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Eosinophilic esophagitis (EOE)

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https://www.readbyqxmd.com/read/29678750/specific-igg-4-antibodies-to-cow-s-milk-proteins-in-pediatric-eosinophilic-esophagitis
#1
Alexander J Schuyler, Jeffrey M Wilson, Anubha Tripathi, Scott P Commins, Princess U Ogbogu, Patrice G Kruzsewski, Barrett H Barnes, Emily C McGowan, Lisa J Workman, Jonas Lidholm, Sheryl L Rifas-Shiman, Emily Oken, Diane R Gold, Thomas A E Platts-Mills, Elizabeth A Erwin
BACKGROUND: Allergen-specific IgG4 antibodies are often associated with tolerance, but specific IgG4 antibodies (sIgG4 ) to causally relevant foods have recently been reported in adult eosinophilic esophagitis (EoE). Prevalence and levels of food-sIgG4 are not well established in the general pediatric population. OBJECTIVE: We sought to investigate serum food-sIgG4 with component diagnostics in children with EoE and children from an unselected birth cohort and to explore the effects of sex, age and milk consumption on sIgG4 levels METHODS: Sera from 71 cases of pediatric EoE and 210 early-adolescent children from an unselected birth cohort (Project Viva) were assayed for sIgG4 and specific IgE (sIgE) to major cow's milk (CM) proteins (α-lactalbumin, β-lactoglobulin, caseins) and to wheat, soy, egg, and peanut proteins...
April 17, 2018: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29669943/whole-exome-sequencing-uncovers-oxidoreductases-dhtkd1-and-ogdhl-as-linkers-between-mitochondrial-dysfunction-and-eosinophilic-esophagitis
#2
Joseph D Sherrill, Kiran Kc, Xinjian Wang, Ting Wen, Adam Chamberlin, Emily M Stucke, Margaret H Collins, J Pablo Abonia, Yanyan Peng, Qiang Wu, Philip E Putnam, Phillip J Dexheimer, Bruce J Aronow, Leah C Kottyan, Kenneth M Kaufman, John B Harley, Taosheng Huang, Marc E Rothenberg
Eosinophilic esophagitis (EoE) is an allergic inflammatory esophageal disorder with a complex underlying genetic etiology often associated with other comorbidities. Using whole-exome sequencing (WES) of 63 patients with EoE and 60 unaffected family members and family-based trio analysis, we sought to uncover rare coding variants. WES analysis identified 5 rare, damaging variants in dehydrogenase E1 and transketolase domain-containing 1 (DHTKD1). Rare variant burden analysis revealed an overabundance of putative, potentially damaging DHTKD1 mutations in EoE (P = 0...
April 19, 2018: JCI Insight
https://www.readbyqxmd.com/read/29628359/gene-expression-phenotype-associations-in-adults-with-eosinophilic-esophagitis
#3
Evan S Dellon, Sara R Selitsky, Robert M Genta, Richard H Lash, Joel S Parker
BACKGROUND: Gene expression patterns have not been extensively examined in the context of clinical features of eosinophilic esophagitis (EoE). AIMS: To assess whether gene expression is associated with clinically defined phenotypes in adults with EoE. METHODS: This was an analysis of prospectively collected esophageal biopsies in newly diagnosed EoE patients. We determined differential gene expression with a 94 gene panel in relation to clinical features and phenotypes...
March 27, 2018: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29616839/the-cultivable-bacterial-flora-of-the-esophagus-in-subjects-with-esophagitis
#4
Elisabeth Norder Grusell, Gunnar Dahlén, Magnus Ruth, Henrik Bergquist, Mogens Bove
BACKGROUND: The healthy human esophagus is colonized by bacteria similar to that of the oral mucosa. However, little is known about the microbiome of the esophagus in esophagitis or the possible role of bacteria in the inflammatory response. AIM: To survey bacterial diversity and compare the microbiome of the esophagus in subjects with gastro-esophageal reflux disease (GERD) and eosinophilic esophagitis (EoE). MATERIAL AND METHODS: Seventeen subjects diagnosed with GERD and 10 with EoE underwent endoscopic examination with brush sampling and biopsies from the oral cavity, upper and lower esophagus...
April 4, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29611076/assessing-adherence-and-barriers-to-long-term-elimination-diet-therapy-in-adults-with-eosinophilic-esophagitis
#5
Ryan Wang, Ikuo Hirano, Bethany Doerfler, Angelika Zalewski, Nirmala Gonsalves, Tiffany Taft
BACKGROUND: The six-food elimination diet (SFED) is an effective treatment approach for eosinophilic esophagitis (EoE), but it can be challenging and affect patients' quality of life. AIM: Assess patients' long-term adherence to SFED and potential factors influencing adherence. METHODS: EoE patients were recruited online via multiple platforms. Patients were classified as reaching the maintenance stage if they responded to SFED and identified specific trigger foods by reintroduction...
April 2, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29608193/compounded-oral-viscous-budesonide-is-effective-and-provides-a-durable-response-in-eosinophilic-esophagitis
#6
Craig C Reed, Claire Fan, Nathaniel Koutlas, Zoe Stefanadis, Swathi Eluri, Nicholas J Shaheen, Evan S Dellon
Aim: Because no approved medications exist for eosinophilic esophagitis (EoE), patients must use off-label drugs or create their own formulations. We assessed the efficacy of a standardized compounded budesonide suspension for treatment of EoE. Materials and methods: We conducted a retrospective cohort study of EoE patients at the University of North Carolina treated with compounded budesonide dispensed by a specialty compounding pharmacy. Outcomes (symptomatic global response [yes/no], endoscopic response [% with individual findings], and histologic response [absolute eosinophil count; % with <15 eos/hpf])were assessed after the initial and last treatment in our system...
2018: HSOA journal of gastroenterology & hepatology research
https://www.readbyqxmd.com/read/29605980/diagnostic-trends-and-clinical-characteristics-of-eosinophilic-esophagitis-a-korean-single-center-database-study
#7
Ga Hee Kim, Kee Wook Jung, Hwoon-Yong Jung, Kee Don Choi, JungBok Lee, Young Soo Park, So-Woon Kim, Jeong Hoon Lee, Do Hoon Kim, Ji Yong Ahn, Ho June Song, Gin Hyug Lee, Jin-Ho Kim
Background/Aims: The prevalence of eosinophilic esophagitis (EoE) is reportedly increasing in Western countries. However, its prevalence in Korea remains unknown. We investigated the diagnostic trends and clinical characteristics of EoE in Korea. Methods: Using an endoscopic database maintained at a tertiary care center, we retrospectively reviewed the biopsy reports regarding 18 399 biopsy specimens collected from all patients who underwent esophagogastroduodenoscopy and esophageal biopsy at this facility between 2006 and 2014...
April 30, 2018: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/29594977/low-prevalence-of-biopsy-proven-eosinophilic-esophagitis-in-patients-with-esophageal-food-impaction-in-mexican-population
#8
Diego García-Compeán, José A González-González, José J Duran-Castro, Gilberto Herrera-Quiñones, Omar D Borjas-Almaguer, Héctor J Maldonado-Garza
BACKGROUND: Eosinophilic esophagitis (EoE) is the most common cause of dysphagia and esophageal food impaction (EFI) in the USA, Western Europe, and Australia. In Mexico, the uncomplicated form of this disease is infrequent, and prevalence in patients with EFI is unknown. AIMS: To determine the prevalence and causes of EFI, endoscopic and therapeutic aspects, and establish the prevalence of biopsy-proven EoE in patients with EFI. METHODS: Diagnostic upper gastrointestinal endoscopy reports from January 2011 to December 2016 were retrospectively reviewed...
March 29, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29571547/eosinophilic-esophagitis
#9
Amanda B Muir
Eosinophilic esophagitis (EoE) is a chronic allergic inflammatory disease of the esophagus that effects children and adults. Typical symptoms of EoE typically involve failure to thrive and vomiting in small children, and dysphagia and food impaction in adolescents and adults. However, throat clearing, choking, gagging, and hoarseness have also been observed and these issues often bring patients to first seek otolaryngology and pulmonary evaluation. Diagnosis is only made by esophogastroduodenoscopy with biopsy, so clinicians must have a low threshold for considering eosinophilic esophagitis even in the absence of frank gastrointestinal symptoms...
March 2018: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/29552622/the-esophageal-organoid-system-reveals-functional-interplay-between-notch-and-cytokines-in-reactive-epithelial-changes
#10
Yuta Kasagi, Prasanna M Chandramouleeswaran, Kelly A Whelan, Koji Tanaka, Veronique Giroux, Medha Sharma, Joshua Wang, Alain J Benitez, Maureen DeMarshall, John W Tobias, Kathryn E Hamilton, Gary W Falk, Jonathan M Spergel, Andres J Klein-Szanto, Anil K Rustgi, Amanda B Muir, Hiroshi Nakagawa
Background & Aims: Aberrations in the esophageal proliferation-differentiation gradient are histologic hallmarks in eosinophilic esophagitis (EoE) and gastroesophageal reflux disease. A reliable protocol to grow 3-dimensional (3D) esophageal organoids is needed to study esophageal epithelial homeostasis under physiological and pathologic conditions. Methods: We modified keratinocyte-serum free medium to grow 3D organoids from endoscopic esophageal biopsies, immortalized human esophageal epithelial cells, and murine esophagi...
March 2018: Cellular and Molecular Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29549437/treatment-of-eosinophilic-esophagitis-in-the-pediatric-patient-an-evidence-based-approach
#11
REVIEW
Mery Munoz-Persy, Alfredo J Lucendo
Eosinophilic esophagitis (EoE) is a unique form of non-IgE-mediated food allergy characterized by esophageal eosinophilic infiltration that commonly causes dysphagia and food impaction in children and adolescents. Assessing the efficacy of dietary restrictions or drug therapies to achieve clinical and histologic resolution of EoE through randomized controlled trials and meta-analyses has resulted in new evidence-based guidelines. Avoiding food triggers is the only therapy targeting the cause of the disease...
March 17, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29545632/helicobacter-pylori-infection-does-not-protect-against-eosinophilic-esophagitis-results-from-a-large-multicenter-case-control-study
#12
Javier Molina-Infante, Carolina Gutierrez-Junquera, Edoardo Savarino, Roberto Penagini, Ines Modolell, Ottavia Bartolo, Alicia Prieto-García, Aurelio Mauro, Javier Alcedo, Antonia Perelló, Carlos Guarner-Argente, Noelia Alcaide, Ana M Vegas, Patricia Barros-García, Marianette Murzi-Pulgar, Monica Perona, Javier P Gisbert, Alfredo J Lucendo
OBJECTIVES: Rising trends in eosinophilic esophagitis (EoE) have been repeatedly linked to declining Helicobacter pylori (H. pylori) infection, mostly in retrospective studies. We aimed to prospectively evaluate this inverse association. METHODS: Prospective case-control study conducted in 23 centers. Children and adults naïve to eradication therapy for H. pylori were included. Cases were EoE patients, whereas controls were defined by esophageal symptoms and <5 eos/HPF on esophageal biopsies...
March 15, 2018: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/29544738/a-randomized-double-blind-placebo-controlled-study-of-the-use-of-viscous-oral-cromolyn-sodium-for-the-treatment-of-eosinophilic-esophagitis
#13
Jay Adam Lieberman, Jie Zhang, John Whitworth, Cary Cavender
BACKGROUND: There is a need for effective, non-steroid pharmacologic therapies for eosinophilic esophagitis (EoE). Cromolyn sodium offers an option as mast cells have been implicated in the symptomatology of EoE and cromolyn has also been shown to have some anti-eosinophilic properties. OBJECTIVE: To evaluate the efficacy of cromolyn in reducing esophageal eosinophilia in patients with eosinophilic esophagitis. Secondary outcomes included symptom improvement and adverse effects...
March 12, 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29543695/mucosal-impedance-measurements-differentiate-pediatric-patients-with-active-vs-inactive-eosinophilic-esophagitis
#14
Mary Allyson Lowry, Michael F Vaezi, Hernan Correa, Tina Higginbotham, James C Slaughter, Sari Acra
BACKGROUND & AIMS: Eosinophilic esophagitis (EoE) is a chronic disorder in children that requires continued assessment of disease activity, involving repeated sedation, endoscopy, and biopsy analysis. We investigated whether mucosal impedance measurements can be used to monitor disease activity in pediatric patients with EoE. METHODS: We measured mucosal impedance at 3 locations in the esophagus in pediatric patients (1-18 years old; 32 with active EoE, 10 with inactive EoE, 32 with non-erosive reflux disease [NERD]) and 53 children with symptoms but normal findings from histologic analyses (controls) undergoing routine esophagogastroduodenoscopy at the Vanderbilt Pediatric Gastroenterology Clinic...
March 14, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29528033/incidence-of-childhood-eosinophilic-esophagitis-in-central-brazil-how-many-are-we-missing
#15
L O Gonçalves, M M Lopes, E R Rezende, G Rs Segundo
BACKGROUND: Few studies have assessed the incidence of eosinophilic esophagitis (EoE) in childhood. The study aim is to determine the incidence of EoE in pediatric patients submitted to upper gastrointestinal endoscopy (UGE), with analysis of epidemiological data regarding sex, age, symptomatology, the frequency of atopy and endoscopic and histological findings. METHODS: A retrospective, observational and analytical study performed with an evaluation of medical records of patients aged 0 to 14 years who underwent to upper gastrointestinal endoscopy in a tertiary hospital from January 2004 to January 2014...
March 12, 2018: Journal of Investigational Allergology & Clinical Immunology
https://www.readbyqxmd.com/read/29522850/dietary-therapy-for-eosinophilic-esophagitis
#16
Javier Molina-Infante, Alfredo J Lucendo
Eosinophilic esophagitis (EoE) is a chronic, immune-mediated, esophageal disease triggered predominantly, but not excusively, by food antigens. Presently, available food allergy tests are suboptimal to predict food triggers for EoE, especially in adults. Elemental diet (exclusive feeding with aminoacid-based formulas) and empiric six-food elimination diet (6-FED; withdrawing milk, wheat, egg, soy, nuts and fish/seafood for 6 weeks), have consistently shown the best efficacy rates. However, their high level of restriction and need for multiple endoscopies have hampered their implementation in clinical practice...
March 6, 2018: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29511165/food-allergen-triggers-are-increased-in-children-with-the-tslp-risk-allele-and-eosinophilic-esophagitis
#17
Lisa M Fahey, Prasanna M Chandramouleeswaran, Shaobo Guan, Alain J Benitez, Glenn T Furuta, Seema S Aceves, Mei-Lun Wang, Chris A Liacouras, Amanda B Muir, Patrick Ma Sleiman, Hakon Hakonarson, Jonathan M Spergel, Antonella Cianferoni
OBJECTIVES: TSLP has been shown to be associated with eosinophilic esophagitis (EoE). Specifically, children with EoE often have the nucleotides AA or AG instead of GG at the single nucleotide polymorphism position RS3806932. Presently, the phenotypic characteristics in EoE children with the TSLP EoE risk allele are unknown. METHODS: A retrospective analysis was performed of all children with EoE who had TSLP genotyping at The Children's Hospital of Philadelphia from 2008-2014...
March 6, 2018: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/29509636/long-term-treatment-with-proton-pump-inhibitors-is-effective-in-children-with-eosinophilic-esophagitis
#18
Carolina Gutiérrez-Junquera, Sonia Fernández-Fernández, M Luz Cilleruelo, Ana Rayo, Luis Echeverría, Belén Borrell, Enriqueta Román
OBJECTIVES: Proton pump inhibitor (PPI)-responsive eosinophilic esophagitis (EoE) is frequently observed in children, but data on long-term treatment are scarce. The objective of this study is to evaluate the long-term efficacy and safety of PPIs in children with EoE. METHODS: This prospective study enrolled children with EoE and histological remission to an 8-week esomeprazole trial (1 mg/kg/dose, twice daily). Esomeprazole was maintained at 1 mg/kg/day for 1 year...
March 5, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29509633/pediatric-eosinophilic-esophagitis-is-associated-with-increased-lamina-propria-immunoglobulin-g4-positive-plasma-cells
#19
Nissreen Mohammad, Vishal Avinashi, Edmond Chan, Bruce A Vallance, Elodie Portales-Casamar, Jonathan W Bush
OBJECTIVE: Eosinophilic esophagitis (EoE) is considered a TH2-mediated food allergy disease that leads to submucosal esophageal fibrosis and strictures. Recent studies focused on adults with EoE identified a strong association with elevated esophageal IgG4 immunostaining. Our study aimed to determine the association of IgG4 with EoE in pediatric patients. METHODS: Using our local EoE research registry, we identified 41 adequate biopsies from EoE patients. We used 10 age- and sex-matched patients with no diagnostic abnormalities at endoscopy or on biopsy...
March 5, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29492720/eosinophilic-esophagitis-in-children-endoscopic-findings-at-diagnosis-and-post-intervention
#20
REVIEW
S M Bolton, A F Kagalwalla, J B Wechsler
PURPOSE OF REVIEW: The goal of this review is to present and summarize studies on endoscopic findings in eosinophilic esophagitis (EoE), at diagnosis and in response to treatment, utilizing rigorous peer-reviewed literature in children wherever possible and to introduce a recently proposed standardized endoscopic evaluation system. RECENT FINDINGS: Gold standard of diagnosis and assessment of response to therapy in EoE requires multiple endoscopies with biopsies for histology, which allows for observation of the esophageal mucosa...
February 28, 2018: Current Gastroenterology Reports
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