Update on clinical and immunological features of eosinophilic gastrointestinal diseases.
Update on clinical and immunological features of eosinophilic gastrointestinal diseases.
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DOI：
10.1097/mog.0b013e32834b314c
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发表时间：
2011-10
影响因子：
2.5
通讯作者：
Lee JJ
中科院分区：
文献类型：
--
作者：
Masterson JC;Furuta GT;Lee JJ
嗜酸性粒细胞性胃肠疾病（EGID）是一种日益常见的异质性肠道疾病。本综述的目的是介绍EGID患者护理的最新进展，并总结越来越多的文献定义嗜酸性粒细胞的临床特征和机制要素及其与胃肠道的复杂关系。最近的研究继续定义什么是胃肠道不同部分中嗜酸性粒细胞的“正常”和“异常”数量。EGID的症状复合物似乎主要与粘膜相关，而不是肌肉或血清形式的EGID。粘膜微环境的解剖揭示了一系列复杂的细胞，而不是嗜酸性粒细胞，可能有助于与EGID相关的炎症反应。机制研究已确定遗传扰动（嗜酸性粒细胞趋化因子-3、胸腺基质淋巴细胞生成素、IL-13和丝聚蛋白）也可能导致最常见和研究最充分的EGID（嗜酸性粒细胞性食管炎）的发生。临床医生应始终意识到EGID作为常见胃肠道症状患者的诊断可能性。需要进一步的研究来确定导致嗜酸性胃肠炎相关功能障碍的机制过程。
Eosinophilic gastrointestinal diseases (EGIDs) are an increasingly common heterogeneous group of intestinal diseases. The purpose of this review is to present the latest developments in the care of patients with EGIDs and to summarize a growing literature defining the clinical features and mechanistic elements of eosinophils and their complex relationships with the gastrointestinal tract. Recent studies continue to define what constitutes ‘normal’ and ‘abnormal’ numbers of eosinophils in the different sections of the gastrointestinal tract. Symptom complexes of EGIDs appear to be related primarily to the mucosal, as opposed to the muscular or serosal, forms of EGIDs. Dissection of the mucosal microenvironment is uncovering a complex array of cells, other than eosinophils, that likely contribute to the inflammatory response associated with EGIDs. Mechanistic studies have identified genetic perturbations (eotaxin-3, thymic stromal lymphopoietin, IL-13, and filaggrin) that may also contribute to the development of the most often encountered and well studied EGID, eosinophilic esophagitis. Clinicians should remain aware of EGIDs as a diagnostic possibility for patients with common gastrointestinal symptoms. Additional research is needed to determine mechanistic processes leading to dysfunction associated with eosinophilic gastrointestinal inflammation.