title: Eosinophilic esophagitis: an autoimmune esophageal disorder.
abstract: Eosinophilic esophagitis (EoE) represents a chronic, immune/antigen-mediated esophageal inflammatory disease associated with esophageal dysfunction resulting from severe inflammation. The incidence and prevalence of EoE have been increasing in the past decade; however, the reason for this increase is unclear. There is a chronic inflammatory infiltrate that is present in EoE which promotes inflammation, symptoms, and dysfunction. In addition to eosinophils, interleukin (IL)-5 expressing T cells, B cells, eotaxin-3, IL-13, and IgE-bearing mast cells are present in EoE and are thought to contribute to the disease process. Eosinophils are pro-inflammatory and modulate multiple aspects of the immune response. Eosinophils produce a wide range of inflammatory cytokines, chemokines, granulocyte-monocyte colony-stimulating factors, and tumor necrosis factors. Once activated, eosinophils release granule components, which are toxic to a variety of tissues. Transforming growth factor β1 is a pro-fibrotic molecule produced by epithelial and inflammatory cells, is overexpressed in EoE, and plays a role in esophageal remodeling. Fibrous remodeling in EoE could be associated with symptoms of dysphagia and may explain and predict future esophageal strictures and dysmotility. EoE is a complex disease involving multiple activation pathways, a large number of cells, and various inflammatory molecules. It, along with other atopic disease, is becoming increasingly prevalent and has an important genetic load and may represent as an immunological tolerance disorder of the GI tract.
authors.affiliation: Division of Pediatric Gastroenterology and Nutrition, Cohen Children's Medical Center, North Shore-LIJ Health System, New Hyde Park, NY.
authors.forename: Neha
authors.initials: N
authors.lastname: Malhotra
authors.affiliation: Division of Pediatric Gastroenterology, New York University School of Medicine, New York, NY.
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Levine
mesh_terms: D002648:Child; D002664:Child Nutritional Physiological Phenomena; D004435:Eating; D057765:Eosinophilic Esophagitis / Q000276:immunology* / Q000503:physiopathology / Q000628:therapy; D004804:Eosinophils / Q000276:immunology*; D020022:Genetic Predisposition to Disease; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D015994:Incidence; D018836:Inflammation Mediators; D008407:Mast Cells / Q000276:immunology; D012307:Risk Factors; D015398:Signal Transduction
chemical_list: D018836:Inflammation Mediators