5-53），P=0.042）有所改善。九名患者有积极的症状结果。 DP 增加≥2mm 的 8 名患者中，有 6 名 (75%) 的 PRO 呈阳性 (P=0.077)，而嗜酸性粒细胞计数 <15/h.p.f. 的 7 名患者中，有 2 名 (29%) 为阳性。 PRO 呈阳性（P=0.167）。通过药物和饮食疗法可以改善食管体的扩张性，而无需扩张 EoE。 DP 的改善似乎是比嗜酸性粒细胞计数更好的症状改善指标，支持 FLIP 作为 EoE 中有价值的结果指标。
We aimed to evaluate the effect of medical and diet therapies on esophageal distensibility assessed using the functional lumen imaging probe (FLIP) and the association of changes in esophageal distensibility with clinical outcomes in eosinophilic esophagitis (EoE). Patients with EoE were evaluated with FLIP during endoscopy at baseline and following therapy without interval dilatation. Evaluation also included a validated patient-reported outcome (PRO; a positive PRO was considered at a 30% score improvement), mucosal biopsies, and scoring of endoscopic features of EoE. FLIP data were analyzed to calculate the distensibility plateau (DP). In all, 18 patients (ages 19–54 years; 4 female) treated with topical steroid (8), elimination diet (6), and/or proton-pump inhibitor (4 only treated with proton-pump inhibitor) were included. Follow-up testing occurred at a mean (range) of 14.6 (8–28) weeks. Improvement was observed in DP (13.9 (12.2–19.2) to 16.8 mm (15.8–19.2), P=0.007) and peak eosinophil count (45 (29–65) to 23 per high-power field (h.p.f.) (5–53), P=0.042). Nine patients had a positive symptomatic outcome. Six of 8 (75%) patients with a DP increase ≥2 mm had a positive PRO (P=0.077), while 2 of 7 (29%) patients that achieved an eosinophil count <15/h.p.f. had a positive PRO (P=0.167). Improvement in esophageal body distensibility can be achieved with medical and diet therapies without dilation in EoE. Improved DP appeared to be better indicator of symptomatic improvement than eosinophil count, supporting FLIP as a valuable outcome measure in EoE.
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影响因子：
24.5
作者：
Molina-Infante J;Bredenoord AJ;Cheng E;Dellon ES;Furuta GT;Gupta SK;Hirano I;Katzka DA;Moawad FJ;Rothenberg ME;Schoepfer A;Spechler SJ;Wen T;Straumann A;Lucendo AJ;PPI-REE Task Force of the European Society of Eosinophilic Oesophagitis (EUREOS)
通讯作者：
PPI-REE Task Force of the European Society of Eosinophilic Oesophagitis (EUREOS)
影响因子：
7.7
作者：
Dellon ES;Kim HP;Sperry SL;Rybnicek DA;Woosley JT;Shaheen NJ
通讯作者：
Shaheen NJ
DOI：
10.1016/j.cgh.2015.08.040
发表时间：
2016-01
期刊：
Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association
影响因子：
--
作者：
Dellon ES;Cotton CC;Gebhart JH;Higgins LL;Beitia R;Woosley JT;Shaheen NJ
通讯作者：
Shaheen NJ
将GERD与嗜酸性粒细胞性食性炎区分开：概念和争议。
DOI：
10.1038/nrgastro.2015.75
发表时间：
2015-07
期刊：
Nature reviews. Gastroenterology & hepatology
影响因子：
--
作者：
Kia L;Hirano I
通讯作者：
Hirano I
影响因子：
3.7
作者：
Hirano I;Aceves SS
通讯作者：
Aceves SS