Biology and treatment of eosinophilic esophagitis.
Biology and treatment of eosinophilic esophagitis.
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DOI：
10.1053/j.gastro.2009.07.007
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发表时间：
2009-10
期刊：
影响因子：
29.4
通讯作者：
Rothenberg ME
中科院分区：
文献类型：
--
作者：
Rothenberg ME
嗜酸性粒细胞性食管炎是一种近十年来发现并日益增多的临床疾病，其特征是抗原驱动的嗜酸性粒细胞在食管中积聚。症状经常与胃食管反流病（GERD）相似，但这两种疾病在组织病理学，遗传特征，治疗反应，遗传风险和与过敏的相关性方面非常不同。疾病的发病机制涉及外部和遗传因素的相互作用，特别是食物抗原和嗜酸性粒细胞趋化因子eotaxin-3。转录本特征和动物模型已经揭示了涉及IL-5和IL-13的适应性T细胞免疫的重要性，其引起食管上皮细胞应答。值得注意的是，症状、食管基因表达失调和病理学在减少特定食物抗原暴露以及抗炎治疗后在很大程度上是可逆的，但慢性治疗是预防复发所必需的。因此，嗜酸性粒细胞性食管炎是一种具有慢性食管炎、特应性、对口服抗原的免疫致敏性、可逆性和家族相关性的独特特征的疾病。
Eosinophilic esophagitis, a recently recognized and growing clinical disorder over the past decade, is characterized by antigen-driven eosinophil accumulation in the esophagus. Symptoms frequently mimic those of gastroesophageal reflux disease (GERD) but the two diseases are quite distinct in terms of their histopathology, genetic signature, response to therapy, hereditary risk and association with allergy. Disease pathogenesis involves the interplay of external and genetic factors, particularly food antigens and the eosinophil chemoattractant eotaxin-3, respectively. Transcript signatures and animal models have uncovered the importance of adaptive T cell immunity involving IL-5 and IL-13 elicited esophageal epithelial cell responses. Notably, symptoms, dysregulated esophageal gene expression and pathology are largely reversible following reduction of specific food antigen exposure, as well as anti-inflammatory therapy, but chronic treatment is necessary to prevent relapse. As such, eosinophilic esophagitis is a disease with the unique features of chronic esophagitis, atopy, immune sensitization to oral antigens, reversibility and familial association.
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