title: Eosinophilic esophagitis: a clinicopathological review.
abstract: Eosinophilic esophagitis (EoE) is considered to be a chronic antigen-driven disease whereby food and/or aeroallergens induce a chronic inflammatory infiltrate in the esophagus, resulting in pathological hyperplasia of the epithelia and muscular layers, and fibrosis of the lamina propria (referred to collectively as remodelling) and the symptoms of dysphagia and food impaction. EoE shares features with other atopic conditions of asthma and atopic dermatitis, such as a TH2 cytokine milieu and a mixed inflammatory infiltrate of eosinophils, mast cells and lymphocytes. Relatively distinct features include the strong male predominance amongst adult patients, and the expression of the eosinophil chemokine eotaxin 3. Current first line treatments such as strict dietary modification and corticosteroids fail many patients. Looking forward, clarification of distinct genotype/phenotype associations, determining the reversibility of remodelling following treatment, and the development of new pharmacotherapies that target fibrotic pathways (as opposed to eosinophilic inflammation per se) or specifically improve barrier integrity appear relevant.
authors.affiliation: Department of Gastroenterology Eastern Health, Monash University Melbourne, Australia. Electronic address: Hamish.philpott@monash.edu.
authors.forename: Hamish
authors.initials: H
authors.lastname: Philpott
authors.affiliation: Department of Gastroenterology Eastern Health, Monash University Melbourne, Australia.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Nandurkar
authors.affiliation: Department of Respiratory and Sleep Medicine Eastern Health, Monash University Melbourne, Australia.
authors.forename: Francis
authors.initials: F
authors.lastname: Thien
authors.affiliation: Department of Gastroenterology The Alfred Hospital, Monash University Melbourne, Australia.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Gibson
authors.affiliation: Department of Pharmacology Clayton Campus, Monash University Melbourne, Australia.
authors.forename: Simon G
authors.initials: SG
authors.lastname: Royce
mesh_terms: D000818:Animals; D017951:Antigen Presentation; D057765:Eosinophilic Esophagitis / Q000276:immunology / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D004947:Esophagus / Q000276:immunology / Q000473:pathology / Q000503:physiopathology; D006801:Humans
keywords: Allergy; Diet; Dysphagia; Eosinophil; Esophagitis; Remodelling