Inage, Eisuke and Furuta, Glenn T. and Menard-Katcher, Calies and Masterson, Joanne C. (2018) Eosinophilic esophagitis: pathophysiology and its clinical implications. American Journal of Physiology-Gastrointestinal and Liver Physiology, 315 (5). G879-G886. ISSN 0193-1857

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Abstract

Classically, eosinophilic esophagitis is an antigen-mediated chronic disease distinct from gastroesophageal reflux disease. Eosinophilic esophagitis is an emerging clinical problem that is growing in recognition. It is characterized clinically by feeding dysfunction, dysphagia, and reflux-like symptoms. Histologically, eosinophilic esophagitis is identifiable by a dense epithelial eosinophilic infiltrate. Experimental modeling and clinical studies over the last decade have greatly improved mechanistic insights and led to improvements in clinical understanding and the assessment of therapeutic options for patients and their clinicians who manage this disease. Here, we review the clinicopathologic diagnostic criteria and our understanding of eosinophilic esophagitis as an allergic disease with genetic and immunological components. We present studies defining the importance of the epithelial barrier and the concept of barrier dysfunction as an initiating or perpetuating factor for this disease. We discuss the relationship between the symptoms of dysphagia and feeding dysfunction, our current knowledge of the underlying pathophysiologic mechanisms, and advances in clinical assessment of esophageal distensibility and narrowing in eosinophilic esophagitis patients. Finally, therapeutic implications relating to the advances that have led to our current understanding of the pathophysiology of eosinophilic esophagitis are explored.

Item Type:	Article
Keywords:	barrier; dysphagia; eosinophilic oesophagitis; feeding dysfunction;
Academic Unit:	Faculty of Science and Engineering > Biology Faculty of Science and Engineering > Research Institutes > Human Health Institute
Item ID:	16282
Identification Number:	https://doi.org/10.1152/ajpgi.00174.2018
Depositing User:	Joanne Masterson
Date Deposited:	11 Jul 2022 15:10
Journal or Publication Title:	American Journal of Physiology-Gastrointestinal and Liver Physiology
Publisher:	American Physiological Society
Refereed:	Yes
URI:	Publisher
Use Licence:	This item is available under a Creative Commons Attribution Non Commercial Share Alike Licence (CC BY-NC-SA). Details of this licence are available here

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