Eosinophilic Esophagitis: Pathophysiology and Definition

Gastrointest Endosc Clin N Am. 2018 Jan;28(1):1-14. doi: 10.1016/j.giec.2017.07.011. Epub 2017 Oct 7.

Abstract

Eosinophilic esophagitis is an adaptive immune response to patient-specific antigens, mostly foods. Eosinophilic esophagitis is not solely IgE-mediated and is likely characterized by Th2 lymphocytes with an impaired esophageal barrier function. The key cytokines and chemokines are thymic stromal lymphopoeitin, interleukin-13, CCL26/eotaxin-3, and transforming growth factor-β, all involved in eosinophil recruitment and remodeling. Chronic food dysphagia and food impactions, the feared late complications, are related in part to dense subepithelial fibrosis, likely induced by interleukin-13 and transforming growth factor-β.

Keywords: Eosinophilic esophagitis; PPI-REE; Pathophysiology; Proton pump inhibitor responsive esophageal eosinophilia.

Publication types

  • Review

MeSH terms

  • Cytokines / genetics
  • Cytokines / metabolism*
  • Eosinophilic Esophagitis / genetics
  • Eosinophilic Esophagitis / immunology*
  • Eosinophilic Esophagitis / metabolism
  • Eosinophilic Esophagitis / pathology*
  • Esophagus / pathology*
  • Fibrosis
  • Gene-Environment Interaction
  • Humans
  • Leukocytes / immunology*
  • Mast Cells / immunology

Substances

  • Cytokines