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https://www.readbyqxmd.com/read/28339136/eosinophilic-oesophagitis-phenotypes-ready-for-primetime
#1
REVIEW
Dan Atkins, Glenn T Furuta, Chris A Liacouras, Jonathan M Spergel
Eosinophilic Oesophagitis (EoE) is one of the most common causes of reflux like symptoms and feeding problems in children and food impaction and dysphagia in adults with a prevalence of 1:2500. Therapeutic options include diet, use of swallowed corticosteroids or dilation. In the last several years, recent clinical and translational research have identified some common and distinctive features, for example, the varying response to diet and medications. As EoE shares some characteristics with both asthma and inflammatory bowel disease, the advances in these fields suggests that various phenotypes may also exist in patients with EoE...
March 24, 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/28333765/adherence-to-celiac-disease-and-eosinophilic-esophagitis-biopsy-guidelines-is-poor-in-children
#2
Thomas Wallach, Robert M Genta, Benjamin Lebwohl, Peter H R Green, Norelle R Reilly
OBJECTIVES: Celiac disease (CD) and eosinophilic esophagitis (EoE) are underdiagnosed gastrointestinal conditions which adversely impact children's health. Prior studies have shown that diagnostic guidelines for CD are not consistently followed in adults. The aims of this study are to assess the frequency with which endoscopists comply with diagnostic guidelines for CD and EoE in children, and to determine whether an association exists between adherence to biopsy guidelines and disease detection in pediatric patients...
March 22, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28296675/eosinophilic-esophagitis-and-esophageal-granular-cell-tumor-an-unexpected-association
#3
Mary Ellen Riffle, Alexandros D Polydorides, Jessica Niakan, Mirna Chehade
Esophageal granular cell tumors (GCTs) are rare. Eosinophilic esophagitis (EoE) is an immune-mediated disease characterized by esophageal eosinophilia despite proton pump inhibitor (PPI) therapy. Given that GCTs occur at sites of scarring and inflammation, we sought to determine the prevalence of EoE in patients with esophageal GCTs. Our center's pathology database was searched for GCT specimens from 1995 to 2014. Slides were blindly rereviewed. GCTs were scored for atypical cytological features. Presence and number of eosinophils in the tumor and the surrounding esophageal epithelium and any EoE features were recorded...
March 14, 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28294586/pediatric-eosinophilic-esophagitis-in-portugal
#4
J L Alves Marcelino, R Cardoso de Aguiar, F Cabral Duarte, A Célia Costa, M A Pereira-Barbosa
Eosinophilic esophagitis (EoE) is an increasingly frequent diagnosis in our clinical practice, mainly in pediatric age. Allergic responses to food and aeroallergens have been increasingly implicated in the etiology of this disease. We describe a retrospective data analysis of pediatric EoE patients followed in our Immunoallergology Department. Of the 25 children (22 male, average 10.8 years), 88% had prior history of rhinoconjunctivitis, 76% asthma, 48% eczema and 36% food allergy. After evaluation, we identified in 76% and 92% of patients food and aeroallergen sensitization, respectively; 68% had simultaneously food and inhalant sensitization and 96% had at least one positive test to aeroallergens or food allergens...
March 2017: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28291175/ppi-trial-for-eosinophilic-esophagitis-chaos-in-the-community
#5
Seth Lipka, Ambuj Kumar, Joel E Richter
INTRODUCTION: Despite consensus eosinophilic esophagitis (EoE) statement published in 2011 calling for a 2-month trial of protons pump inhibitor (PPI), the guidelines are not followed by many. We studied the practice patterns in our community and response to a PPI retrial in patients previously diagnosed with "idiopathic EoE." METHODS: All patients presenting to the senior author's practice with suspected EoE from 2011 to 2015. Two cohorts were studied: (1) patients diagnosed in the community as "idiopathic EoE"; (2) treatment naïve patients given a PPI trial at University of South Florida...
March 13, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28283156/dietary-therapy-and-nutrition-management-of-eosinophilic-esophagitis-a-work-group-report-of-the-american-academy-of-allergy-asthma-and-immunology
#6
Marion Groetch, Carina Venter, Isabel Skypala, Berber Vlieg-Boerstra, Kate Grimshaw, Raquel Durban, Alison Cassin, Michelle Henry, Kara Kliewer, Lynda Kabbash, Dan Atkins, Anna Nowak-Węgrzyn, Mark Holbreich, Mirna Chehade
Eosinophilic esophagitis (EoE) is a chronic/immune-antigen-mediated disease characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation. Dietary elimination therapy has been shown to be an effective, drug-free prescription for the treatment of EoE. A range of different dietary elimination therapies have been used. Regardless of the elimination diet chosen, dietary therapy requires in-depth nutrition assessment and management. Elimination diets are not without risk and may impact nutritional status, eating pleasure, and overall quality of life...
March 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28260802/autophagy-inhibitor-3-methyladenine-alleviates-overload-exercise-induced-cardiac-injury-in-rats
#7
Hua Liu, Hui Lei, Yue Shi, Jin-Ju Wang, Ning Chen, Zhang-Hua Li, Yang-Fang Chen, Qi-Fa Ye, Yi Yang
Overload-exercise (OE) causes myocardial injury through inducing autophagy and apoptosis. In this study we examined whether an autophagy inhibitor 3-methyladenine (3-MA) could alleviate OE-induced cardiac injury. Rats were injected with 3-MA (15 mg/kg, iv) or saline before subjected to various intensities of OE, including no swim (control), 2 h swim (mild-intensity exercise, MIE), 2 h swim with 2.5% body weight overload (moderate OE; MOE), 5% overload (intensive OE; IOE) or 2.5% overload until exhausted (exhaustive OE; EOE)...
March 6, 2017: Acta Pharmacologica Sinica
https://www.readbyqxmd.com/read/28247277/diagnosis-and-treatment-of-eosinophilic-esophagitis-in-clinical-practice
#8
REVIEW
Yasuhiko Abe, Yu Sasaki, Makoto Yagi, Takao Yaoita, Shoichi Nishise, Yoshiyuki Ueno
Eosinophilic esophagitis (EoE) is a chronic and abnormal Th2 type immunological response characterized by intense eosinophilic inflammation localized within the esophagus. This leads to esophageal dysfunction and remodeling accompanied by subepithelial fibrosis. Recently, EoE has been recognized as one of the major causes of dysphagia or food impaction in adults. The prevalence of EoE has been increasing over the past several decades, particularly in Western countries. EoE should be differentiated from secondary esophageal eosinophilia (EE) in gastroesophageal reflux disease (GERD) and eosinophilic gastroenteritis, involving the entire gastrointestinal tract...
April 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28231565/correlation-of-high-resolution-manometric-findings-with-symptoms-of-dysphagia-and-endoscopic-features-in-adults-with-eosinophilic-esophagitis
#9
Ulrike von Arnim, Arne Kandulski, Jochen Weigt, Peter Malfertheiner
BACKGROUND: Eosinophilic esophagitis (EoE) presents with dysphagia, but data about motility patterns using high-resolution manometry (HRM) are rare. We aimed at evaluating esophageal motility patterns in EoE and their correlation to endoscopic and dysphagia scores. METHODS: Twenty-six EoE patients and 23 controls were included after 4 weeks of treatment with proton pump inhibitors. Dysphagia and endoscopic scores were evaluated before performing HRM. EoE patients were classified to have fibrostenotic (FS) or inflammatory (IF) type...
February 23, 2017: Digestive Diseases
https://www.readbyqxmd.com/read/28224995/genetics-of-eosinophilic-esophagitis
#10
REVIEW
L C Kottyan, M E Rothenberg
Eosinophilic esophagitis (EoE) is a chronic, allergic disease associated with marked mucosal eosinophil accumulation. EoE disease risk is multifactorial and includes environmental and genetic factors. This review will focus on the contribution of genetic variation to EoE risk, as well as the experimental tools and statistical methodology used to identify EoE risk loci. Specific disease-risk loci that are shared between EoE and other allergic diseases (TSLP, LRRC32) or unique to EoE (CAPN14), as well as Mendellian Disorders associated with EoE, will be reviewed in the context of the insight that they provide into the molecular pathoetiology of EoE...
February 22, 2017: Mucosal Immunology
https://www.readbyqxmd.com/read/28201841/evaluation-of-narrow-band-imaging-signs-in-eosinophilic-and-lymphocytic-esophagitis
#11
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
#12
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
#13
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
#14
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: This study sought to 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 health care 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
#15
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
#16
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...
2017: Digestion
https://www.readbyqxmd.com/read/28154800/eosinophilic-esophagitis-current-understanding-and-evolving-concepts
#17
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
#18
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
#19
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...
March 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
#20
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
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