title: Eosinophilic esophagitis: an immune-mediated esophageal disease.
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.
authors.affiliation: Pediatric Department, E. Wolfson Medical Center, Holon, Israel.
authors.forename: Jenny
authors.initials: J
authors.lastname: Weinbrand-Goichberg
authors.forename: Idit
authors.initials: I
authors.lastname: Segal
authors.forename: Adi
authors.initials: A
authors.lastname: Ovadia
authors.forename: Arie
authors.initials: A
authors.lastname: Levine
authors.forename: Ilan
authors.initials: I
authors.lastname: Dalal
mesh_terms: D000818:Animals; D016207:Cytokines / Q000235:genetics / Q000276:immunology / Q000378:metabolism; D057765:Eosinophilic Esophagitis / Q000209:etiology / Q000276:immunology*; D004804:Eosinophils / Q000276:immunology*; D004947:Esophagus / Q000276:immunology / Q000378:metabolism*; D005512:Food Hypersensitivity / Q000150:complications / Q000276:immunology*; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000150:complications / Q000276:immunology*; D018836:Inflammation Mediators / Q000378:metabolism*; D000094632:Thymic Stromal Lymphopoietin
chemical_list: D016207:Cytokines; D018836:Inflammation Mediators; D000094632:Thymic Stromal Lymphopoietin