Eosinophilic esophagitis: An immune-mediated esophageal disease

Jenny Weinbrand-Goichberg, Idit Segal, Adi Ovadia, Arie Levine, Ilan Dalal

Research output: Contribution to journalReview articlepeer-review

Abstract

Eosinophilic esophagitis (EoE) is an emerging disease defined by esophageal dysfunction, by typical endoscopic findings and by abnormal eosinophilic inflammation within the esophagus. Eosinophilic accumulation in the esophagus occurs as a result of esophageal overexpression of pro-inflammatory mediators, including T cells and mast cells, cytokines such as interleukin (IL)-13, IL-5 and IL-15, as well as chemoattractants (eotaxin and transforming growth factor-β1, fibroblast growth factor and the newly characterized gene - thymic stromal lymphopoietin, which is a key regulator of allergic sensitization initiation). The role of allergy, particularly food allergy in EoE is indisputable, as elimination diet is a proven commonly used treatment for the disease. However, unlike classical immediate IgE-mediated reaction to allergen, EoE is associated with an altered immune response, characterized by a combination of IgE-mediated and non-IgE-mediated mechanisms. In this review, we aim to discuss the many typical aspects of EoE as opposed to other entities involving the esophagus, with focusing on the aberrant immune-mediated key players contributing to the pathogenesis of this unique disease.

Original languageEnglish
Pages (from-to)249-260
Number of pages12
JournalImmunologic Research
Volume56
Issue number2-3
DOIs
StatePublished - Jul 2013

Keywords

  • Elimination diet
  • Eosinophilic inflammation
  • Eotaxin-3
  • Esophagitis
  • Food allergy
  • Mix IgE and non-IgE mediated

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