Article thumbnail

Role of Mucosal Inflammation in Eosinophilic Esophagitis: Review of the Literature

By Ghulamullah Shahzad, Paul Mustacchia and Marianne Frieri


Eosinophilic esophagitis (EE) is increasingly recognized in adults. It is an inflammatory disease of the esophageal mucosa, with variable presentation, unresponsive to acid suppression therapy. The diagnosis requires histological confirmation of intense eosinophilic infiltration on esophageal biopsy specimen, however exact criteria required to make a diagnosis of EE is still being debated and a clear differentiation from gastroesophageal reflux disease (GERD) is important. Allergen elimination or anti-inflammatory therapy may be effective in such patients. The imperfect diagnostic criteria for EE mandate an understanding of the immunology and the pathophysiology of the disease. It may facilitate the introduction of novel treatment modalities in an individual unresponsive to acid suppression therapy. This paper describes basic elements of the immune-mediated injury to the esophageal mucosa and management aspects to provide a better understanding of the condition

Topics: Review Article
Publisher: International Scholarly Research Network
OAI identifier:
Provided by: PubMed Central

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.

Suggested articles


  1. (2001). A .M i s h r a ,S .P .H o g a n ,E .B .B r a n d t ,a n dM .E .R o t h e n b e r g , “An etiological role for aeroallergens and eosinophils in experimentalesophagitis,”JournalofClinicalInvestigation,vol.
  2. (2002). A .M i s h r a ,S .P .H o g a n ,E .B .B r a n d t ,a n dM .E .R o t h e n b e r g , “IL-5 promotes eosinophil trafficking to the esophagus,”
  3. (2010). A functional role for CCR6 on proallergic T cells in the gastrointestinal tract,”
  4. (2001). A pathological function for eotaxin and eosinophils in eosinophilic gastrointestinal inflammation,”
  5. (2007). Advances in the understanding of allergic asthma,”
  6. (1993). Altered cytokine production in atopic dermatitis: a preliminary study,” Pediatric Asthma,
  7. (2006). Anti-IL-5 (mepolizumab) therapy for eosinophilic esophagitis,”
  8. (2008). Anti-TNF-α (infliximab) therapy for severe adult eosinophilic esophagitis,”
  9. (2006). Authors’ response to detection of causative foods by skin prick and atopy patch tests in patients with eosinophilic esophagitis: things are not what they seem,”
  10. (2009). Biology and treatment of eosinophilic esophagitis,”
  11. Bl´ a z q u e z ,S .Z h a n g ,L .M a y e r
  12. (2008). Comparisonoforalprednisoneandtopical fluticasoneinthetreatment of eosinophilic esophagitis: a randomized trial
  13. (2007). Corticosteroiddependent eosinophilic oesophagitis: azathioprine and 6-mercaptopurine can induce and maintain long-term remission,”
  14. (2003). E.Ruchelli, and C.A.Liacouras, “Elemental diet is an effective treatment for eosinophilic esophagitis in children and adolescents,”
  15. (2003). E.Ruchelli, andC.A.Liacouras, “Elemental diet is an effective treatment for eosinophilic esophagitis in children and adolescents,”
  16. (2007). Eosinophilic disorders,”
  17. (1995). Eosinophilic esophagitis attributed to gastroesophageal reflux: improvement with an amino acidbased formula,”
  18. (1978). Eosinophilic esophagitis in a patient with vigorous achalasia,”
  19. (2006). Eosinophilic esophagitis in adults: a systematic review,”
  20. (2006). Eosinophilic esophagitis in adults: clinical, endoscopic, histologic findings, and response to treatment with fluticasone propionate,”
  21. (2004). Eosinophilic esophagitis,” The New England
  22. (2005). Eosinophilic esophagitis: a 10-year experience
  23. (2007). Eosinophilic esophagitis: an update,”
  24. (2004). Eosinophilic esophagitis: asthma of the esophagus?”
  25. (2002). Eosinophils express functional IL-13 in eosinophilic inflammatory diseases,”
  26. (2006). Eotaxin-3 and a uniquely conserved gene-expression profile in eosinophilic esophagitis,”
  27. (2007). F.Y.Wang,S.K.Gupta,andJ.F.Fitzgerald,“Isthereaseasonal variation in the incidence or intensity of allergic eosinophilic esophagitis in newly diagnosed children?”
  28. (2007). Familial dysphagia and eosinophilia,”
  29. (2006). Food allergies and eosinophilic esophagitis—two case studies,”
  30. (1999). Food allergy perception and reality,” in Food Hypersensitivity and Adverse Reactions: A Practical Guide for Diagnosis and Management,B l a c k w e l l Science,
  31. (2007). Human keratinocytes secrete TNFα stimulated with cytomix and D. pteronyssinus extract,”
  32. (2005). Inflammatory issues in allergic rhinitis and asthma,”
  33. (2003). Intratracheal IL-13 induces eosinophilic esophagitis by an
  34. (2003). Natural history of primary eosinophilic esophagitis: a follow-up of 30 adult patients for up to 11.5 years,”
  35. (2006). P a r fi t t ,J .C .G r e g o r ,N .G .S u s k i n ,H .A .J a w a ,a n dD .
  36. (2003). Pollen and eosinophilic esophagitis,”
  37. (2004). r i e r i ,B .B e n n u r i ,C .D i a s ,Y .C .H u a n g ,a n dP .S c h a e f e r , “Association between CD62 ligand on na¨ ıve and memory T cells and history of cow’s milk hypersensitivity in atopic patients,”
  38. r i e r i ,S .M a r t i n e z ,K .A g a r w a l ,a n dP .T r o t t a ,“ Ap r e -liminary study of interleukin 4 detection in atopic pediatric and adult patients: effect of dietary modification,” Pediatric Asthma,AllergyandImmunology,vol.7,no.1,pp.27–35,1993.
  39. (2005). Symposium cont. Asthma concepts in the new millennium: update in asthma pathophysiology,”
  40. (2006). T h o m p s o n ,A .S .A r o r a ,Y .R o m e r o ,a n dE .H . Dauer, “Eosinophilic esophagitis: its role in aerodigestive tract disorders,”
  41. (2003). t t w o o d ,C .J .L e w i s ,C .S .B r o n d e r ,C .D .M o r r i s
  42. (1993). t t w o o d ,T .C .S m y r k
  43. (2008). The effect of enantiomers of beta-agonists on myofibroblast-derived vascular endothelial growth factor and other matrix components in the presence of dust-mite extract,”
  44. (2008). The natural history and complications of eosinophilic esophagitis,”
  45. (2002). The use of skin prick tests and patch tests to identify causative foods in eosinophilic esophagitis,”
  46. (2005). Treatment of eosinophilic esophagitis with specific food elimination diet directed by a combination of skin prick and patch tests,”
  47. (1993). V i t e l l a s ,W .F .B e n n e t t ,J .G .B o v a ,J .C .J o h n s t o n