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Eosinophilic esophagitis: current understanding and evolving concepts
Eosinophilic esophagitis (EoE) is now considered to represent a form of food allergy and this is demonstrated by a response to elimination diet in many patients. A critical additional factor may be an inherent impairment in epithelial barrier integrity, possibly worsened by reflux of gastric content...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Asia Pacific Association of Allergy, Asthma and Clinical Immunology
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5287068/ https://www.ncbi.nlm.nih.gov/pubmed/28154800 http://dx.doi.org/10.5415/apallergy.2017.7.1.3 |
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author | Philpott, Hamish Kweh, Barry Thien, Francis |
author_facet | Philpott, Hamish Kweh, Barry Thien, Francis |
author_sort | Philpott, Hamish |
collection | PubMed |
description | Eosinophilic esophagitis (EoE) is now considered to represent a form of food allergy and this is demonstrated by a response to elimination diet in many patients. A critical additional factor may be an inherent impairment in epithelial barrier integrity, possibly worsened by reflux of gastric contents and improved with proton pump inhibitor (PPI) use. Key clinic challenges are posed by the absence of reliable allergy tests to guide elimination diet, and the subsequent need for invasive endoscopic assessment following empirical food challenge, meaning that corticosteroids will remain the mainstay of therapy for many. From a research standpoint, determining if impairments in barrier integrity are innate, and how PPIs address this deficit (which may be pH independent) are important questions that when answered may allow future therapeutic advancement. |
format | Online Article Text |
id | pubmed-5287068 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Asia Pacific Association of Allergy, Asthma and Clinical Immunology |
record_format | MEDLINE/PubMed |
spelling | pubmed-52870682017-02-02 Eosinophilic esophagitis: current understanding and evolving concepts Philpott, Hamish Kweh, Barry Thien, Francis Asia Pac Allergy Current Review Eosinophilic esophagitis (EoE) is now considered to represent a form of food allergy and this is demonstrated by a response to elimination diet in many patients. A critical additional factor may be an inherent impairment in epithelial barrier integrity, possibly worsened by reflux of gastric contents and improved with proton pump inhibitor (PPI) use. Key clinic challenges are posed by the absence of reliable allergy tests to guide elimination diet, and the subsequent need for invasive endoscopic assessment following empirical food challenge, meaning that corticosteroids will remain the mainstay of therapy for many. From a research standpoint, determining if impairments in barrier integrity are innate, and how PPIs address this deficit (which may be pH independent) are important questions that when answered may allow future therapeutic advancement. Asia Pacific Association of Allergy, Asthma and Clinical Immunology 2017-01 2017-01-26 /pmc/articles/PMC5287068/ /pubmed/28154800 http://dx.doi.org/10.5415/apallergy.2017.7.1.3 Text en Copyright © 2017. Asia Pacific Association of Allergy, Asthma and Clinical Immunology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Current Review Philpott, Hamish Kweh, Barry Thien, Francis Eosinophilic esophagitis: current understanding and evolving concepts |
title | Eosinophilic esophagitis: current understanding and evolving concepts |
title_full | Eosinophilic esophagitis: current understanding and evolving concepts |
title_fullStr | Eosinophilic esophagitis: current understanding and evolving concepts |
title_full_unstemmed | Eosinophilic esophagitis: current understanding and evolving concepts |
title_short | Eosinophilic esophagitis: current understanding and evolving concepts |
title_sort | eosinophilic esophagitis: current understanding and evolving concepts |
topic | Current Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5287068/ https://www.ncbi.nlm.nih.gov/pubmed/28154800 http://dx.doi.org/10.5415/apallergy.2017.7.1.3 |
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