title: Allergic mechanisms of Eosinophilic oesophagitis.
abstract: Eosinophilic oesophagitis (EoE) is characterized by oesophageal dysfunction and oesophageal eosinophilia refractory to proton-pump-inhibitor treatment. EoE is a food allergy, as elimination of food trigger(s) abrogates the disease, while trigger reintroduction causes recurrence. The allergic mechanism of EoE involves both IgE and non-IgE processes. There is a break in oral tolerance, the immune mechanism allowing enteric exposure to food and micro-organisms without causing deleterious immune responses. Changes in life-style, alterations in gut flora and use of antibiotics may be increasing disease prevalence. Mouse models of EoE and human studies revealed the role of regulatory T-cells and iNKT-cells in the pathogenesis. Th2-cytokines like IL-4, IL-5 and IL-13, and other cytokines like TGFβ and TSLP are involved, but perhaps no one cytokine is critically important for driving the disease. Control of EoE may require a pharmaceutical approach that blocks more than one target in the Th2-inflammatory pathway.
authors.affiliation: Food Allergy Center at Tufts Medical Center and Floating Hospital for Children, Division of Allergy and Immunology, Division of Gastroenterology and Hepatology, Division of Pediatric Gastroenterology and Nutrition, Tufts Medical Center, Boston, MA, USA. Electronic address: jleung3@tuftsmedicalcenter.org.
authors.forename: John
authors.initials: J
authors.lastname: Leung
authors.affiliation: Food Allergy Center at Tufts Medical Center and Floating Hospital for Children, Division of Allergy and Immunology, Division of Gastroenterology and Hepatology, Division of Pediatric Gastroenterology and Nutrition, Tufts Medical Center, Boston, MA, USA. Electronic address: koenbeukema@gmail.com.
authors.forename: Koen Robert
authors.initials: KR
authors.lastname: Beukema
authors.affiliation: Food Allergy Center at Tufts Medical Center and Floating Hospital for Children, Division of Allergy and Immunology, Division of Gastroenterology and Hepatology, Division of Pediatric Gastroenterology and Nutrition, Tufts Medical Center, Boston, MA, USA. Electronic address: ashen@tuftsmedicalcenter.org.
authors.forename: Alice Hangzhou
authors.initials: AH
authors.lastname: Shen
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D057765:Eosinophilic Esophagitis / Q000276:immunology / Q000503:physiopathology*; D005512:Food Hypersensitivity / Q000276:immunology / Q000503:physiopathology*; D006801:Humans; D007108:Immune Tolerance / Q000502:physiology; D007109:Immunity / Q000502:physiology; D007073:Immunoglobulin E / Q000097:blood; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology
chemical_list: D007073:Immunoglobulin E
keywords: Allergic mechanism; Antigen sensitization; Barrier dysfunction; Eosinophilic oesophagitis; Food allergy; Oral tolerance; Pathogenesis; t-helper lymphocyte type 2 immunity