title: From genetics to treatment of eosinophilic esophagitis.
abstract: OBJECTIVE
  Eosinophilic Esophagitis (EoE) is an emerging chronic atopic disease. Recent advances in understanding its genetic and molecular biology pathogenesis may lead to a better management of the disease
  
  
  RESULTS
  EoE is an atopic disease. Most of the patients affected by EoE have other atopic diseases such as allergic rhinitis, asthma, IgE-mediated food allergies and/or atopic dermatitis. The local inflammation is a T helper type 2 (Th2) flogosis, which most likely is driven by a mixed IgE and n-IgE-mediated reaction to food and/or environmental allergens. Epidemiological studies show that EoE is an atopic disease with a strong genetic component. Genetic studies have shown that EoE is associated with single nucleotide polymorphism on genes, which are released by the epithelium and important in atopic inflammation such as thymic stromal lymphopoietin located (TSLP) close to the Th2 cytokine cluster [interleukin (IL)-4, IL-5, IL-13] on chromosome 5q22, Calpain 14, EMSY, and Eotaxin3. When the EoE diagnosis is made, it is imperative to control the local eosinophilic inflammation not only to give symptomatic relief to the patient, but also to prevent complications such as esophageal stricture and food impaction.
  
  
  CONCLUSIONS
  EoE is treated like many other atopic diseases with a combination of topical steroids and/or food antigen avoidance. The new understanding of EoE may lead to more specific and definitive treatments of EoE.
authors.affiliation: Division of Allergy and Immunology, The Children's Hospital of Philadelphia, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Antonella
authors.initials: A
authors.lastname: Cianferoni
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Spergel
mesh_terms: D002154:Calpain / Q000235:genetics; D016207:Cytokines / Q000235:genetics; D057765:Eosinophilic Esophagitis / Q000235:genetics / Q000628:therapy*; D004848:Epithelium / Q000378:metabolism*; D020022:Genetic Predisposition to Disease; D006801:Humans; D007167:Immunotherapy; D009363:Neoplasm Proteins / Q000235:genetics; D009687:Nuclear Proteins / Q000235:genetics; D011110:Polymorphism, Genetic; D012097:Repressor Proteins / Q000235:genetics; D013256:Steroids / Q000627:therapeutic use; D018418:Th2 Cells / Q000502:physiology*; D000094632:Thymic Stromal Lymphopoietin
chemical_list: D016207:Cytokines; C480344:EMSY protein, human; D009363:Neoplasm Proteins; D009687:Nuclear Proteins; D012097:Repressor Proteins; D013256:Steroids; C000602625:CAPN14 protein, human; D002154:Calpain; D000094632:Thymic Stromal Lymphopoietin