The role of proton pump inhibitor therapy in the management of eosinophilic esophagitis.
Eosinophilic esophagitis (EoE) is a chronic esophageal disease characterized by a Th2 inflammatory response triggered by food/environmental allergens. Solid data confirm that up to half of patients with suspected EoE achieve complete remission on proton pump inhibitors (PPI) therapy. This disease phenotype is currently labelled as PPI-responsive esophageal eosinophilia (PPI-REE). Albeit initially believed to represent gastro-esophageal reflux disease (GERD), evolving evidence has underscored that PPI-REE and EoE show a significant overlap regarding clinic, endoscopic, histologic, Th2 immune-mediated inflammation and gene expression features. Moreover, PPI therapy can effectively reverse Th2 inflammation and the EoE transcriptome expression in PPI-REE patients. Therefore, EoE and PPI-REE likely represent a common allergic disorder, where PPI therapy should be considered a short- and long-term therapeutic asset, along with diet and topical steroids.
a Department of Gastroenterology , Hospital San Pedro de Alcantara , Caceres , Spain.
Javier
J
Molina-Infante
a Department of Gastroenterology , Hospital San Pedro de Alcantara , Caceres , Spain.
Raul
R
Prados-Manzano
a Department of Gastroenterology , Hospital San Pedro de Alcantara , Caceres , Spain.
Pedro Luis
PL
Gonzalez-Cordero
D000818:Animals; D004802:Eosinophilia / Q000188:drug therapy*; D057765:Eosinophilic Esophagitis / Q000188:drug therapy*; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D006801:Humans; D007249:Inflammation; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D018418:Th2 Cells / Q000187:drug effects* / Q000276:immunology; D059467:Transcriptome / Q000187:drug effects
D054328:Proton Pump Inhibitors
Eosinophilic esophagitis; gastro-esophageal reflux disease; proton pump inhibitor drugs; proton pump inhibitor responsive esophageal eosinophilia