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Eosinophilic esophagitis (EOE)

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https://www.readbyqxmd.com/read/28201841/evaluation-of-narrow-band-imaging-signs-in-eosinophilic-and-lymphocytic-esophagitis
#1
Tamaki Ichiya, Kyosuke Tanaka, Carlos A Rubio, Ulf Hammar, Peter T Schmidt
Background and study aims No specific endoscopic signs for diagnosing eosinophilic esophagitis (EoE) have been described and very few studies have reported endoscopic signs for lymphocytic esophagitis (LyE). This study aimed to assess the utility of narrow-band imaging magnifying endoscopy (NBI-ME) in predicting EoE/LyE diagnosis before histopathological assessment. Patients and methods Adult patients with dysphagia and/or food impaction who underwent esophagogastroduodenoscopy followed by NBI-ME and biopsies were included...
February 15, 2017: Endoscopy
https://www.readbyqxmd.com/read/28194801/differences-in-eosinophil-molecular-profiles-between-children-and-adults-with-eosinophilic-esophagitis
#2
Christine Lingblom, Timo Käppi, Henrik Bergquist, Mogens Bove, Rikard Arkel, Robert Saalman, Christine Wennerås
BACKGROUND: Eosinophilic esophagitis (EoE) afflicts both children and adults. It has been debated whether pediatric and adult EoE represent different disease entities. The objectives of this study were to determine if the blood eosinophil molecular pattern of children with EoE is: 1) distinct from that of healthy children; and 2) different from that of adults with EoE. METHODS: Blood eosinophils from children and adults with EoE, and healthy controls, were analyzed with flow cytometry regarding levels of CD23, CD44, CD54, CRTH2, FOXP3 and galectin-10...
February 14, 2017: Allergy
https://www.readbyqxmd.com/read/28192821/-eosinophilic-esophagitis-update-pathogenesis-diagnosis-and-therapy
#3
Ulrike von Arnim, S Miehlke, A Madisch, M Vieth, A Straumann, P Malfertheiner
Eosinophilic esophagitis (EoE) is a clinicopathological condition of the esophagus that has become increasingly recognised over the last decade. EoE represents a chronic immune-mediated inflammatory disease of the esophagus. In adults dysphagia is the predominant symptom. Upper gastrointestinal endoscopy is required in order to take biopsies from the esophagus. The diagnose is confirmed histologically by typical eosinophilic infiltration of the esophagus mucosa. Until now there is no approved therapy world-wide although we know that topic and systemic steroids are highly effective in EoE...
January 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28192145/population-based-familial-aggregation-of-eosinophilic-esophagitis-suggests-a-genetic-contribution
#4
Kristina Allen-Brady, Rafael Firszt, John C Fang, Jathine Wong, Ken R Smith, Kathryn A Peterson
BACKGROUND: Prior familial clustering studies have observed an increased risk of eosinophilic esophagitis (EoE) mostly among first-degree relatives suggesting a genetic contribution to EoE, and twin studies have suggested a powerful contribution from environmental factors. OBJECTIVE: Clarify the contribution of genetic factors to EoE through estimation of familial aggregation and risk of EoE in extended relatives. METHODS: The Utah Population Database, a population-based genealogy resource linked to electronic medical records for healthcare systems across the state of Utah, was used to identify EoE cases and age, sex and birthplace-matched controls at a 5:1 ratio...
February 10, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28181994/a-gene-expression-panel-is-accurate-for-diagnosis-and-monitoring-treatment-of-eosinophilic-esophagitis-in-adults
#5
Evan S Dellon, Ranjitha Veerappan, Sara R Selitsky, Joel S Parker, Leana L Higgins, RoseMary Beitia, Robert M Genta, Richard H Lash
OBJECTIVE: Eosinophilic esophagitis (EoE) can be difficult to diagnose. We aimed to evaluate whether a gene expression score could differentiate adult EoE cases from non-EoE controls and to determine whether scores normalized after treatment for EoE. METHODS: We analyzed prospectively collected esophageal biopsies from EoE patients (diagnosed as per consensus guidelines and after a proton pump inhibitor trial) and non-EoE controls. Gene expression for a previously constructed 94 gene panel was quantified for a single RNA-later preserved biopsy...
February 9, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28161707/pathogenesis-of-double-dose-proton-pump-inhibitor-resistant-non-erosive-reflux-disease-and-mechanism-of-reflux-symptoms-and-gastric-acid-secretion-suppressive-effect-in-the-presence-or-absence-of-helicobacter-pylori-infection
#6
Noriyuki Kawami, Nana Takenouchi, Mariko Umezawa, Shintaro Hoshino, Yuriko Hanada, Yoshimasa Hoshikawa, Hirohito Sano, Yoshio Hoshihara, Tsutomu Nomura, Eiji Uchida, Katsuhiko Iwakiri
BACKGROUND: Various mechanisms have been suggested to be responsible for contributing to the occurrence of proton pump inhibitor (PPI)-resistant non-erosive reflux disease (NERD). The aims of this study were to clarify the pathogenesis of PPI-resistant NERD. METHODS: Fifty-three patients with NERD, who had persistent reflux symptoms despite taking double-dose PPI, were included in this study. After excluding eosinophilic esophagitis (EoE) and primary esophageal motility disorder, esophageal impedance-pH monitoring was carried out...
February 4, 2017: Digestion
https://www.readbyqxmd.com/read/28154800/eosinophilic-esophagitis-current-understanding-and-evolving-concepts
#7
REVIEW
Hamish Philpott, Barry Kweh, Francis Thien
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...
January 2017: Asia Pacific Allergy
https://www.readbyqxmd.com/read/28131390/calpain-14-and-its-association-with-eosinophilic-esophagitis
#8
REVIEW
Vladislav A Litosh, Mark Rochman, Jeffrey K Rymer, Aleksey Porollo, Leah C Kottyan, Marc E Rothenberg
Calpains are a family of intracellular, calcium-dependent cysteine proteases involved in a variety of regulatory processes, including cytoskeletal dynamics, cell-cycle progression, signal transduction, gene expression, and apoptosis. These enzymes have been implicated in a number of disease processes, notably for this review involving eosinophilic tissue inflammation, such as eosinophilic esophagitis (EoE), a chronic inflammatory disorder triggered by allergic hypersensitivity to food and associated with genetic variants in calpain 14 (CAPN14)...
January 25, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28124203/the-role-of-allergy-testing-in-eosinophilic-esophagitis-an-update-of-the-evidence
#9
Hamish Philpott, Francis Thien
Allergy testing has been advocated for patients with eosinophilic esophagitis (EoE) as a means of defining food triggers and directing dietary therapy. Several recent and comprehensive studies have demonstrated the futility of skin prick (SPT), skin patch (APT) and serum food antigen specific IgE (SIgE) estimates in this context. Furthermore, if identification of food triggers is the endpoint (as opposed to the ability of an allergy test-directed diet merely to induce remission), previous positive studies have limitations...
January 25, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28118289/utility-of-gastric-and-duodenal-biopsies-during-follow-up-endoscopy-in-children-with-eosinophilic-esophagitis
#10
Sunpreet Kaur, John M Rosen, Alyssa A Kriegermeier, Joshua B Wechsler, Amir F Kagalwalla, Jeffrey B Brown
OBJECTIVES: Eosinophilic esophagitis (EoE) is a chronic antigen-mediated immune disorder of the esophagus. Consensus guidelines recommend obtaining esophageal, gastric and duodenal biopsies at diagnostic endoscopy when EoE is suspected. The utility of repeated gastric and duodenal biopsies during follow-up endoscopy in patients previously diagnosed with EoE is not established. The aim of this study was to explore the role of gastric and duodenal biopsies in children with an established diagnosis of EoE undergoing repeat endoscopy to assess histological response to treatment...
January 21, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28117605/quality-assessment-of-clinical-practice-guidelines-for-eosinophilic-esophagitis-using-the-agree-ii-instrument
#11
Alfredo J Lucendo, Ángel Arias, Olga Redondo-González, Javier Molina-Infante
BACKGROUND: High-quality evidence-based clinical practice guidelines can guide diagnosis and treatment to optimize outcomes. We aimed to systematically review the quality of international guidelines on eosinophilic esophagitis (EoE). METHODS: MEDLINE and Scopus databases were searched for appropriate guidelines up to 2016. Two gastroenterologists and two methodologists independently evaluated the documents using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument...
February 1, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28104354/profound-loss-of-esophageal-tissue-differentiation-in-eosinophilic-esophagitis
#12
M Rochman, J Travers, C E Miracle, M C Bedard, T Wen, N P Azouz, J M Caldwell, K Kc, J D Sherrill, B P Davis, J K Rymer, K M Kaufman, M E Rothenberg
BACKGROUND: A key question in the allergy field is to understand how tissue specific disease is manifested. Eosinophilic esophagitis (EoE) is an emerging tissue specific allergic disease whose pathogenesis remains unclear. OBJECTIVE: Herein, we tested the hypothesis that a defect in tissue specific esophageal genes is an integral part of EoE pathogenesis. METHODS: We interrogated the pattern of expression of esophagus-specific signature genes derived from the Human Protein Atlas in the EoE transcriptome and in EPC2 esophageal epithelial cells...
January 16, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28055990/dilation-of-pediatric-eosinophilic-esophagitis-adverse-events-and-short-term-outcomes
#13
Calies Menard-Katcher, Glenn T Furuta, Robert E Kramer
OBJECTIVES: Although several studies report the experience with adult eosinophilic esophagitis (EoE) related stricture, outcomes for pediatric patients with EoE associated fibrostenosis and stricture is even more limited. To address this, we aim to identify the adverse event rate and short-term outcomes of the largest reported cohort of children with EoE to undergo esophageal dilation for management of symptomatic esophageal narrowing. METHODS: A retrospective assessment of all children, 18 years and younger, who underwent esophageal dilation at an academic children's hospital over a 5-year period was conducted...
July 18, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28045773/the-association-between-celiac-disease-and-eosinophilic-esophagitis-mayo-experience-and-meta-analysis-of-the-literature
#14
Salim Hommeida, Mouaz Alsawas, Mohammad H Murad, David A Katzka, Rayna M Grothe, Imad Absah
BACKGROUND: The association between celiac disease (CD) and eosinophilic esophagitis (EoE) has been the focus of multiple studies with variable results. Both diseases are immune mediated, and dietary triggers play a role in their pathogenesis. OBJECTIVES: The aim of the study was to analyze the risk of EoE in children with CD, assess the magnitude of association between CD and EoE in children, and report the characteristics and outcomes of children with both conditions...
December 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28042003/the-prevalence-of-eosinophilic-esophagitis-in-pediatric-patients-with-ige-mediated-food-allergy
#15
David A Hill, Jesse W Dudley, Jonathan M Spergel
BACKGROUND: Eosinophilic esophagitis (EoE) is an allergic inflammatory disease that is triggered by food allergens and characterized by progressive esophageal dysfunction. Recently, EoE has been identified in patients who underwent oral immunotherapy (OIT) for IgE-mediated food allergy, suggesting an association. OBJECTIVE: We sought to ascertain whether significant associations exist between IgE-mediated food allergies and EoE. METHODS: Using the analysis of electronic medical record data and manual chart review, we examined our subspecialty care network of 35,528 children and adolescents to identify and characterize patients with IgE-mediated and EoE food allergy...
December 30, 2016: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28041975/determination-of-esophageal-eosinophil-counts-and-other-histologic-features-of-eosinophilic-esophagitis-by-pathology-trainees-is-highly-accurate
#16
Spencer Rusin, Shannon Covey, Irina Perjar, Johnny Hollyfield, Olga Speck, Kimberly Woodward, John T Woosley, Evan S Dellon
Many studies of eosinophilic esophagitis (EoE) utilize expert pathology review, but it is unknown whether less experienced pathologists can reliably assess EoE histology. We aimed to determine whether trainee pathologists can accurately quantify esophageal eosinophil counts and identify associated histologic features of EoE, as compared to expert pathologists. We used a set of 40 digitized slides from patients with varying degrees of esophageal eosinophilia. Each of six trainee pathologists underwent a teaching session and used our validated protocol to determine eosinophil counts and associated EoE findings...
December 29, 2016: Human Pathology
https://www.readbyqxmd.com/read/28005266/enhanced-activation-of-eosinophils-in-peripheral-blood-and-implications-for-eosinophilic-esophagitis-diagnosis
#17
Valéria Botan, Tatiana Karla Dos Santos Borges, Erica Alessandra Rocha Alves, Shirley Claudino Pereira Couto, Heinrich Bender Kohnert Seidler, Maria Imaculada Muniz-Junqueira
BACKGROUND AND AIM: Eosinophils are markers of the eosinophilic esophagitis (EoE) disease, and this work aimed to assess whether activation of eosinophils could be a noninvasive test to contribute for EoE diagnosis. METHODS: The activation state of peripheral blood eosinophils in EoE patients (31) and control subjects (10) was assessed based on the morphological aspects of the eosinophil after adherence to slide. COX-2 and 5-LOX expressions were evaluated by means of immunofluorescence microscopy to verify if and which eicosanoid pathway is triggered in eosinophils in blood in EoE...
December 22, 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27998193/update-on-dietary-therapy-for-eosinophilic-esophagitis-in-children-and-adults
#18
Javier Molina-Infante, Pedro Luis Gonzalez-Cordero, Angel Arias, Alfredo J Lucendo
Eosinophilic esophagitis (EoE) is a chronic inflammatory esophageal disease triggered predominantly, but not excusively, by food antigens. Elimination diet thus remains the only therapy targeting the cause of the disease. Importantly, EoE is a unique form of non-IgE mediated food allergy, largely dependant upon delayed, cell-mediated hypersensitivity. Areas covered: A comprehensive review of literature to summarize and update the most relevant advances on dietary therapy for pediatric and adult EoE patients is conducted...
February 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27979389/eosinophilic-esophagitis-update-in-diagnosis-and-management-position-paper-by-the-italian-society-of-gastroenterology-and-gastrointestinal-endoscopy-sige
#19
REVIEW
Nicola de Bortoli, Roberto Penagini, Edoardo Savarino, Santino Marchi
Eosinophilic esophagitis (EoE) is a chronic immune-mediated disease of the esophagus characterized by symptoms related to esophageal dysfunction, as well as significant esophageal eosinophilia. The entity exists worldwide but has been most extensively studied in Western countries. However, a wide range of symptoms has been noticed such as chest pain or gastro-esophageal reflux disease-like symptoms. Upper gastro-intestinal endoscopy and esophageal biopsies are crucial for the diagnosis. Endoscopy might be normal or reveal typical patterns such as rings, furrows, exudates, edema, and stricture...
December 2, 2016: Digestive and Liver Disease
https://www.readbyqxmd.com/read/27956893/eosinophilic-disorders-of-the-gastro-intestinal-tract-an-update
#20
REVIEW
Erminia Ridolo, Valerie Melli, Gianluigi De' Angelis, Irene Martignago
Eosinophilic diseases of the gastrointestinal tract, including eosinophilic esophagitis (EoE) and eosinophilic gastroenteritis (EGE), are rare chronic pathologies of the digestive system, with an immuno-mediated pathogenesis. Recent data suggest that, together with the "classic" IgE-response to allergens, also a delayed hypersensitivity mechanism could be involved in the development of eosinophilic disorders. EoE and EGE were studied only in the latest decades and as a consequence accurate data are not yet available, concerning not only pathogenesis, but also epidemiology, treatment and outcomes...
2016: Clinical and Molecular Allergy: CMA
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