title: Clinical implications and pathogenesis of esophageal remodeling in eosinophilic esophagitis.
abstract: In eosinophilic esophagitis (EoE), remodeling changes are manifest histologically in the epithelium and subepithelium where lamina propria fibrosis, expansion of the muscularis propria, and increased vascularity occur. The clinical symptoms and complications of EoE are largely consequences of esophageal remodeling. Available therapies have demonstrated variable ability to reverse existing remodeling changes of the esophagus. Systemic therapies have the potential of addressing subepithelial remodeling. Esophageal dilation remains a useful, adjunctive therapeutic maneuver in symptomatic adults with esophageal stricture. As novel treatments emerge, it is essential that therapeutic end points account for the fundamental contributions of esophageal remodeling to overall disease activity.
authors.affiliation: Division of Gastroenterology, Northwestern University Feinberg School of Medicine, 676 North Saint Clair, Suite 1400, Chicago, IL 60611, USA.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Hirano
authors.affiliation: Division of Allergy and Immunology, Departments of Pediatrics and Medicine, University of California, San Diego, Rady Children's Hospital, San Diego, 9500 Gilman Drive, MC-0760, La Jolla, CA 92093-0760, USA. Electronic address: saceves@ucsd.edu.
authors.forename: Seema S
authors.initials: SS
authors.lastname: Aceves
mesh_terms: D057765:Eosinophilic Esophagitis / Q000209:etiology* / Q000473:pathology* / Q000628:therapy; D004945:Esophagoscopy; D004947:Esophagus / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008365:Manometry
keywords: Dysphagia; Endoscopy; Eosinophilic esophagitis; Esophagitis; Fibrosis; Gastroesophageal reflux disease; Remodeling