Unravelling the pathogenesis of Eosinophilic Esophagitis from genetic predisposition to environmental triggers.

IF 3.8 3区 医学 Q3 IMMUNOLOGY
Sohail Aziz, Raffaele Pellegrino, Pietro Buono, Mara Creoli, Diego Torre, Claudia Chiantese, Antonio Colucci, Marianna Casertano, Paola Ciamarra, Alessandro Federico, Antonietta Gerarda Gravina, Caterina Strisciuglio
{"title":"Unravelling the pathogenesis of Eosinophilic Esophagitis from genetic predisposition to environmental triggers.","authors":"Sohail Aziz, Raffaele Pellegrino, Pietro Buono, Mara Creoli, Diego Torre, Claudia Chiantese, Antonio Colucci, Marianna Casertano, Paola Ciamarra, Alessandro Federico, Antonietta Gerarda Gravina, Caterina Strisciuglio","doi":"10.1093/cei/uxaf039","DOIUrl":null,"url":null,"abstract":"<p><p>Eosinophilic Esophagitis (EoE) is a chronic disease primarily driven by immune-mediated pathogenesis, characterized by eosinophil-driven inflammation of the oesophagus, leading to organ dysfunction and fibrosis. Although initially considered a rare disorder, EoE is now recognized as one of the leading causes of food impaction and dysphagia. Advances in knowledge and diagnostic techniques have contributed to its increased detection; however, epidemiologic data suggest that the surge in incidence represents an actual rise in disease prevalence rather than solely increased awareness. The pathogenesis of EoE remains largely unclear, but it is believed to involve a complex interplay of genetic predisposition, environmental factors, diet-derived allergens, and immune dysregulation. A significant role in the pathogenesis of EoE is attributed to environmental and, particularly, food allergens, with mechanisms that extend beyond IgE-mediated pathways, as evidenced by the lack of efficacy of anti-IgE therapies such as omalizumab in clinical trials. A key pathogenic feature is the dysregulated activation of pathways mediated by T-helper type 2 (Th2) lymphocytes. Supporting the role of the Th2 system in EoE inflammation is the demonstrated efficacy of monoclonal inhibitors of interleukin 4 and 13 (i.e. dupilumab), currently the only approved biological therapy for this condition. Additionally, the role of autophagic processes in EoE pathogenesis is becoming increasingly evident. This review aims to provide a concise overview of the key pathogenic mechanisms of EoE and the currently available diagnostic approaches, both invasive and non-invasive, for managing this disorder.</p>","PeriodicalId":10268,"journal":{"name":"Clinical and experimental immunology","volume":" ","pages":""},"PeriodicalIF":3.8000,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232548/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and experimental immunology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/cei/uxaf039","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Eosinophilic Esophagitis (EoE) is a chronic disease primarily driven by immune-mediated pathogenesis, characterized by eosinophil-driven inflammation of the oesophagus, leading to organ dysfunction and fibrosis. Although initially considered a rare disorder, EoE is now recognized as one of the leading causes of food impaction and dysphagia. Advances in knowledge and diagnostic techniques have contributed to its increased detection; however, epidemiologic data suggest that the surge in incidence represents an actual rise in disease prevalence rather than solely increased awareness. The pathogenesis of EoE remains largely unclear, but it is believed to involve a complex interplay of genetic predisposition, environmental factors, diet-derived allergens, and immune dysregulation. A significant role in the pathogenesis of EoE is attributed to environmental and, particularly, food allergens, with mechanisms that extend beyond IgE-mediated pathways, as evidenced by the lack of efficacy of anti-IgE therapies such as omalizumab in clinical trials. A key pathogenic feature is the dysregulated activation of pathways mediated by T-helper type 2 (Th2) lymphocytes. Supporting the role of the Th2 system in EoE inflammation is the demonstrated efficacy of monoclonal inhibitors of interleukin 4 and 13 (i.e. dupilumab), currently the only approved biological therapy for this condition. Additionally, the role of autophagic processes in EoE pathogenesis is becoming increasingly evident. This review aims to provide a concise overview of the key pathogenic mechanisms of EoE and the currently available diagnostic approaches, both invasive and non-invasive, for managing this disorder.

从遗传易感性到环境诱因揭示嗜酸性食管炎的发病机制。
嗜酸性粒细胞性食管炎(EoE)是一种主要由免疫介导的发病机制驱动的慢性疾病,其特征是嗜酸性粒细胞驱动的食管炎症,导致器官功能障碍和纤维化。虽然最初被认为是一种罕见的疾病,但EoE现在被认为是食物嵌塞和吞咽困难的主要原因之一。知识和诊断技术的进步促进了该病的发现;然而,流行病学数据表明,发病率的激增代表了疾病患病率的实际上升,而不仅仅是认识的提高。EoE的发病机制仍不清楚,但据信与遗传易感性、环境因素、饮食源性过敏原和免疫失调等复杂的相互作用有关。环境,特别是食物过敏原在EoE的发病机制中起着重要作用,其机制超出了ige介导的途径,如临床试验中抗ige疗法(如omalizumab)缺乏疗效。一个关键的致病特征是由t辅助型2 (Th2)淋巴细胞介导的途径激活失调。支持Th2系统在EoE炎症中的作用的是白细胞介素4和13的单克隆抑制剂(即dupilumab)的有效性,这是目前唯一批准的用于该疾病的生物疗法。此外,自噬过程在EoE发病机制中的作用越来越明显。这篇综述的目的是提供一个简要概述的主要致病机制的EoE和目前可用的诊断方法,包括侵入性和非侵入性,以管理这种疾病。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
8.40
自引率
2.20%
发文量
101
审稿时长
3-8 weeks
期刊介绍: Clinical & Experimental Immunology (established in 1966) is an authoritative international journal publishing high-quality research studies in translational and clinical immunology that have the potential to transform our understanding of the immunopathology of human disease and/or change clinical practice. The journal is focused on translational and clinical immunology and is among the foremost journals in this field, attracting high-quality papers from across the world. Translation is viewed as a process of applying ideas, insights and discoveries generated through scientific studies to the treatment, prevention or diagnosis of human disease. Clinical immunology has evolved as a field to encompass the application of state-of-the-art technologies such as next-generation sequencing, metagenomics and high-dimensional phenotyping to understand mechanisms that govern the outcomes of clinical trials.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信