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Eosinophilic esophagitis (EOE)

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https://www.readbyqxmd.com/read/29048518/disease-related-predictors-of-health-related-quality-of-life-in-youth-with-eosinophilic-esophagitis
#1
Mary K Lynch, Margaux J Barnes, Reed A Dimmitt, Lisa Martin, Marc E Rothenberg, Burel R Goodin
Objective: To evaluate relations between health-related quality of life (HRQoL) and clinical symptom presentation in youth with eosinophilic esophagitis (EoE). We hypothesized that presence of dysphagia, reflux, nausea/vomiting, and epigastric pain would be related to poorer HRQoL. In predictive models, it was hypothesized that dysphagia, reflux, nausea/vomiting, and epigastric pain would each significantly and uniquely predict poorer HRQoL. Methods: This cross-sectional, two-study design included 91 dyads comprised children with EoE and their respective caregivers across two tertiary children's hospitals, Site 1 in the Midwest (N = 47) and Site 2 in the Deep South (N = 44)...
October 12, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/29048495/evidence-of-disturbed-sleep-in-children-with-eosinophilic-esophagitis-and-persistent-epigastric-pain
#2
Mary K Lynch, Reed A Dimmitt, Burel R Goodin
Objective: To determine whether the experience of persistent epigastric pain is associated with sleep disturbances in children with eosinophilic esophagitis (EoE). We hypothesized that children with EoE and persistent epigastric pain would (1) self-report greater current and worst pain severity, and (2) experience more disturbed sleep on objective and subjective measures in comparison with children with EoE but no persistent pain and healthy children. Methods: Fifty children with EoE were recruited for this cross-sectional study, of which 24 (48%) reported experiencing persistent epigastric pain...
September 15, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/29046486/synaptopodin-is-upregulated-by-il-13-in-eosinophilic-esophagitis-and-regulates-esophageal-epithelial-cell-motility-and-barrier-integrity
#3
Mark Rochman, Jared Travers, J Pablo Abonia, Julie M Caldwell, Marc E Rothenberg
Eosinophilic esophagitis (EoE) is an allergic inflammatory disease of the esophagus mediated by an IL-13-driven epithelial cell transcriptional program. Herein, we show that the cytoskeletal protein synaptopodin (SYNPO), previously associated with podocytes, is constitutively expressed in esophageal epithelium and induced during allergic inflammation. In addition, we show that the SYNPO gene is transcriptionally and epigenetically regulated by IL-13 in esophageal epithelial cells. SYNPO was expressed in the basal layer of homeostatic esophageal epithelium, colocalized with actin filaments, and expanded into the suprabasal epithelium in EoE patients, where expression was elevated 25-fold compared with control individuals...
October 19, 2017: JCI Insight
https://www.readbyqxmd.com/read/29039850/systematic-review-disease-activity-indices-in-eosinophilic-esophagitis
#4
REVIEW
Marijn J Warners, Pieter Hindryckx, Barrett G Levesque, Claire E Parker, Lisa M Shackelton, Reena Khanna, William J Sandborn, Geert R D'Haens, Brian G Feagan, Albert J Bredenoord, Vipul Jairath
OBJECTIVES: There is no clear consensus regarding the most appropriate measure(s) of eosinophilic esophagitis (EoE) disease activity. We aimed to identify all scoring indices used for the measurement of disease activity in EoE, appraise their operating properties, and discuss their value as outcome measures. METHODS: MEDLINE, EMBASE, and CENTRAL (The Cochrane library) were searched from inception to 11 May 2016. Randomized controlled trials (RCTs), cohort, case-control, and cross-sectional studies that reported outcomes to measure EoE disease activity or response to treatment were eligible...
October 17, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29038643/current-diagnostic-and-treatment-strategies-for-eosinophilic-esophagitis
#5
Anna M Lipowska, Robert T Kavitt
Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder of the esophagus diagnosed by the presence of esophageal symptoms accompanied by an esophageal eosinophilic infiltrate. EoE has an increasing worldwide prevalence and can be a cause of dysphagia and food impactions. There is an important role for the use of proton pump inhibitors in the diagnostic pathway of EoE. Treatment paradigms for EoE aim to minimize esophageal inflammation and improve symptom control. Dietary therapy targets dietary allergens and encompasses the elemental diet, the allergy testing-directed elimination diet, and the empiric elimination diet...
September 2017: Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29033756/progression-from-an-inflammatory-to-a-fibrostenotic-phenotype-in-eosinophilic-esophagitis
#6
Nathaniel T Koutlas, Evan S Dellon
Previous studies have suggested that eosinophilic esophagitis (EoE) progresses from chronic inflammation to fibrostenosis. However, natural history data illustrating this progression in individual patients are lacking. Here, we present 6 patients who progressed from an inflammatory to a fibrostenotic phenotype of EoE in the absence of treatment. At the time of diagnosis, none of the patients had significant evidence of fibrostenosis, but they did have other inflammatory findings of EoE such as edema, linear furrows, or exudates...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29032661/a-prospective-study-of-eosinophilic-esophagitis-and-the-expression-of-tight-junction-proteins-in-patients-with-gastroesophageal-reflux-disease-symptoms
#7
Kenichiro Okimoto, Makoto Arai, Hideaki Ishigami, Keiko Saito, Shoko Minemura, Daisuke Maruoka, Tomoaki Matsumura, Tomoo Nakagawa, Tatsuro Katsuno, Masaki Suzuki, Yukio Nakatani, Osamu Yokosuka
Background/Aims: Eosinophilic esophagitis (EoE) is often erroneously diagnosed as gastroesophageal reflex disease (GERD). The aim of this study is to investigate the prevalence of EoE and the expression of tight junction (TJ) proteins in patients with GERD symptoms. Methods: One hundred patients with GERD symptoms and 10 healthy controls were prospectively studied. Sixty-two patients had symptoms refractory to proton pump inhibitors (PPI). All patients underwent esophageal biopsy...
October 17, 2017: Gut and Liver
https://www.readbyqxmd.com/read/29029802/early-life-environmental-exposures-interact-with-genetic-susceptibility-variants-in-pediatric-patients-with-eosinophilic-esophagitis
#8
Elizabeth T Jensen, Jonathan T Kuhl, Lisa J Martin, Carl D Langefeld, Evan S Dellon, Marc E Rothenberg
BACKGROUND: Although eosinophilic esophagitis (EoE) is associated with certain gene variants, the rapidly increasing incidence of EoE suggests that environmental factors contribute to disease development. OBJECTIVE: We tested for gene-environment interaction between EoE-predisposing polymorphisms (within TSLP, LOC283710/KLF13, CAPN14, CCL26, and TGFB) and implicated early-life factors (antibiotic use in infancy, cesarean delivery, breast-feeding, neonatal intensive care unit [NICU] admission, and absence of pets in the home)...
September 12, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29026590/eosinophilic-esophagitis-what-can-we-learn-from-crohn-s-disease
#9
REVIEW
Javier Molina-Infante, Alain M Schoepfer, Alfredo J Lucendo, Evan S Dellon
Eosinophilic esophagitis (EoE) is an emerging esophageal inflammatory disorder affecting children and young adults. As a relatively new disease, EoE is still burdened by frequent diagnostic and therapeutic pitfalls in clinical practice. This manuscript posits a number of similarities with Crohn's disease, which may help optimize EoE patient management. Commonalities include epidemiologic trends (Westernized diseases, rising incidence, early-life risk factors), diagnostic considerations (symptoms are poor predictors of disease activity, difficulties in disease activity assessment) and therapeutic issues (similar natural history and therapeutic goals, induction and maintenance phases, combination of drug and endoscopic treatment, potential drug interchangeability, long-term unsolved issues)...
October 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29025076/impact-of-smoking-alcohol-consumption-and-nsaid-use-on-risk-for-and-phenotypes-of-eosinophilic-esophagitis
#10
Nathaniel T Koutlas, Swathi Eluri, Spencer Rusin, Irina Perjar, Johnathan Hollyfield, John T Woosley, Nicholas J Shaheen, Evan S Dellon
There are few data exploring modifiable risk factors for eosinophilic esophagitis (EoE). We aimed to determine if smoking, alcohol consumption, and NSAID use were risk factors for EoE, and to assess their impact on EoE phenotypes and treatment outcomes. We performed a case-control study analyzing data collected from a prospective cohort of adults undergoing upper endoscopy for symptoms of esophageal dysfunction. Incident EoE cases were diagnosed via consensus guidelines. Exposure data were collected via standardized patient questionnaire...
August 30, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29022245/prevalence-of-eosinophilic-esophagitis-in-patients-with-gastroesophageal-reflux-symptoms-a-cross-sectional-study-from-a-tertiary-care-hospital-in-north-india
#11
Bhaskarjyoti Baruah, Tarun Kumar, Prasenjit Das, Bhaskar Thakur, Vishnubatla Sreenivas, Vineet Ahuja, Siddhartha Datta Gupta, Govind K Makharia
BACKGROUND: Eosinophilic esophagitis (EoE) is being recognized increasingly all over the globe; Indian data is however sparse. We screened patients with symptoms of gastroesophageal reflux disease (GERD) for presence of EoE in them. METHODS: Consecutive patients with symptoms suggestive of GERD underwent gastroduodenoscopy and esophageal biopsies, obtained from both the upper esophagus (5 cm below the upper esophageal sphincter) and lower esophagus (5 cm above gastroesophageal junction), as well as from any other endoscopically visible abnormal mucosa...
October 12, 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29018965/the-role-of-maintenance-therapy-in-eosinophilic-esophagitis-who-why-and-how
#12
REVIEW
Hamish Philpott, Evan S Dellon
In patients with eosinophilic esophagitis (EoE) who do not respond to proton pump inhibitors, initial anti-inflammatory/anti-eosinophilic treatment is with either topical corticosteroids or dietary elimination. A large body of literature supports the efficacy of these approaches, with histologic response rates in the 50-90% range for steroids and 70% range for the six-food elimination diet. However, these studies are almost all short-term and data evaluating long-term safety and efficacy of either treatment are limited...
October 10, 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28989006/comparison-of-endoscopy-and-radiographic-imaging-for-detection-of-esophageal-inflammation-and-remodeling-in-adults-with-eosinophilic-esophagitis
#13
Matthew J Nelson, Frank H Miller, Nelson Moy, Angelika Zalewski, Nirmala Gonsalves, Dyanna Gregory, Ikuo Hirano
BACKGROUND AND AIMS: Eosinophil predominant mucosal inflammation is central to the diagnosis and activity assessment of eosinophilic esophagitis (EoE). Esophageal mural remodeling is an important consequence of EoE that is responsible for adverse events of dysphagia, food impaction, and esophageal stenosis. The aim of this study was to compare upper endoscopy (EGD) with barium upper gastrointestinal study (UGI) for the detection of esophageal inflammation and remodeling in adults with EoE...
October 5, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28987502/optimal-histologic-cutpoints-for-treatment-response-in-patients-with-eosinophilic-esophagitis-analysis-of-data-from-a-prospective-cohort-study
#14
Craig C Reed, W Asher Wolf, Cary C Cotton, Spencer Rusin, Irina Perjar, Johnathan Hollyfield, John T Woosley, Nicholas J Shaheen, Evan S Dellon
BACKGROUND AND AIMS: No prospective studies substantiate 15 eos/hpf as an appropriate endpoint for treatment of eosinophilic esophagitis (EoE). We aimed to determine a histologic cutpoint that identifies successful treatment of EoE by assessing symptomatic and endoscopic improvement. METHODS: We performed a prospective cohort study of 62 consecutive adult patients undergoing outpatient esophagogastroduodenoscopy at the University of North Carolina from 2009 through 2014...
October 4, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28981449/using-serum-ige-antibodies-to-predict-esophageal-eosinophilia-in-children
#15
Elizabeth A Erwin, Dale A Rhoda, Margaret Redmond, Jean B Ly, John M Russo, Ivor D Hill, Thomas A E Platts-Mills
OBJECTIVES: Symptoms of eosinophilic esophagitis (EoE) are variable and can be nonspecific. Food-specific serum IgE antibodies are frequently found in EoE patients and are obtained using a widely available blood test. Our objective was to evaluate the ability of food-specific IgE antibodies to predict the presence of esophageal eosinophilia. METHODS: We reviewed 144 medical records for pediatric patients having esophageal biopsy and serum analysis for IgE antibodies to food (exploratory group)...
February 22, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28981080/improvement-in-esophageal-distensibility-in-response-to-medical-and-diet-therapy-in-eosinophilic-esophagitis
#16
Dustin A Carlson, Ikuo Hirano, Angelika Zalewski, Nirmala Gonsalves, Zhiyue Lin, John E Pandolfino
OBJECTIVES: We aimed to evaluate the effect of medical and diet therapies on esophageal distensibility assessed using the functional lumen imaging probe (FLIP) and the association of changes in esophageal distensibility with clinical outcomes in eosinophilic esophagitis (EoE). METHODS: Patients with EoE were evaluated with FLIP during endoscopy at baseline and following therapy without interval dilatation. Evaluation also included a validated patient-reported outcome (PRO; a positive PRO was considered at a 30% score improvement), mucosal biopsies, and scoring of endoscopic features of EoE...
October 5, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28978963/editorial-deep-remission-in-eosinophilic-esophagitis-with-long-term-steroids-difficult-to-attain-and-maintain
#17
EDITORIAL
Jeffrey Alexander
The study by Greuter et al. entitled "Long-term treatment of eosinophilic esophagitis and swallowed topical corticosteroids: development and evaluation of a therapeutic concept" follows 351 patients over 6 years. This gives considerable insight into long-term topical steroid management of EoE and establishes the concept of deep remission in EoE.
October 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28937540/herpes-simplex-virus-esophagitis-in-immunocompetent-children-a-harbinger-of-eosinophilic-esophagitis
#18
Julia Fritz, Diana Lerner, Mariko Suchi
Herpes simplex virus (HSV) is a common cause of infectious esophagitis. The aim of this retrospective study is to identify comorbid and predisposing conditions and sequelae of HSV esophagitis in immunocompetent children. We reviewed sixteen cases of HSV esophagitis diagnosed from January, 1982 to March, 2016. Five patients were immunosuppressed, 11 were immunocompetent and included in the study. Three (27%) had no other significant medical history. Five patients (45%) had repeat biopsies following their HSV infection which showed eosinophilic infiltrate consistent with current diagnostic criteria of eosinophilic esophagitis (EoE), one of whom had known EoE...
September 20, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28906318/nutritional-state-and-feeding-behaviors-of-children-with-eosinophilic-esophagitis-and-gastroesophageal-reflux-disease
#19
Pooja Mehta, Glenn T Furuta, Taryn Brennan, Michelle L Henry, Nancy Creskoff Maune, Shikha S Sundaram, Calies Menard-Katcher, Dan Atkins, Faith Takurukura, Sandra Giffen, Zhaoxing Pan, Angela M Haas
OBJECTIVE: Because both gastroesophageal reflux disease (GERD) and eosinophilic esophagitis (EoE) are associated with malnutrition and feeding dysfunction, this study compares growth, nutrition and feeding behaviors in children with GERD and EoE. METHODS: Subjects aged 1-7 with GERD or EoE were enrolled in a prospective study. Assessments included length/height, weight, 3-day food diary, serum biomarkers of nutrition, and the Behavioral Pediatric Feeding Assessment Scale (BPFAS)...
September 12, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28895370/eosinophilic-esophagitis-current-evidence-based-diagnosis-and-treatment-in-children-and-adults
#20
Alfredo J Lucendo
Eosinophilic esophagitis (EoE) is a disease caused by an immune response to food antigens in contact with the esophageal mucosa that has arisen as a common disorder in current clinical practice. Its diagnosis is defined by the combination of symptoms of esophageal dysfunction and inflammation of the esophageal mucosa predominantly by eosinophils. Its chronic course and frequent progression to subepithelial fibrosis leading to strictures and narrow-caliber esophagus indicate the need for treatment. Information provided by recent clinical trials and systematic reviews allowed for the development of new clinical guidelines, endorsed by several European scientific societies...
September 11, 2017: Minerva Gastroenterologica e Dietologica
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