Immunogenetic, Molecular and Microbiotic Determinants of Eosinophilic Esophagitis and Clinical Practice-A New Perspective of an Old Disease

Int J Mol Sci. 2021 Oct 7;22(19):10830. doi: 10.3390/ijms221910830.

Abstract

Eosinophilic oesophagitis (EoE) is a chronic, allergic disease associated with a T-lymphocyte response inducing esophageal eosinophilic infiltration in the esophagus. Inflammation and tissue fibrosis are responsible for the main clinical symptoms such as food impaction and dysphagia. The etiopathogenesis is multifactorial in which genetic and environmental factors coexist. The most common trigger is a non-IgE-mediated food allergy to milk, wheat, egg, soybean, nuts, fish, and seafood. The second factor we focus on is the contribution of genetic variation to the risk of EoE, describing the expression profile of selected genes associated with eosinophilic oesophagitis. We raise the topic of treatment, aiming to eliminate inflammation through an elimination diet and/or use of pharmacologic therapy with the use of proton pump inhibitors or steroids and endoscopic procedures to dilate the esophagus. We demonstrate that early diagnosis and effective treatment prevent the development of food impaction and decreased quality of life. The increasing presence of EoE requires bigger awareness among medical specialists concerning clinical features, the course of EoE, diagnostic tools, and management strategies.

Keywords: diet therapy; environmental factors; eosinophilic esophagitis; genetic factors; microbiome; molecular mechanism.

Publication types

  • Review

MeSH terms

  • Animals
  • Bacteremia / complications*
  • Eosinophilic Esophagitis / drug therapy
  • Eosinophilic Esophagitis / etiology
  • Eosinophilic Esophagitis / pathology*
  • Humans
  • Immunogenetics*
  • Proton Pump Inhibitors / therapeutic use*

Substances

  • Proton Pump Inhibitors