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Eosinophilic oesophagitis: clinical presentation and pathogenesis

Bystrom, J; O'Shea, NR; (2014) Eosinophilic oesophagitis: clinical presentation and pathogenesis. Postgraduate Medical Journal , 90 (1063) pp. 282-289. 10.1136/postgradmedj-2012-131403. Green open access

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Eosinophilic oesophagitis (EoE) is an inflammatory disorder of the oesophagus which has become increasingly recognised over recent years, although it remains underdiagnosed in many centres. It is characterised histologically by a significant eosinophilic infiltration of the oesophageal mucosa (>15 eosinophils per high powered field), and clinically with features of oesophageal dysfunction such a dysphagia, food impaction, and proton pump inhibitor (PPI) resistant dyspepsia. Fibrosis and oesophageal remodelling may occur and lead to oesophageal strictures. An allergic predisposition is common in the EoE population, which appears to be primarily food antigen driven in children and aeroallergen driven in adults. Evidence suggests that the pathogenesis of EoE is due to a dysregulated immunological response to an environmental allergen, resulting in a T helper type 2 (Th2) inflammatory disease and remodelling of the oesophagus in genetically susceptible individuals. Allergen elimination and anti-inflammatory therapy with corticosteroids are currently the mainstay of treatment; however, an increasing number of studies are now focused on targeting different stages in the disease pathogenesis. A greater understanding of the underlying mechanisms resulting in EoE will allow us to improve the therapeutic options available.

Type: Article
Title: Eosinophilic oesophagitis: clinical presentation and pathogenesis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/postgradmedj-2012-131403
Publisher version: http://dx.doi.org/10.1136/postgradmedj-2012-131403
Language: English
Additional information: This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/
Keywords: HISTOPATHOLOGY, IMMUNOLOGY, PUBLIC HEALTH, Adrenal Cortex Hormones, Adult, Anti-Inflammatory Agents, Constriction, Pathologic, Deglutition Disorders, Dilatation, Eosinophilic Esophagitis, Esophagus, Female, Genetic Predisposition to Disease, Humans, Male, Treatment Outcome
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/1466860
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