Future of therapy and monitoring for eosinophilic esophagitis and eosinophilic gastrointestinal diseases.

IF 5.8 2区 医学 Q1 ALLERGY
Andrew Dickerson, Evan S Dellon, Seema S Aceves
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引用次数: 0

Abstract

Eosinophilic gastrointestinal disorders, including eosinophilic esophagitis, are chronic Th2 mediated diseases. Establishing a diagnosis and initiating treatment is crucial to limit disease progression that may lead to tissue remodeling and the development of strictures that significantly impact patient quality of life. Expert consensus guidelines provide a framework for treating eosinophilic esophagitis with diet elimination, proton pump inhibitors, swallowed topical steroids, or dupilumab and for monitoring with sedated endoscopy for gross and histologic evaluation. While this provides an established algorithm for treating and monitoring eosinophilic esophagitis, there is less established for the rarer eosinophilic gastrointestinal disorders (eosinophilic gastritis, enteritis, and colitis). Research advancements continue to emerge at a rapid pace, identifying potential biomarkers, therapeutic targets, and monitoring strategies. In this article, we review the current accepted methods for treating and monitoring eosinophilic gastrointestinal disorders with a focus on eosinophilic esophagitis, assess what is currently under investigation, and provide an aspirational vision for future disease management with a streamlined algorithm of personalized medicine and less invasive monitoring.

嗜酸性粒细胞性食管炎和嗜酸性粒细胞性胃肠道疾病的治疗和监测前景。
嗜酸性粒细胞性胃肠道疾病,包括嗜酸性粒细胞性食管炎,是慢性Th2介导的疾病。建立诊断和开始治疗对于限制疾病进展至关重要,疾病进展可能导致组织重塑和狭窄的发展,从而严重影响患者的生活质量。专家共识指南为治疗嗜酸性粒细胞性食管炎提供了一个框架,包括饮食消除、质子泵抑制剂、吞咽局部类固醇或杜匹单抗,以及镇静内窥镜监测,以进行大体和组织学评估。虽然这为治疗和监测嗜酸性粒细胞性食管炎提供了一种成熟的算法,但对于罕见的嗜酸性粒细胞性胃肠道疾病(嗜酸性粒细胞性胃炎、肠炎和结肠炎),尚缺乏成熟的算法。研究进展继续以快速的步伐出现,确定潜在的生物标志物,治疗靶点和监测策略。在本文中,我们回顾了目前公认的治疗和监测嗜酸性粒细胞性胃肠道疾病的方法,重点是嗜酸性粒细胞性食管炎,评估了目前正在研究的方法,并为未来的疾病管理提供了一个理想的愿景,即通过简化的个性化医疗算法和更少的侵入性监测。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.50
自引率
6.80%
发文量
437
审稿时长
33 days
期刊介绍: Annals of Allergy, Asthma & Immunology is a scholarly medical journal published monthly by the American College of Allergy, Asthma & Immunology. The purpose of Annals is to serve as an objective evidence-based forum for the allergy/immunology specialist to keep up to date on current clinical science (both research and practice-based) in the fields of allergy, asthma, and immunology. The emphasis of the journal will be to provide clinical and research information that is readily applicable to both the clinician and the researcher. Each issue of the Annals shall also provide opportunities to participate in accredited continuing medical education activities to enhance overall clinical proficiency.
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